Periocular Squamous Cell Carcinoma: TNM Staging and Recurrence

Area of Science:

• Ophthalmology
• Oncology
• Dermatology

Background:

• Eyelid squamous cell carcinoma (SCC) is a common malignancy.
• Accurate staging and understanding recurrence patterns are crucial for effective management.

Purpose of the Study:

• To analyze the TNM stage, management strategies, and recurrence rates of patients with histologically confirmed eyelid SCC.
• To identify factors associated with recurrence in eyelid SCC.

Main Methods:

• A retrospective case series was conducted across three Australian centers.
• 254 patients with eyelid SCC were analyzed using the AJCC 7th edition TNM staging criteria.
• Outcomes and recurrence rates were evaluated based on TNM stage at presentation.

Main Results:

• Local recurrence occurred in 6.8% of treated patients, with a significantly higher rate in recurrent tumors (20%) versus primary tumors (5.3%).
• Higher T stage was significantly associated with perineural invasion (PNI) and local recurrence.
• No T-stage threshold was identified below which recurrence was impossible, with three T1 primary tumors recurring.

Conclusions:

• Higher T stage is a significant predictor of local recurrence in eyelid SCC.
• Recurrent tumors face a substantially increased risk of subsequent recurrence compared to primary tumors.
• Consideration of sentinel lymph node biopsy or close nodal surveillance is advised for high T-stage or recurrent tumors.