354例眼睑皮脂腺癌预后因素分析

Prognostic factors of 354 cases for eyelid sebaceous gland carcinoma

目的分析眼睑皮脂腺癌患者的预后相关因素。设计回顾性病例系列。研究对象2006-2020年北京同仁医院手术治疗的354例眼睑皮脂腺癌患者。方法回顾患者的临床诊疗信息及随访资料,根据第八版美国抗癌联合会(AJCC)分期标准对肿瘤进行分期。用Logistic回归分析复发相关因素,用Kaplan-Meier法绘制生存曲线并用log-rank法进行检验。主要指标患者性别、年龄、居住地区、发病部位、肿瘤大小及分期、病程、是否复发或转移。结果354例患者入组时平均年龄(61.68±11.55)岁,女性212例(59.89%)。214例(60.45%)上睑发病。病程中位时长为6.00(3.00,17.00)个月。T1、T2、T3、T4期肿瘤分别为166例(46.89%)、129例(36.44%)、36例(10.17%)、23例(6.50%)。68例(19.21%)术后复发。22例肿瘤转移,其中3例因转移离世。5年、10年转移率分别为4.69%(n=10)、7.98%(n=17),总转移率为10.33%。年龄较大(P=0.035)及AJCC分期较重(P=0.012)是术后复发的危险因素。结论眼睑皮脂腺癌患者年龄越大、肿瘤分期越高,复发可能越大。

Objective To explore risk factors of prognosis in eyelid sebaceous gland carcinoma(SGC).Design Retrospective case series.Participants 354 eyelid SGC patients with surgical treatment from 2006 to 2020 in Beijing Tongren Hospital.Method Medical records and follow-up data were reviewed.The tumor was graded by 8th American Joint Committee on Cancer(AJCC).Logistic regression was used to analyze the related factors of recurrence.Kaplan-Meier method and log-rank test was used for survival analysis.Main Outcome Measures Gender,age,habitation region,initial tumor location,size and classification of the tumor,duration of patient's complaints,recurrence and metastasis.Results 354 patients were with a mean age of 61.68±11.55 years and 212 cases(59.89%)were female.Upper eyelids were the most predilection sites of SGC with 214 cases(60.45%).The median duration time was 6.00(3.00,17.00)months before operations(range from 0.25~120 months).The classification of cases included T1 to T4 stage,with the number of 166(46.89%),129(36.44%),36(10.17%)and 23(6.50%),respectively.68 patient relapsed with a rate of 19.21%.3 of 22 metastasis patients died from the tumor.The 5-year metastasis rate was 4.69%(n=10),the 10-year metastasis rate was 7.98%(n=17),and the total metastasis rate was 10.33%.Older age(P=0.035)and severe AJCC stage(P=0.012)were the risk factors of recurrence.Conclusion The older the age and the higher grade of eyelid sebaceous gland carcinoma patients,the greater the chance of recurrence.