Mohs micrographic surgery for eyelid sebaceous carcinoma: A multicenter cohort of 360 patients - 16/05/19
, Xianqun Fan, MD, PhD a, b, ⁎ Abstract |
Background |
The decision to perform Mohs micrographic surgery (MMS) or wide local excision (WLE) for eyelid sebaceous carcinoma (SC) is controversial.
Objective |
To compare local recurrence, metastasis, and tumor-related mortality of patients with eyelid SC who were initially treated with MMS versus with WLE.
Methods |
A multicenter cohort study. Medical records were reviewed for factors associated with recurrence, metastasis, and tumor-related mortality. All eligible patients were followed up. The impact of initial surgical modality on the prognoses were determined by Cox analyses after control for all confounders.
Results |
Of the 360 patients included in this cohort, 115 (31.9%) underwent MMS as primary resection, whereas 245 (68.1%) underwent WLE. After a median follow-up period of 60.0 months, local recurrence was observed in 18 patients (15.7%) in the MMS group and 97 patients (39.6%) in the WLE group. Metastasis occurred in 9 patients (7.8%) who underwent MMS and 38 (15.5%) who underwent WLE. In all, 6 patients in the MMS group (5.2%) and 21 in the WLE group (8.6%) died of metastatic SC. Multivariable Cox regression indicated that compared with the WLE group, the MMS group exhibited more favorable local recurrence control (hazard ratio [HR], 0.42; 95% confidence interval [CI], 0.24-0.73; P = .002) but a comparable metastasis rate (HR, 1.38; 95% CI, 0.60-3.18; P = .453) and comparable tumor-related mortality (HR, 1.70; 95% CI, 0.59-4.93; P = .329). However, this beneficial effect became nonremarkable for patients with pagetoid intraepithelial neoplasia (HR, 1.73; 95% CI, 0.37-8.21; P = .488).
Limitations |
Retrospective nature of the study.
Conclusion |
MMS should be proposed for eyelid SC without orbital involvement to achieve recurrence control; however, this surgical procedure did not change the long-term outcomes in terms of metastasis or tumor-related mortality. Patients with pagetoid intraepithelial neoplasia may require adjuvant measures.
Le texte complet de cet article est disponible en PDF.Key words : eyelid sebaceous carcinoma, metastasis, Mohs micrographic surgery, recurrence, tumor-related mortality
Abbreviations used : CI, HR, MMS, SC, UM, WLE
Plan
| Chuandi Zhou and Fan Wu contributed equally to this paper. |
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| Funding sources: Supported by the Scientific Research Program of the National Health and Family Planning Commission of China (201402014), The Science and Technology Commission of Shanghai (17DZ2260100), Innovation Fund for Translational Medicine (15ZH1005), and Shanghai Shuguang Project (14SG18). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. |
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| Conflicts of interest: None disclosed. |
Vol 80 - N° 6
P. 1608 - juin 2019 Retour au numéro
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