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眼睑恶性肿瘤的临床结局及预后因素:一项关于手术治疗及重建技术的17年回顾性分析

Clinical Outcomes and Prognostic Factors in Eyelid Malignancy: A 17-Year Retrospective Analysis of Surgical Management and Reconstruction Techniques.

作者信息

Al Harthi Abdulaziz S, Park Jungyul, Yang Suk-Woo

机构信息

Department of Ophthalmology, Majmaah University College of Medicine, Al Majma'ah, Saudi Arabia.

Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Korean J Ophthalmol. 2025 Feb;39(1):14-22. doi: 10.3341/kjo.2024.0003. Epub 2024 Oct 22.

Abstract

PURPOSE

To assess clinical outcomes in patients undergoing surgical excision and eyelid reconstruction for malignancies.

METHODS

This 17-year retrospective study (2004-2021) analyzed patients with malignant eyelid tumors who underwent excision and reconstruction. Data on tumor type, size, location, surgical techniques, complications, and prognostic factors for recurrence were evaluated.

RESULTS

A total of 152 patients underwent surgical excision and reconstruction for eyelid malignancies. Basal cell carcinoma was the most common (52.6%), followed by sebaceous cell carcinoma (32.2%). Direct lid closure was the most frequent reconstructive method. Postoperative complications, including ectropion, entropion, and canalicular obstruction, were minimal but required additional surgery in some cases. Recurrence occurred in 13 patients. Lymph node involvement (odds ratio, 21.291; p = 0.004) and positive intraoperative frozen margins (odds ratio, 7.083; p = 0.018) were significant risk factors for local recurrence.

CONCLUSIONS

Surgical excision and reconstruction are effective treatments for eyelid malignancies, with techniques tailored to tumor size, location, and extension to ensure proper lid function. Lymph node involvement and positive intraoperative frozen margins are key predictors of local recurrence.

摘要

目的

评估接受手术切除及眼睑重建治疗恶性肿瘤患者的临床结局。

方法

这项为期17年的回顾性研究(2004 - 2021年)分析了接受切除及重建手术的眼睑恶性肿瘤患者。对肿瘤类型、大小、位置、手术技术、并发症及复发的预后因素进行了评估。

结果

共有152例患者接受了眼睑恶性肿瘤的手术切除及重建。基底细胞癌最为常见(52.6%),其次是皮脂腺癌(32.2%)。直接眼睑闭合是最常用的重建方法。术后并发症,包括睑外翻、睑内翻和泪小管阻塞,发生率较低,但部分病例需要额外手术。13例患者出现复发。淋巴结受累(比值比,21.291;p = 0.004)和术中冰冻切缘阳性(比值比,7.083;p = 0.018)是局部复发的显著危险因素。

结论

手术切除及重建是治疗眼睑恶性肿瘤的有效方法,技术应根据肿瘤大小、位置及范围进行调整以确保眼睑功能正常。淋巴结受累和术中冰冻切缘阳性是局部复发的关键预测因素。

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