Abstract
Purpose
To investigate whether the clinical and pathologic T category classification, as defined by the American Joint Committee on Cancer (AJCC), is associated with lymph nodes (LN) or distant metastasis in patients with eyelid sebaceous carcinoma.
Methods
Forty patients treated for eyelid sebaceous carcinoma at Seoul National University Hospital between March 1999 and December 2011 were retrospectively staged according to the AJCC 7th edition criteria. Three different primary tumor classifications—(1) clinical tumor size at presentation; (2) clinical AJCC T stage (cT) at presentation based not only on size, but also on the extent of involvement and (3) pathologic AJCC T stage (pT) based on histopathological examination—were compared and evaluated with regard to their association with LN or distant metastasis.
Results
In univariate analysis, the AJCC cT (p = 0.005) and pT (p = 0.029) categories were significantly associated with metastasis, but clinical tumor size alone did not correlate with metastasis (p = 0.093). Clinical and pathologic AJCC stage T2b or higher tumors were significantly associated with metastasis compared to stage T1 or T2a tumors [odds ratio cT, 8.00 (p = 0.025); pT, 6.91 (p = 0.028)].
Conclusions
The clinical and pathologic AJCC T category has predictive value for LN or distant metastasis in eyelid sebaceous carcinoma. However, the clinically assessed largest tumor dimension alone is not an effective predictive factor. Clinicians should be aware of the increased risk of metastasis in patients with tumors of stage T2b or higher at initial presentation.
Similar content being viewed by others
References
Shields JA, Demirci H, Marr BP, Eagle RC Jr, Shields CL. Sebaceous carcinoma of the ocular region: a review. Surv Ophthalmol. 2005;50:103–22.
Shields JA, Demirci H, Marr BP, Eagle RC Jr, Shields CL. Sebaceous carcinoma of the eyelids: personal experience with 60 cases. Ophthalmology. 2004;111:2151–7.
Khan JA, Doane JF, Grove AS Jr. Sebaceous and meibomian carcinomas of the eyelid. Recognition, diagnosis, and management. Ophthalmic Plast Reconstr Surg. 1991;7:61–6.
Shields JA, Shields CL. Sebaceous adenocarcinoma of the eyelid. Int Ophthalmol Clin. 2009;49:45–61.
Tryggvason G, Bayon R, Pagedar NA. Epidemiology of sebaceous carcinoma of the head and neck: implications for lymph node management. Head Neck. 2012;34:1765–8.
Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. Carcinoma of the eyelid. In: Edge SB, Byrd DR, Compton CC, et al., editors. AJCC cancer staging manual. 7th ed. New York: Springer; 2009. p. 523–30.
Shinder R, Ivan D, Seigler D, Dogan S, Esmaeli B. Feasibility of using American Joint Committee on Cancer Classification criteria for staging eyelid carcinomas. Orbit. 2011;30:202–7.
Crawford C, Fernelius C, Young P, Groo S, Ainbinder D. Application of the AJCC 7th edition carcinoma of the eyelid staging system: a medical center pathology based, 15-year review. Clin Ophthalmol. 2011;5:1645–8.
Erovic BM, Goldstein DP, Kim D, Al Habeeb A, Waldron J, Ghazarian D. Sebaceous gland carcinoma of the head and neck: the Princess Margaret Hospital experience. Head Neck. 2013;35:316–20.
Esmaeli B, Nasser QJ, Cruz H, Fellman M, Warneke CL, Ivan D. American Joint Committee on Cancer T category for eyelid sebaceous carcinoma correlates with nodal metastasis and survival. Ophthalmology. 2012;119:1078–82.
Finger PT. The 7th edition AJCC staging system for eye cancer: an international language for ophthalmic oncology. Arch Pathol Lab Med. 2009;133:1197–8.
Ainbinder DJ, Esmaeli B, Groo SC, Finger PT, Brooks JP. Introduction of the 7th edition eyelid carcinoma classification system from the American Joint Committee on Cancer–International Union Against Cancer staging manual. Arch Pathol Lab Med. 2009;133:1256–61.
Chao AN, Shields CL, Krema H, Shields JA. Outcome of patients with periocular sebaceous gland carcinoma with and without conjunctival intraepithelial invasion. Ophthalmology. 2001;108:1877–83.
Pfeiffer ML, Savar A, Esmaeli B. Sentinel lymph node biopsy for eyelid and conjunctival tumors: what have we learned in the past decade? Ophthalmic Plast Reconstr Surg. 2013;29:57–62.
Maalouf TJ, Dolivet G, Angioi KS, Leroux A, Genin P, George JL. Sentinel lymph node biopsy in patients with conjunctival and eyelid cancers: experience in 17 patients. Ophthalmic Plast Reconstr Surg. 2012;28:30–4.
Savar A, Oellers P, Myers J, Prieto VG, Torres-Cabala C, Frank SJ, et al. Positive sentinel node in sebaceous carcinoma of the eyelid. Ophthalmic Plast Reconstr Surg. 2011;27:e4–6.
Ho VH, Ross MI, Prieto VG, Khaleeq A, Kim S, Esmaeli B. Sentinel lymph node biopsy for sebaceous cell carcinoma and melanoma of the ocular adnexa. Arch Otolaryngol Head Neck Surg. 2007;133:820–6.
Acknowledgments
This study was supported by grant No 04-2005-0270 from the Seoul National University Hospital Research Fund.
Conflicts of interest
Y. J. Choi, None; H. C. Jin, None; M. J. Lee, None; N. Kim, None; H.-K. Choung, None; S. I. Khwarg, None.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Choi, Y.J., Jin, H.C., Lee, M.J. et al. Prognostic value of clinical and pathologic T stages defined by the American Joint Committee on Cancer for eyelid sebaceous carcinoma in Korea. Jpn J Ophthalmol 58, 327–333 (2014). https://doi.org/10.1007/s10384-014-0321-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10384-014-0321-9