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Intraepithelial growth pattern for eyelid sebaceous carcinoma: a cohort of 214 patients from a single institution
  1. Chuandi Zhou1,2,
  2. Peiwei Chai1,
  3. Wenwen Xia3,
  4. Jiang Li4,
  5. Renbing Jia1,
  6. Xianqun Fan1
  1. 1Department of Ophthalmology, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China
  2. 2Department of Ophthalmology, Shanghai General Hospital, Shanghai, China
  3. 3Department of Pathology, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China
  4. 4Department of Oral Pathology, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China
  1. Correspondence to Professor Xianqun Fan, Department of Ophthalmology, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai 200011, China; fanxq{at}sjtu.edu.cn; Dr Renbing Jia; renbingjia{at}sjtu.edu.cn; Dr Jiang Li; lij1042{at}sh9hospital.org.cn

Abstract

Aims To determine the distribution of three different intraepithelial growth patterns (pagetoid, bowenoid and papillary) in eyelid sebaceous carcinoma (SC) and correlate them with the clinical characteristics and prognosis.

Methods A retrospective cohort study. The medical charts and pathological sections were retrospectively reviewed. All eligible patients were followed up for recurrence, metastasis and tumour-related mortality. The clinical significance of each intraepithelial growth pattern was determined by Cox regression.

Results Of the 214 patients, 67 (31%) presented with intraepithelial invasion, among them, 34 (16%) were pagetoid, 27 (13%) were bowenoid and 6 (2.8%) were papillary. Patients of pagetoid intraepithelial spread showed significantly longer diagnostic delay (p=0.001) and more initial misdiagnoses of blepharitis (p=0.035). After a median follow-up period of 34.0 months, 67 (46%) patients in the non-intraepithelial group, 17 (50%) in the pagetoid group, 8 (30%) in the bowenoid group and 2 (33%) in the papillary group recurred. And 30 (20%) patients in the non-intraepithelial group, 9 (27%) in the pagetoid group and 4 (15%) in the bowenoid group developed metastasis. Moreover, 15 (10%) patients in the non-intraepithelial group, 6 (18%) in the pagetoid group and 1 (3.7%) in the bowenoid group died of SC. Cox regression indicated that pagetoid intraepithelial growth pattern was remarkably associated with increased chances of tumour-related mortality (HR=2.95, 95% CI 1.14 to 7.64, p=0.026).

Conclusions Intraepithelial tumour invasion was presented in nearly one third of patients with eyelid SC. Pagetoid intraepithelial neoplasia, the predominant growth pattern, significantly increased the risk of tumour-related mortality. Meticulous histopathological intraepithelial examination is recommended for every patient of eyelid SC. Special attention should be paid to those with pagetoid invasion, who may require more intensive managements.

  • eye lids
  • pathology

Data availability statement

Data are available upon reasonable request. Our data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request. Our data are available upon reasonable request.

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Footnotes

  • CZ and PC contributed equally.

  • Contributors XF, RJ and JL contributed to research design and data acquisition and research execution. CZ, PC contributed to data acquisition and research execution, data analysis and interpretation and manuscript preparation. WX contributed to data acquisition and research execution. XF is the guarantor of this paper.

  • Funding This work was supported by National Natural Science Foundation of China (82002891, 82103240), Natural Science Foundation of Shanghai (20ZR1445600), Shanghai Songjiang district science and technology project (19SJKJGG19), Scientific Research Programme of the National Health and Family Planning Commission of China (201402014).

  • 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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