Excision combined with ocular surface reconstruction followed by topical chemotherapy for ocular surface squamous neoplasia.

IF 2.1 3区 医学 Q2 OPHTHALMOLOGY Japanese Journal of Ophthalmology Pub Date : 2024-10-02 DOI:10.1007/s10384-024-01111-0
Hiroko Nakai, Kosuke Ueda, Koji Kitazawa, Hideki Fukuoka, Tsutomu Inatomi, Norihiko Yokoi, Shigeru Kinoshita, Go Horiguchi, Satoshi Teramukai, Chie Sotozono
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Abstract

Purpose: To investigate the visual prognosis of ocular surface squamous neoplasia (OSSN) after tumor resection and ocular surface reconstruction, and clarify factors that influence recurrence.

Study design: Retrospective cohort study.

Methods: Medical records of all patients who underwent surgical treatment for OSSN at our hospital between January 1996 and December 2019 were reviewed. Tumor size/location, histological classification, surgical procedure, intraoperative mitomycin-C use, and postoperative topical 5-fluorouracil (5-FU) administration were examined, and pre and postoperative visual acuity (VA) were compared to elucidate factors that influence disease recurrence.

Results: Tumor excision was performed in 70 eyes of 70 cases (43 men, 27 women; average age: 71.6 ± 12.6 years) with dysplasia (8 eyes), carcinoma in situ (26 eyes), and invasive squamous cell carcinoma (36 eyes). Tumors were found in the limbus (N = 59 eyes), palpebral conjunctiva (N = 8 eyes), and from the bulbar to palpebral conjunctiva (N = 3 eyes). Surgical procedures performed were limbal transplantation/keratoepithelioplasty (N = 29 eyes), cultivated oral mucosal epithelial transplantation (N = 3 eyes), and auto-conjunctival epithelium transplantation (N = 2 eyes). Ocular surface was reconstructed using amniotic membrane, donor cornea, or cultivated epithelial sheet. The mean follow-up was 38.6 ± 38.6 months (range, 2 months to 13.8 years). VA postoperatively improved in 25 (61.0%) cases. Recurrence occurred in 19 (27.1%) cases at from 2 to 50 months (median: 12.5 months) postoperative. Uni- and multivariate analyses revealed that presurgical tumor size and postoperative administration of 5-FU were significantly related to recurrence.

Conclusion: Combined surgical excision and postoperative topical 5-FU administration effectively prevented OSSN recurrence, and ocular surface reconstruction contributed to improvement of VA.

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眼表面鳞状细胞瘤切除联合眼表面重建后局部化疗。
目的:研究眼表鳞状上皮肿瘤(OSSN)在肿瘤切除和眼表重建后的视觉预后,并明确影响复发的因素:研究设计:回顾性队列研究:回顾1996年1月至2019年12月期间在我院接受手术治疗的所有OSSN患者的病历。检查肿瘤大小/位置、组织学分类、手术方法、术中丝裂霉素-C的使用情况、术后局部5-氟尿嘧啶(5-FU)的使用情况,并比较术前术后视力(VA),以阐明影响疾病复发的因素:70例患者(43名男性,27名女性;平均年龄:71.6 ± 12.6岁)中有8眼发育不良、26眼原位癌和36眼浸润性鳞状细胞癌。肿瘤发生在角膜缘(59 眼)、睑结膜(8 眼)和球结膜至睑结膜(3 眼)。进行的手术包括角膜缘移植/角膜上皮成形术(29 眼)、培养口腔粘膜上皮移植(3 眼)和自体结膜上皮移植(2 眼)。使用羊膜、供体角膜或培养上皮片重建眼表。平均随访时间为 38.6 ± 38.6 个月(2 个月至 13.8 年)。25例(61.0%)患者术后视力有所改善。术后 2 至 50 个月(中位数:12.5 个月)复发的病例有 19 例(27.1%)。单变量和多变量分析显示,术前肿瘤大小和术后服用5-FU与复发有显著关系:结论:联合手术切除和术后局部应用 5-FU 可有效预防 OSSN 复发,眼表重建有助于改善视力。
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来源期刊
CiteScore
4.80
自引率
8.30%
发文量
65
审稿时长
6-12 weeks
期刊介绍: The Japanese Journal of Ophthalmology (JJO) was inaugurated in 1957 as a quarterly journal published in English by the Ophthalmology Department of the University of Tokyo, with the aim of disseminating the achievements of Japanese ophthalmologists worldwide. JJO remains the only Japanese ophthalmology journal published in English. In 1997, the Japanese Ophthalmological Society assumed the responsibility for publishing the Japanese Journal of Ophthalmology as its official English-language publication. Currently the journal is published bimonthly and accepts papers from authors worldwide. JJO has become an international interdisciplinary forum for the publication of basic science and clinical research papers.
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