Gerring R C, Ott C T, Curry J M, Sargi Z B, Wester S T
Department of Otolaryngology, Head and Neck Surgery, Sylvester Comprehensive Cancer Center, Jackson Memorial Hospital/University of Miami Miller School of Medicine, Miami, FL, USA.
University of Miami Miller School of Medicine, Miami, FL, USA.
Eye (Lond). 2017 Mar;31(3):379-388. doi: 10.1038/eye.2016.218. Epub 2016 Oct 21.
PurposeTo describe prognostic factors and survival outcomes in patients who underwent orbital exenteration for periocular non-melanoma cutaneous malignancies.MethodsThe authors performed an institutional review board-approved retrospective review of all patients who underwent orbital exenteration for non-melanoma periocular cutaneous malignancies at a tertiary care hospital system over a 10-year period. Patient demographics, tumor, and treatment data were recorded. Survival outcomes included disease-free survival (DFS) and overall survival (OS). Log-rank tests were used to test for difference in survival curves among various potential prognostic indicators, and multivariate analysis was performed using Cox's proportional hazards model.ResultsForty-nine patients with an average age of 70.3 years were followed with a median follow-up of 17.5 months. At 2 years the OS was 78% while the DFS was 61%. The mean DFS for basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and sebaceous gland carcinoma (SGC) were 52.6, 39.2 and 28.1 months, respectively. Multivariate analysis demonstrated that only positive final surgical margin was predictive of worse outcome (P=0.002). Recurrences were most frequent in the first 2 years.ConclusionsDespite the relatively more aggressive nature of periocular malignancies that have invaded the orbit, orbital exenteration offers an overall 2-year DFS of ~60%. BCC had the greatest mean survival time, however this was not statistically significant. We found worse prognosis with positive final surgical margins and recommend a multidisciplinary surgical approach to achieve complete resection when indicated.
描述因眼周非黑色素瘤皮肤恶性肿瘤接受眼眶内容剜除术患者的预后因素和生存结局。
作者对一家三级医疗系统医院在10年期间因眼周非黑色素瘤皮肤恶性肿瘤接受眼眶内容剜除术的所有患者进行了一项经机构审查委员会批准的回顾性研究。记录患者的人口统计学、肿瘤和治疗数据。生存结局包括无病生存期（DFS）和总生存期（OS）。采用对数秩检验来检验各种潜在预后指标之间生存曲线的差异，并使用Cox比例风险模型进行多因素分析。
49例患者，平均年龄70.3岁，中位随访时间为17.5个月。2年时，总生存率为78%，无病生存率为61%。基底细胞癌（BCC）、鳞状细胞癌（SCC）和皮脂腺癌（SGC）的平均无病生存期分别为52.6、39.2和28.1个月。多因素分析表明，仅手术切缘阳性可预测预后较差（P = 0.002）。复发在最初2年最为常见。
尽管侵犯眼眶的眼周恶性肿瘤性质相对更具侵袭性，但眼眶内容剜除术的2年总无病生存率约为60%。基底细胞癌的平均生存时间最长，但无统计学意义。我们发现手术切缘阳性预后较差，建议在有指征时采用多学科手术方法以实现完整切除。
