Department of Ophthalmology, Ludwig-Maximilians-University Munich, Munich, Bavaria, Germany
Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Nordrhein-Westfalen, Germany.
Br J Ophthalmol. 2022 Aug;106(8):1057-1062. doi: 10.1136/bjophthalmol-2020-317969. Epub 2021 Mar 12.
BACKGROUND/AIMS: To assess epidemiological tumour features, risk factors, clinical management and outcome of eyelid squamous cell carcinoma (SCC) and changes thereof. Furthermore, we searched for validating predictors of the American Joint Committee on Cancer (AJCC) 8 classification system.
We evaluated data of 117 patients with histologically proven eyelid SCC at a large tertiary German university centre between January 2009 and March 2020. This retrospective, monocentric analysis included descriptive statistics and non-parametric tests (p<0.05).
Histologically controlled excision and follow-up was performed in 88 (75.2%) patients. In the remaining patients with higher T-category, individual adjuvant therapy combinations were initiated. We found higher numbers of nodal metastasis and recurrence for male patients and higher T-category (p=0.035, p=0.008 and p=0.001, p<0.001). Recurrence rates proved higher for patients with multiple lesions (p=0.008). Disease-specific survival (DSS) was 95.7% at 2 and 94.9% at 5 years of follow-up. Six patients (5.1%) died from eyelid SCC with nodal metastasis and higher T-category being negative prognostic factors (p<0.001 and p=0.009). Mortality was associated with tumour location in the medial upper eyelid, nodal metastasis being more frequent (p=0.001 and p=0.009) and tumour of the lower eyelid alone as positive predictor (p=0.012). T category differed in 34 (29.1%) patients when comparing AJCC 7 and 8 (p<0.001). Changes in T category as per the AJCC 8 classification resulted in better prediction of DSS (p=0.024).
Special attention should be paid to male patients, tumour location in the upper medial eyelid and lymph node diagnostics. Prediction of DSS proved superior as per the AJCC 8 staging system.
背景/目的：评估眼睑鳞状细胞癌（SCC）的流行病学肿瘤特征、风险因素、临床管理和结局，并寻找美国癌症联合委员会（AJCC）第 8 分期系统的有效预测指标。
我们对 2009 年 1 月至 2020 年 3 月期间在德国一家大型大学中心接受组织学证实的眼睑 SCC 治疗的 117 例患者的数据进行了评估。本回顾性、单中心分析包括描述性统计和非参数检验（p<0.05）。
88 例（75.2%）患者接受了组织学控制切除和随访。对于 T 分期较高的其余患者，开始了个体化辅助治疗联合。我们发现男性患者的淋巴结转移和复发率较高，T 分期也较高（p=0.035、p=0.008 和 p=0.001、p<0.001）。多发病变患者的复发率更高（p=0.008）。2 年和 5 年的疾病特异性生存率（DSS）分别为 95.7%和 94.9%。6 例（5.1%）患者死于眼睑 SCC 伴淋巴结转移和较高的 T 分期，这是负性预后因素（p<0.001 和 p=0.009）。死亡率与内侧上眼睑的肿瘤位置有关，淋巴结转移更常见（p=0.001 和 p=0.009），而下眼睑单独的肿瘤是阳性预测指标（p=0.012）。当比较 AJCC 第 7 版和第 8 版时，34 例（29.1%）患者的 T 分期存在差异（p<0.001）。根据 AJCC 第 8 版的 T 分期改变，对 DSS 的预测更好（p=0.024）。
应特别关注男性患者、上内侧眼睑的肿瘤位置和淋巴结诊断。根据 AJCC 第 8 分期系统，DSS 的预测效果更好。
