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Clinical science
Clinical and pathological risk factors for worse stage and mortality of eyelid and periocular squamous cell carcinoma
  1. Yingxiu Luo1,2,
  2. Huifang Chen1,
  3. Shengfang Ge1,2,
  4. Yamin Rao3,
  5. Jie Yu1,2,
  6. Xianqun Fan1,2,
  7. Renbing Jia1,2,
  8. Shiqiong Xu1,2,
  9. Yefei Wang1,2
  1. 1 Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
  2. 2 Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
  3. 3 Department of pathology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
  1. Correspondence to Dr Renbing Jia, Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China; renbingjia{at}sjtu.edu.cn; Dr Yefei Wang; paper34{at}163.com; Dr Shiqiong Xu; 215769592{at}qq.com

Abstract

Background The clinical and pathological risk factors for worse T stage and prognosis in eyelid and periocular squamous cell carcinomas (SCCs) remain unclear. P63 was reported to predict a worse prognosis in other SCCs; however, this correlation was not validated in eyelid and periocular SCCs.

Methods We reported on a retrospective case series of 85 consecutive patients with eyelid and periocular SCCs from 1995 to 2019. Cox proportional hazards regression models and logistic regression models were applied for risk factor analysis.

Results Thirty-nine (45.8%) patients were diagnosed with T4 SCCs. Four (5.1%) patients developed nodal metastasis, and five (6.4%) patients developed distant metastasis during the follow-up. 2-year and 5-year disease-specific survival rates were 95.3% and 86.4%, respectively. Poorly or moderately differentiated eyelid and periocular SCCs were associated with worse T stage (p=0.001; p=0.008). Poor differentiation was associated with a higher risk of recurrence (p=0.024). Disease-specific death was more common in patients with T4 stage SCCs (p=0.038, HR=9.05). P63 expression was more common in patients with T3c or worse stage (p=0.008, OR=3.77). P63 expression alone was associated with worse differentiation (p=0.029), higher risk of perineural invasion (p=0.042, OR=4.61) and metastasis (p=0.009, HR=3.99). P63 expression (p=0.012, HR=7.80), coexpression of P63 and Ki67 (p=0.007, HR=9.21) and distant metastasis (p=0.001, HR=11.23) were associated with disease-specific death.

Conclusion Patients presented with more aggressive orbital invasion features and a higher rate of distant metastasis in this cohort. P63 and coexpression of Ki67 predicted a worse stage, differentiation and prognosis, including metastasis and death due to disease.

  • eye lids
  • neoplasia
  • pathology

Data availability statement

Data are available on reasonable request. The datasets used and analysed during the current study are available from the corresponding authors on reasonable request.

https://doi.org/10.1136/bjophthalmol-2020-317546

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    Data availability statement

    Data are available on reasonable request. The datasets used and analysed during the current study are available from the corresponding authors on reasonable request.

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    Footnotes

    • YL and HC contributed equally.

    • RJ, SX and YW contributed equally.

    • Contributors YW, SX and XF designed this study. RJ and YW provided the data of patients. SX and JY did literature search. SG and YL designed the figures, did data collection and drafted the manuscript. SX and YL did data analysis and interpretation. YR provided pathological reports. RJ did proofread of the manuscript. YW, SX and RJ are the cocorresponding authors. All authors approved this manuscript.

    • Funding This work was supported by National Natural Science Foundation of China (grant 81802702), Shanghai Municipal Science and Technology Major Project(17JC1420100), Science and Technology Commission of Shanghai (grant 17DZ2260100), Innovative research team of high-level local universities in Shanghai(SSMU-ZDCX20180401).

    • Disclaimer The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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