PT  - JOURNAL ARTICLE
AU  - Ho-Seok Sa
AU  - Maria Laura Rubin
AU  - Shiqiong Xu
AU  - Jing Ning
AU  - Michael Tetzlaff
AU  - Oded Sagiv
AU  - Thomas J Kandl
AU  - Bita Esmaeli
TI  - Prognostic factors for local recurrence, metastasis and survival for sebaceous carcinoma of the eyelid: observations in 100 patients
AID  - 10.1136/bjophthalmol-2018-312635
DP  - 2019 Jul 01
TA  - British Journal of Ophthalmology
PG  - 980--984
VI  - 103
IP  - 7
4099  - http://bjo.bmj.com/content/103/7/980.short
4100  - http://bjo.bmj.com/content/103/7/980.full
SO  - Br J Ophthalmol2019 Jul 01; 103
AB  - 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.