Mohs micrographic surgery versus wide local excision for sebaceous adenocarcinoma of the eyelid : Analysis of a national database.

Abstract

BACKGROUND:

Sebaceous adenocarcinomas are rare and potentially aggressive tumors, which typically arise in the periocular region. Surgical treatments for eyelid sebaceous adenocarcinomas include Mohs micrographic surgery (MMS) and wide local excision (WLE). The objective of this study was to compare long-term survival outcomes of MMS versus WLE techniques for eyelid sebaceous adenocarcinomas.

METHODS:

A retrospective analysis was performed using data obtained from the Surveillance, Epidemiology, and End Results (SEER) cancer registry database. We analyzed cases diagnosed from 1998 to 2015 within the database. Patients diagnosed with sebaceous adenocarcinoma were identified using ICD codes. Cases were limited to primary sebaceous adenocarcinomas involving specifically the eyelid region. The main outcomes were assessed by Kaplan-Meier (KM) survival and Cox proportional hazards model.

RESULTS:

Sixty-seven cases of MMS were compared with 114 cases of WLE for eyelid sebaceous carcinoma. Overall KM survival rates for MMS compared to WLE at 5-year (75.6% vs. 70.3%) and 10-year follow-up (69.2% vs. 46.9%) did not show significant difference by logrank (P = 0.062). Similarly, after adjusting for demographic, tumor, and treatment characteristics, there was no significant difference in cancer-specific survival (HR 0.45, 95% CI 0.03-6.92, P = 0.57) and overall survival (HR 0.94, 95% CI 0.50-1.74, P = 0.83) when MMS surgical technique was compared with WLE techniques.

CONCLUSIONS:

Our adjusted analyses demonstrated no differences in overall survival or cancer-adjusted survival for patients with eyelid sebaceous adenocarcinomas treated with MMS compared with WLE. In areas requiring preservation of tissue because of cosmetic or functional purposes, MMS is a reasonable surgical approach.

• Authors: Kevin Phan, Asad Loya
• Journal: Journal of plastic, reconstructive & aesthetic surgery : JPRAS (J Plast Reconstr Aesthet Surg) Vol. 72 Issue 6 Pg. 1007-1011 (Jun 2019) ISSN: 1878-0539 [Electronic] Netherlands
• PMID: 30894313 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2019 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Topics

• Adenocarcinoma, Sebaceous (pathology, surgery)
• Aged
• Australia (epidemiology)
• Dissection (adverse effects, methods)
• Eyelids (pathology, surgery)
• Female
• Humans
• Kaplan-Meier Estimate
• Long Term Adverse Effects (mortality)
• Male
• Mohs Surgery (adverse effects, methods)
• Outcome and Process Assessment, Health Care
• Proportional Hazards Models
• Registries (statistics & numerical data)
• Retrospective Studies
• Sebaceous Gland Neoplasms (pathology, surgery)