Ocular oncology and pathology · 2026
Treatment Delay and Risk of Orbital Exenteration in Periocular Sebaceous Carcinoma.
СтатьяНазвание и аннотация: Перевод в очереди
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Welk Grant M, Yu Caroline Y, Israilevich Rachel, Dalvin Lauren A, Tooley Andrea A
Аннотация
INTRODUCTION: This single-institution study characterizes outcomes in periocular sebaceous carcinoma and evaluates whether treatment delay is associated with orbital exenteration.
METHODS: Retrospective case series of all patients diagnosed with primary periocular sebaceous carcinoma between January 1, 2000, and December 31, 2022, at a single academic institution. Clinical, histopathologic, treatment, and outcome data were analyzed. Association between time to treatment and orbital exenteration was assessed using logistic regression.
RESULTS: The study included 25 patients (median age 76.6 years). Prior misdiagnosis occurred in 21 (84%), most commonly as chalazia (n = 7) or blepharitis (n = 6). Most tumors were AJCC T1, with predominantly poor or moderate differentiation. Mean time from presentation-to-treatment was 5.67 months (range 0.26-28.52 months), with a subset experiencing prolonged delays. Most patients underwent wide local excision (52%) or Mohs surgery (32%), with 4 (16%) requiring exenteration. Each 3-month increase in time to treatment was associated with 16% greater odds of orbital exenteration (OR: 1.16, 95% CI: 1.01-1.38; p = 0.042). Demographic and socioeconomic variables were not associated with differences in delays or outcomes. Median follow-up was 43 months, during which visual acuity remained stable in non-exenterated patients (median logMAR change -0.125). Local tumor recurrence occurred in 4 (16%) at a median of 26.46 months. Overall survival was 54.2% at 10 years, with no deaths attributed to sebaceous carcinoma.
CONCLUSION: Treatment delay was associated with increased odds of orbital exenteration and not with measured socioeconomic factors. These findings suggest a potential relationship between time-to-treatment and extent of surgical management, with possible implications for vision preservation and quality of life.
METHODS: Retrospective case series of all patients diagnosed with primary periocular sebaceous carcinoma between January 1, 2000, and December 31, 2022, at a single academic institution. Clinical, histopathologic, treatment, and outcome data were analyzed. Association between time to treatment and orbital exenteration was assessed using logistic regression.
RESULTS: The study included 25 patients (median age 76.6 years). Prior misdiagnosis occurred in 21 (84%), most commonly as chalazia (n = 7) or blepharitis (n = 6). Most tumors were AJCC T1, with predominantly poor or moderate differentiation. Mean time from presentation-to-treatment was 5.67 months (range 0.26-28.52 months), with a subset experiencing prolonged delays. Most patients underwent wide local excision (52%) or Mohs surgery (32%), with 4 (16%) requiring exenteration. Each 3-month increase in time to treatment was associated with 16% greater odds of orbital exenteration (OR: 1.16, 95% CI: 1.01-1.38; p = 0.042). Demographic and socioeconomic variables were not associated with differences in delays or outcomes. Median follow-up was 43 months, during which visual acuity remained stable in non-exenterated patients (median logMAR change -0.125). Local tumor recurrence occurred in 4 (16%) at a median of 26.46 months. Overall survival was 54.2% at 10 years, with no deaths attributed to sebaceous carcinoma.
CONCLUSION: Treatment delay was associated with increased odds of orbital exenteration and not with measured socioeconomic factors. These findings suggest a potential relationship between time-to-treatment and extent of surgical management, with possible implications for vision preservation and quality of life.