Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Br J Ophthalmol. 2019 Jul;103(7):980-984. doi: 10.1136/bjophthalmol-2018-312635. Epub 2018 Aug 21.
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.
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.
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.
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.
背景/目的：验证美国癌症联合委员会（AJCC）第 8 版分类对眼睑皮脂腺癌局部复发、转移和生存的预测价值。
我们对 100 例连续的眼睑皮脂腺癌患者进行了回顾性研究。根据 AJCC 第 7 版和第 8 版标准对眼睑癌进行分期。评估 T 和 N 分期与局部复发、淋巴结转移、远处转移和生存等疾病相关结局之间的关系。
60 名女性和 40 名男性的中位年龄为 67 岁（范围：41-94 岁）。局部复发、淋巴结转移、远处转移和疾病相关死亡的患者比例分别为 6%、21%、7%和 6%。2 年和 5 年疾病特异性生存率（DSS）分别为 93.8%和 92.0%。存在以下显著相关性：（1）T2c 或更差的类别与淋巴结转移（p=0.04）和远处转移（p=0.01）相关，（2）T3b 或更差的类别与局部复发（p=0.01）和疾病相关死亡（p=0.01）相关，（3）初诊时 N1 类别与远处转移（p<0.01）和疾病相关死亡（p<0.01）相关。与第 7 版相比，AJCC 第 8 版分类显示 T 分期分布的同质性更好（p<0.01），对淋巴结转移的判别能力略有提高（C=0.734 比 C=0.728）。
根据 AJCC 第 8 版分类，T 分期和 N 分期可预测眼睑皮脂腺癌的局部复发、转移和 DSS 结局。对于 T2c 或更差 T 分期和/或初诊时 N1 疾病的患者，外科医生应进行严格的淋巴结和全身转移监测。
