Department of Ophthalmology, Helsinki University Hospital and University of Helsinki, PO Box 220, FI-00029 HUS, Helsinki, Finland.
Department of Ophthalmology, S:t Erik's Eye Hospital, Karolinska Institutet, Stockholm, Sweden.
BMC Ophthalmol. 2020 Mar 16;20(1):103. doi: 10.1186/s12886-020-01367-3.
The purpose was to describe the Nordic treatment practices and to reach a Nordic consensus for the treatment of sebaceous eyelid carcinoma.
The treatment practices data was collected by a questionnaire with 37 questions to the Nordic oculoplastic surgeons and analyzed. A PubMed MEDLINE database search was done to gather data on the published treatment practices and recommendations. A working group that consisted of in minimum one senior consultant from each leading Nordic University Eye Hospital was assigned. A structured interactive method was used to establish the consensus.
Twenty-four doctors responded to the questionnaire. 23/24 (96%) of the respondents took a biopsy before surgery. Regional lymph node scanning was routinely done by 14/23 (61%) and a systemic screening of a metastatic disease by 13/23 (57%). 6/22 (27%) never took conjunctival mapping biopsies and 12/23 (52%) never screened for Muir- Torre. Respondents used Mohs surgery, frozen section or multi-stage excision with delayed closure, and 5-6 mm was the mostly preferred margin. Sentinel lymph node biopsy was a possible option for 9/22 (41%) and cryotherapy and Mitomycin C for 6/22 (27%) respondents. 50% of respondents considered radiation as a treatment option. 15/16 (94%) respondents always followed-up their patients, most for 5 years. Two thirds scanned regional lymph nodes during the follow-up. Consensus was reached for 18 statements representing three domains: preoperative work-up, treatment and follow-up.
Treatment practices differ in between the five Nordic countries which have similar public health care systems. In the article the authors present a Nordic consensus for the treatment of eyelid sebaceous carcinoma.
本研究旨在描述北欧的治疗实践，并就治疗眼睑皮脂腺癌达成北欧共识。
通过 37 个问题的问卷收集治疗实践数据，并对北欧眼整形医师进行分析。在 PubMed MEDLINE 数据库中搜索已发表的治疗实践和建议数据。分配一个由至少一位来自每个北欧领先大学眼科医院的资深顾问组成的工作组。采用结构化互动方法达成共识。
24 名医生对问卷做出回应。24 名受访者中的 23 名（96%）在手术前进行活检。14 名（61%）例行进行区域淋巴结扫描，13 名（57%）进行全身性转移性疾病筛查。6 名（27%）从不进行结膜定位活检，12 名（52%）从不筛查 Muir-Torre。受访者采用 Mohs 手术、冷冻切片或多阶段切除延迟闭合，5-6mm 是最常选择的切缘。22 名中的 9 名（41%）可以选择前哨淋巴结活检，6 名（27%）选择冷冻疗法和丝裂霉素 C。50%的受访者认为放射治疗是一种治疗选择。16 名中的 15 名（94%）总是对患者进行随访，大多数随访 5 年。三分之二的受访者在随访期间检查区域淋巴结。达成了 18 项陈述的共识，代表三个领域：术前检查、治疗和随访。
在具有相似公共医疗保健系统的五个北欧国家中，治疗实践存在差异。在本文中，作者提出了眼睑皮脂腺癌的北欧治疗共识。
