The Efficacy Of Mohs Micrographic Surgery In The Management Of Eyelid Sebaceous Carcinoma

Purpose:To analyze the efficacy of Mohs micrographic surgery in the management of eyelid sebaceous carcinoma.Method : Collect information of patients with eyelid sebaceous carcinoma who accepted Mohs micrographic surgery from January 2006 to August 2016,in ophthalmology department of the Ninth people's hospital affiliated to Shanghai Jiao tong university school of medicine.Summarize the clinicopathological features,including: gender,age,focal areas,origin,maximum diameter,course,TNM staging and pathologic differentiation.Count the recurrence rate,metastasis rate and mortality of 1 year,3 years and 5 years.In addition,analyze the operation effect and the possible factors affecting the prognosis of patients.Result:A total of 61 patients received follow-up,with an average follow-up time of 47.1±35 months(median 39 months,range 5-128 month),including 27 male(44.3%),34 female(55.7%),the sex ratio was 1:1.26.The average age is 65.56±14.3 years old(median 66 years old,range 32-94 years old);the maximum diameter is 11.38±7.7 mm on average(median 10 mm,range 2-30 mm);the average duration is 17.57±27.3 months(median 12 months,range 0.5-156 months).34 cases(55.7%)in the right eye,27 cases in the left eye(44.3%),40 cases(65.6%)in upper eyelid while 20 cases(32.8%)in lower eyelid.1 case(1.6%)involved both upper and lower eyelids.Well-differentiated in 5 cases(8.2%),moderate-differentiated in 49 cases(80.3%)and 7 cases(11.5%)are poor-differentiated.In general,there were 7 cases with recurrence,the 1-year,3-years,5-years recurrence rate was 7%?9.3%?12.7%.There were 7 cases with metastasis,including 1 case of distant metastasis,the 1-year,3-years,5-years metastasis rate was 5%?10.5%?13.7%.There were 6 patients died during the follow-up,including 4 cases related to tumor metastasis,the 1-year,3-years,5-years mortality was 0%?2.5%?10.5%.There was significant correlation between maximum diameter of lesion and patients' prognosis.Patients with TNM staging of T2c(AJCC 8th edition)or higher had higher risk of poor prognosis.Conclusion:Mohs micrographic surgery have positive effects on eyelid sebaceous carcinoma in situ.Comparing with the traditional wild local excision sugery,Moth micrographic surgery have lower recurrence rate,metastasis rate and morality rate,thus it is worth promoting.