Eyelid and periocular sebaceous gland carcinoma: risk factors for recurrence, exenteration, metastasis, and death in 355 patients.

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC ACS Applied Electronic Materials Pub Date : 2024-10-01 DOI:10.1016/j.jcjo.2024.09.003

Swathi Kaliki, Vijitha S Vempuluru, Vishakha Tanna, Anshika Luthra

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Abstract

Objective: To analyze factors predictive of tumor recurrence, orbital exenteration, lymph node metastasis, systemic metastasis, and metastasis-related death in patients with eyelid and periocular sebaceous gland carcinoma (eSGC) undergoing protocol-based management.

Methods: Retrospective interventional study RESULTS: Of the 355 patients with eSGC, 248 (70%) were referred to us without any prior intervention, and 107 (30%) had a history of prior intervention. The treatment modalities after presentation to our center included excisional biopsy (n = 303, 85%), orbital exenteration (n = 36, 85%), neoadjuvant chemotherapy (n = 12, 3%), and topical mitomycin C (n = 4, 1%). The 15-year Kaplan Meier estimates of tumor recurrence, need for orbital exenteration, lymph node metastasis, systemic metastasis, and metastasis-related death were 23%, 26%, 12%, 8%, and 9%, respectively. Multivariate Cox regression model identified positive histopathological margins (p < 0.001) and perivascular invasion (p < 0.001) as predictors of tumor recurrence; diffuse tumor morphology (p = 0.009), tumor diameter >20 mm (p = 0.027), orbital extension of the tumor (p < 0.001), perivascular invasion (p = 0.013), and pagetoid tumor spread (p < 0.001) on histopathology as predictors of orbital exenteration; diffuse tumor morphology (p = 0.005), tumor diameter >10 mm (p = 0.015), and perivascular invasion (p = 0.008) as predictors of lymph node metastasis; diffuse tumor morphology (p = 0.024) as a predictor of systemic metastasis; and multicentric tumor origin (p = 0.035) as a predictor of metastasis-related death.

Conclusion: Clinical features, including diffuse tumor morphology, multicentric tumor origin, larger tumor diameter, and orbital extension of the tumor, and histopathological features, including pagetoid tumor spread, positive histopathological margins, and perivascular invasion, are predictors of poor outcomes in eSGC.

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眼睑和眼周皮脂腺癌：355 名患者的复发、切除、转移和死亡风险因素。

目的：分析接受方案治疗的眼睑和眼周皮脂腺癌（eSGC）患者肿瘤复发、眼眶外翻、淋巴结转移、全身转移和转移相关死亡的预测因素：结果：在355例eSGC患者中，248例（70%）是在未接受任何干预的情况下转诊到我们这里的，107例（30%）曾接受过干预。转诊至本中心后的治疗方式包括切除活检（303例，85%）、眼眶外扩张术（36例，85%）、新辅助化疗（12例，3%）和局部丝裂霉素C（4例，1%）。肿瘤复发、需要眼眶外开刀、淋巴结转移、全身转移和转移相关死亡的15年卡普兰-梅耶估计值分别为23%、26%、12%、8%和9%。多变量 Cox 回归模型发现，组织病理学边缘阳性（p < 0.001）和血管周围浸润（p < 0.001）是肿瘤复发的预测因素；弥漫性肿瘤形态（p = 0.009）、肿瘤直径 >20 mm（p = 0.027）、肿瘤眼眶扩展（p < 0.001）、血管周围浸润（p = 0.013）和页片状肿瘤扩散（p < 0.001）作为眼眶外扩张的预测因素；弥漫性肿瘤形态（p = 0.005）、肿瘤直径>10 mm（p = 0.015）和血管周围浸润（p = 0.008）作为淋巴结转移的预测因素；弥漫性肿瘤形态（p = 0.024）作为全身转移的预测因素；多中心肿瘤来源（p = 0.035）作为转移相关死亡的预测因素：结论：弥漫性肿瘤形态、多中心肿瘤来源、肿瘤直径较大、肿瘤向眼眶延伸等临床特征和页状肿瘤扩散、组织病理学边缘阳性、血管周围侵犯等组织病理学特征是预测eSGC不良预后的指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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