Clinical presentation and prognostic factors of eyelid sebaceous carcinoma

To clarify the demographics, clinical features, outcomes, and prognostic factors of Japanese patients with eyelid sebaceous carcinoma.

Retrospective study.

Fifty-two patients with eyelid sebaceous carcinoma diagnosed histopathologically at the National Cancer Center Hospital in Japan between 2013 and 2023 were reviewed and their outcomes were examined.

There were 21 men and 31 women. The median age at diagnosis was 73 (range 39-95) years old. The tumor was located in the upper eyelid in 33 patients (63%), in the lower eyelid in 16 patients (31%), and in both eyelids in 3 patients (6%). The initial curative treatment included surgical resection with or without eyelid reconstruction in 41 cases (79%), orbital exenteration in 4 cases (8%), and radiation therapy in 7 cases (13%). Two- and five-year adjusted survival rates were 97.4% and 93.7%, respectively. Local recurrence occurred in 15 cases (29%). Lymph node metastasis was confirmed in 13 cases (27%), distant metastasis in 5 cases (10%), and 3 patients (6%) died of lung metastasis. T2b or more advanced T stage was associated with a risk of shorter overall survival (HR = 5.3, 95% CI = 1.2-23, p = 0.024) compared with T2a or earlier stage, as well as lymph node metastasis (HR = 82, 95% CI = 2.6-2.6e+03, p = 0.013). A positive surgical margin increased the risk of local recurrence (HR = 37, 95% CI = 5.9- 235, p = 0.00012).

Proper diagnosis and margin-free resection are necessary before eyelid sebaceous carcinoma can further develop.