Background The clinical and pathological risk factors for worse T stage and prognosis in eyelid and periocular squamous cell carcinomas (SCCs) remain unclear. P63 was reported to predict a worse prognosis in other SCCs; however, this correlation was not validated in eyelid and periocular SCCs.
Methods We reported on a retrospective case series of 85 consecutive patients with eyelid and periocular SCCs from 1995 to 2019. Cox proportional hazards regression models and logistic regression models were applied for risk factor analysis.
Results Thirty-nine (45.8%) patients were diagnosed with T4 SCCs. Four (5.1%) patients developed nodal metastasis, and five (6.4%) patients developed distant metastasis during the follow-up. 2-year and 5-year disease-specific survival rates were 95.3% and 86.4%, respectively. Poorly or moderately differentiated eyelid and periocular SCCs were associated with worse T stage (p=0.001; p=0.008). Poor differentiation was associated with a higher risk of recurrence (p=0.024). Disease-specific death was more common in patients with T4 stage SCCs (p=0.038, HR=9.05). P63 expression was more common in patients with T3c or worse stage (p=0.008, OR=3.77). P63 expression alone was associated with worse differentiation (p=0.029), higher risk of perineural invasion (p=0.042, OR=4.61) and metastasis (p=0.009, HR=3.99). P63 expression (p=0.012, HR=7.80), coexpression of P63 and Ki67 (p=0.007, HR=9.21) and distant metastasis (p=0.001, HR=11.23) were associated with disease-specific death.
Conclusion Patients presented with more aggressive orbital invasion features and a higher rate of distant metastasis in this cohort. P63 and coexpression of Ki67 predicted a worse stage, differentiation and prognosis, including metastasis and death due to disease.
- eye lids
Data availability statement
Data are available on reasonable request. The datasets used and analysed during the current study are available from the corresponding authors on reasonable request.
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YL and HC contributed equally.
RJ, SX and YW contributed equally.
Contributors YW, SX and XF designed this study. RJ and YW provided the data of patients. SX and JY did literature search. SG and YL designed the figures, did data collection and drafted the manuscript. SX and YL did data analysis and interpretation. YR provided pathological reports. RJ did proofread of the manuscript. YW, SX and RJ are the cocorresponding authors. All authors approved this manuscript.
Funding This work was supported by National Natural Science Foundation of China (grant 81802702), Shanghai Municipal Science and Technology Major Project(17JC1420100), Science and Technology Commission of Shanghai (grant 17DZ2260100), Innovative research team of high-level local universities in Shanghai(SSMU-ZDCX20180401).
Disclaimer The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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