Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
Department of Ophthalmology, Grantham Hospital, Aberdeen, Hong Kong SAR, China.
Eye (Lond). 2019 Sep;33(9):1433-1442. doi: 10.1038/s41433-019-0432-0. Epub 2019 Apr 5.
To determine the practice patterns of ophthalmic plastic surgeons regarding the management of eyelid sebaceous carcinoma (SC).
An electronic survey was distributed to oculoplastic surgical colleagues in the Asia Pacific region requesting clinical information and treatment approaches to SC.
The responses from 192 respondents from the Asia Pacific region was included and analyzed in this study. For initial diagnosis, most surgeons selected incisional biopsy (55%), followed by complete excision (35%). Initial workup was mainly by palpation of lymph nodes, chest X-ray, and computerized tomography scan (CT-scan) of the orbit. Conjunctival map biopsy was done in selected cases. Sentinel lymph node biopsy (SLNB) was done mainly for tumors larger than 10 mm. Management was mainly by surgical excision (5 mm margin) combined with adjuvant therapy in some cases, with radiotherapy being the most common. Margin status was determined most frequently by frozen section as evaluated by the pathologist (57%) followed by Mohs micrographic surgery (18%). Surveillance was based mainly on physical examination alone.
The Asia Pacific oculoplastic surgeons prefer incisional biopsy for lesions suspicious of SC prior to definitive surgery. This is in contrast to survey results previously reported in other populations. Frozen section control (done by an oculoplastic surgeon with pathology support) is most commonly used for margin control and conjunctival map biopsies are done only in selected cases. Despite the potential benefits of SLNB, access and expertise in this area is currently lacking in the Asia Pacific region.
确定眼科整形外科医生在治疗眼睑皮脂癌 (SC) 方面的实践模式。
向亚太地区的眼整形外科同仁发送电子调查，要求提供 SC 的临床信息和治疗方法。
本研究纳入并分析了来自亚太地区 192 名受访者的回复。对于初始诊断，大多数外科医生选择切开活检（55%），其次是完全切除（35%）。最初的检查主要是通过触诊淋巴结、胸部 X 光和眼眶计算机断层扫描（CT 扫描）。在选定的病例中进行结膜地图活检。前哨淋巴结活检（SLNB）主要用于大于 10mm 的肿瘤。管理主要是通过手术切除（5mm 边缘）结合某些情况下的辅助治疗，放射治疗最常见。病理学家评估的冰冻切片（57%）最常确定边缘状态，其次是 Mohs 显微外科手术（18%）。监测主要基于单独的体格检查。
亚太地区的眼整形外科医生在进行确定性手术之前，更喜欢对疑似 SC 的病变进行切开活检。这与之前在其他人群中报告的调查结果形成对比。冰冻切片控制（由具有病理支持的眼整形外科医生进行）最常用于边缘控制，仅在选定的情况下进行结膜地图活检。尽管前哨淋巴结活检有潜在的益处，但在亚太地区，目前缺乏在该领域的途径和专业知识。
