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Ophthalmology. 2012 Oct;119(10):1974-81. doi: 10.1016/j.ophtha.2012.04.022. Epub 2012 Jun 14.

Predictors of ocular surface squamous neoplasia recurrence after excisional surgery.

Author information

1
Miami Veteran Affairs Medical Center, Miami, Florida, USA.

Abstract

PURPOSE:

To identify predictors of ocular surface squamous neoplasm (OSSN) recurrence after operative resection.

DESIGN:

Retrospective case series.

PARTICIPANTS:

Three hundred eighty-nine consecutive patients who underwent excisional biopsy for OSSN lesions at the Bascom Palmer Eye Institute from January 1, 2001, to September 20, 2010.

METHODS:

Review of pathology records and patient charts.

MAIN OUTCOME MEASURES:

Identification of factors predictive of OSSN recurrence.

RESULTS:

Of 389 excised OSSN lesions, 44 recurred during follow-up. The 1-year recurrence rate was 10% and the 5-year recurrence rate was 21%, with a mean time to recurrence in those with a recurrence of 2.5 years (standard deviation, 3.4). Using the American Joint Committee on Cancer (AJCC) clinical staging system, T3 and T2 lesions portended a higher risk of recurrence compared with T1 (T2/T1 hazard ratio [HR], 2.05 [P = 0.04]; T3/T1 HR, 2.31 [P = 0.07]). In addition, a location characteristic that increased the risk of tumor recurrence was tarsal involvement (AJCC T3 stage lesion; HR, 4.12; P = 0.007). Nasal location was associated with a decreased risk of tumor recurrence (HR, 0.41; P = 0.008). Pathologic characteristics significantly associated with tumor recurrence were the presence of positive margins (HR, 2.73; P = 0.008) and higher grade lesions (carcinoma in situ and squamous cell carcinoma versus dysplasia; HR, 2.55; P = 0.02). Treatment with adjuvant cryotherapy significantly decreased the risk of tumor recurrence (HR, 0.51; P = 0.03). In those patients with positive margins, the use of postoperative topical interferon therapy lowered the recurrence rate to a level similar to that of patients with negative margins.

CONCLUSIONS:

Certain patient and tumor factors are associated with a higher risk of OSSN recurrence after operative excision, such as tarsal tumor location and positive surgical margins. Postoperative adjuvant therapy should be considered in patients with high-risk OSSN characteristics.

PMID:
22704832
PMCID:
PMC3459154
DOI:
10.1016/j.ophtha.2012.04.022
[Indexed for MEDLINE]
Free PMC Article

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