Risk factors analysis and nomogram for predicting recurrence in periocular basal cell carcinoma

Xincen Hou; Alexander C Rokohl; Katharina Berndt; Senmao Li; Xiaojun Ju; Philomena A Wawer Matos; Wanlin Fan; Ludwig M Heindl

doi:10.1016/j.jcjo.2024.12.003

Risk factors analysis and nomogram for predicting recurrence in periocular basal cell carcinoma

Can J Ophthalmol. 2024 Dec 30:S0008-4182(24)00368-5. doi: 10.1016/j.jcjo.2024.12.003. Online ahead of print.

Authors

Xincen Hou¹, Alexander C Rokohl², Katharina Berndt¹, Senmao Li¹, Xiaojun Ju¹, Philomena A Wawer Matos², Wanlin Fan¹, Ludwig M Heindl³

Affiliations

¹ Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
² Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Center for Integrated Oncology, Aachen-Bonn-Cologne-Duesseldorf, Cologne, Germany.
³ Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Center for Integrated Oncology, Aachen-Bonn-Cologne-Duesseldorf, Cologne, Germany.. Electronic address: [email protected].

PMID: 39746661
DOI: 10.1016/j.jcjo.2024.12.003

Abstract

Objectives: Aim to develop a nomogram to effectively predict the potential for recurrence after surgical resection in patients with periocular basal cell carcinoma (BCC).

Methods: We conducted a retrospective study involving 329 patients with eyelid BCC. Univariate and multivariate Cox proportional risk regression was used to screen for independent factors affecting BCC recurrence. Kaplan-Meier survival curve analysis was performed to evaluate their impact on prognosis. On the basis of the results obtained from Cox regression analysis, a nomogram was established for the 1-, 2-, and 3-year recurrence-free survival (RFS) rates of BCC.

Results: In this study, a total of 15 patients out of 329 patients (4.6%) developed local recurrence. Multivariate analysis revealed that age, pathological type, previous history of BCC, and the number of surgeries were independent risk factors for BCC recurrence (p < 0.05, respectively). These risk factors were utilized to construct a nomogram to predict postoperative recurrence for these patients. The C-index of the nomogram was 0.867 (95% CI: 0.817-0.916), and the receiver operating characteristic curves were used to assess the discriminatory degree of the nomogram, with area under the curve values of 0.978, 0.870, and 0.916 at 1, 2, and 3 years, respectively. The calibration curves were basically fitted to the ideal curves.

Conclusions: Age, pathological type, previous history of BCC, and the number of surgeries are significant risk factors for periocular BCC recurrence. Establishing a nomogram related to recurrence risk factors can more accurately predict the recurrence-free survival of individual patients.