Malignant Eyelid Neoplasm Prognosis Dependent on Histologic Type

Retrospective study shows histologic type is the most important prognostic indicator for malignant eyelid neoplasms following wide local excision.

Pathological classification is independently associated with recurrence and metastasis in patients who have undergone wide local excision of malignant eyelid neoplasms, according to research published in BMC Ophthalmology. The study shows that basal cell carcinoma has the best prognosis, followed by sebaceous gland carcinoma, squamous cell carcinoma and malignant melanoma, and that those tumors in stage T4b have the lowest survival rate.

Researchers conducted a retrospective study to investigate the correlation between clinical and pathological characteristics and outcomes in patients with eyelid malignant neoplasms who have undergone wide local excision.

A total of 141 cases (54% women and 46% men; average age, 65.34±9.69 [range, 41-88] years) treated at a single center between January 2010 and December 2015 were included in the study. 

The most common eyelid malignancy was basal cell carcinoma (59.5%), followed by sebaceous gland carcinoma (29%), squamous cell carcinoma (7.8%), and malignant melanoma (2.1%). The average duration from onset of clinical symptoms to treatment was 61.09±122.21 months (range, 1-828). The mean follow-up time after treatment was 102.52 months (36–144).

Wide local excision is an effective and economical treatment for eyelid malignant neoplasms. Histologic type is the most important prognostic indicator for malignant eyelid neoplasms.

The investigators found the mean overall survival was 61.09±10.29 months (range, 72–144) and the overall survival rate was 97.3% for basal cell carcinoma, 75.7% for sebaceous gland carcinoma, 81.9% for squamous cell carcinoma, and 33.3% for malignant melanoma.

With Cox-regression analysis, the researchers demonstrated that pathological classification (hazard ratio [HR], 1.959; 95% confidence interval [CI], 1.012-3.790; P =.046) and eyelid tumor surgery history (HR, 17.168; 95% CI, 1.889-156.011; P =.012) were independently associated with recurrence. They found that pathological classification (HR, 2.177; 95% CI ,1.423 -3.331; P <.001) was independently associated with metastasis. The team reported that recurrence and metastasis were most likely to occur within 3 years of surgery in this patient population.

“Wide local excision is an effective and economical treatment for eyelid malignant neoplasms. Histologic type is the most important prognostic indicator for malignant eyelid neoplasms,” according to the researchers.

The primary limitation of the study was its single-center, retrospective design.

References:

Han Y, Kong M, Luo Y, Sun B, Wang Z, Zhang H. Clinicopathological features of patients with wide local excision of eyelid malignant neoplasms: a more than five years retrospective study from China. BMC Ophthalmol. 2022;22(1):436. Published 2022 Nov 15. doi:10.1186/s12886-022-02645-y