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Feasibility of using American Joint Committee on Cancer Classification criteria for staging eyelid carcinomas
Roman Shinder1, Doina Ivan, Deborah Seigler
1Section of Ophthalmology, Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Purpose:
To evaluate the feasibility of staging eyelid carcinomas using the American Joint Committee on Cancer (AJCC) criteria, and to compare the 6(th) and 7(th) editions.
Methods:
The records of 27 consecutive patients who underwent excision of eyelid carcinoma between April 2007 and April 2008 were reviewed. Patients with melanoma, lymphoid tumors, nonmeasurable disease, or medial or lateral canthal tumors were excluded. Each patient was staged using the AJCC 6(th) and 7(th) edition criteria based on clinical, pathologic, and radiographic data.
Results:
The study included 13 men and 14 women aged 32 to 93 years (median, 65 years). Seventeen patients had basal cell carcinoma; 3, squamous cell carcinoma; 6, sebaceous carcinoma; and 1, Merkel cell carcinoma. Tumor location was lower eyelid in 20 patients and upper eyelid in 7. TNM designations were reliably determined for all 27 patients and were: A) using the 6(th) edition: T1N0M0, 6 patients; T2N0M0, 6; T2N1M0, 1; T3N0M0, 4; T4N0M0, 9; and T4N1M0, 1. B) using the 7(th) edition: T1N0M0, 6 patients; T2aN0M0, 8; T2aN1M0, 1; T2bN0M0, 2; T3aN0M0, 6; T3aN1M0, 1; T3bN0M0, 2; and T4N0M0, 1. Pathologic tumor size and nodal status, and systemic work-up were recorded for all patients.
Conclusions:
Eyelid carcinomas can be reliably staged using the AJCC criteria. There are notable differences between the 6(th) and 7(th) editions of AJCC TNM designation. We recommend AJCC staging using the latest published edition during the initial work-up for all patients with eyelid carcinoma to make reporting of outcomes more reliable and reproducible.
