Prognosis of eyelid sebaceous gland carcinoma based on the tumor (T) category of the American Joint Committee on Cancer (AJCC) classification

Abstract

The purpose of this study was to evaluate the clinical features and prognosis of eyelid sebaceous gland carcinoma (SGC) based on the T category of the American Joint Committee on Cancer (AJCC) classification (7th edition). This is a retrospective interventional case series study. Based on the T category of the AJCC classification, 191 patients with eyelid sebaceous gland carcinoma were classified as T1 (n = 1, 1 %), T2 (n = 111, 58 %), T3 (n = 76, 40 %), and T4 (n = 3, 2 %). Based on multivariate analysis, the factors predictive of regional lymph node metastasis included duration of symptoms >6 months (p = 0.04) and orbital tumor extension (p < 0.001). The factors predictive of systemic metastasis included orbital tumor extension (p < 0.001) and perivascular invasion (p = 0.007). The factor predictive of death due to systemic metastasis included orbital tumor extension (p < 0.001). Kaplan-Meier estimates of regional lymph node metastasis at 5 and 10 years, respectively, were 0 and 0 % for T1, 11 and 11 % for T2, 44 and 59 % for T3, and 100 and 100 % for T4 (p < 0.001). Kaplan-Meier estimates of systemic metastasis at 5 and 10 years, respectively, were 0 and 0 % for T1, 6 and 6 % for T2, 35 and 35 % for T3, and 100 and 100 % for T4 (p < 0.001). Kaplan-Meier estimates of death due to metastasis at 5 and 10 years, respectively, were 0 and 0 % for T1, 3 and 3 % for T2, 30 and 50 % for T3, and 100 and 100 % for T4 (p < 0.001). Primary tumor (T) category of the AJCC classification predicts the prognosis of patients with eyelid SGC. The risk of systemic metastasis and death increases with increasing tumor category.

14-year case series of eyelid sebaceous gland carcinoma in Chinese patients and review of management

“…Similarly, in the Korean cohort, T2b or worse were associated with lymph node metastasis 10. The Indian cohort also found that the risk of systemic metastasis and death was related to an increasing T category 9. However, in the Japanese cohort, the authors found that tumours even smaller than T2a were associated with tumour metastasis 8.…”

MR and CT Imaging of the Normal Eyelid and its Application in Eyelid Tumors

“…Staging of an eyelid tumor is based on the TNM classification and is a critical element in determining the appropriate treatment, a key factor defining prognosis, and will assist in the evaluation of the results of the treatment [8,9,21,22]. Regarding eyelid tumors, different T-stagings are applied depending on the type of tumor and on the layer of origin of the tumor within the eyelid.…”

Nordic treatment practices survey and consensus for treatment of eyelid sebaceous carcinoma

“…A higher risk for recurrence or metastasis has been reported in patients with symptoms over 6 months, involvement of both upper and lower eyelids, multicentric origin, diffuse or a non-lobular pattern, pagetoid spread, orbital involvement, perineural invasion and stage T2b (AJCC 7th -edition) or worse [60,61]. In a chinese study of 238 patients, risk factors for tumor-related death were orbital involvement, the greatest tumor basal diameter, pagetoid spread and lymph node metastasis at initial diagnosis [62].…”

“…Stage T2b (AJCC 7th-edition) and stage T2c (AJCC 8-th edition) or a more advanced disease is reported to correlate with regional lymph node metastasis and T2b or T3a or worse (AJCC 7th-edition) and stage T2c (AJCC 8-th edition) are reported to correlate with distant metastases [11,15,46,58]. Kaliki et al [61] estimate of lymph node metastasis at 5 and 10 years are 0 and 0% for T1, 11and 11% for T2, 44 and 59% for T3 and 100 and 100% for T4, [13]…”