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Prognostic factors for local recurrence, metastasis and survival for sebaceous carcinoma of the eyelid: observations in 100 patients
  1. Ho-Seok Sa1,2,
  2. Maria Laura Rubin3,
  3. Shiqiong Xu1,4,
  4. Jing Ning3,
  5. Michael Tetzlaff5,
  6. Oded Sagiv1,
  7. Thomas J Kandl1,
  8. Bita Esmaeli1
  1. 1 Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  2. 2 Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
  3. 3 Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  4. 4 Department of Ophthalmology, Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
  5. 5 Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  1. Correspondence to Dr Bita Esmaeli, Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; besmaeli{at}mdanderson.org

Abstract

Background/aims To validate the predictive value of the American Joint Committee on Cancer (AJCC) 8th-edition classification for local recurrence, metastasis and survival in patients with eyelid sebaceous carcinoma.

Methods We performed a retrospective review of 100 consecutive patients with eyelid sebaceous carcinoma. Eyelid carcinomas were staged according to the AJCC 7th-edition and 8th-edition criteria. Associations between T and N categories and disease-related outcomes including local recurrence, lymph node metastasis, distant metastasis and survival were evaluated.

Results 60 women and 40 men had a median age of 67 years (range, 41–94 years). The proportions of patients who experienced local recurrence, lymph node metastasis, distant metastasis and death from disease were 6%, 21%, 7% and 6%, respectively. Two-year and 5-year disease-specific survival (DSS) rates were 93.8% and 92.0%, respectively. There were significant correlations between (1) T2c or worse category and lymph node metastasis (p=0.04) and distant metastasis (p=0.01), (2) T3b or worse category and local recurrence (p=0.01) and death from disease (p=0.01) and (3) N1 category at presentation and distant metastasis (p<0.01) and death from disease (p<0.01). The AJCC 8th-edition classification showed a better homogeneity of the T-category distribution (p<0.01) and a slightly higher discrimination ability for lymph node metastasis (C=0.734 vs C=0.728) than the 7th-edition.

Conclusions T and N categories per AJCC 8th-edition classification are predictive of local recurrence, metastasis and DSS outcomes for eyelid sebaceous carcinoma. Surgeons should perform strict surveillance testing for nodal and systemic metastases in patients with T2c or worse T category and/or N1 disease at presentation.

  • AJCC
  • eyelid carcinoma
  • metastasis
  • sebaceous carcinoma
  • staging system
  • survival
  • 8th TNM.

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Footnotes

  • Contributors Conception and design: BE, H-SS. Analysis and interpretation of data: MLR, JN, H-SS and BE. Drafting the article or revising it critically for important intellectual content: all authors. Final approval of the version to be published: BE.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Institutional Review Board of the Ethics Committee at The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

  • Provenance and peer review Not commissioned; externally peer reviewed.

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