Contemporary update of overall prognosis and nomogram to predict individualized survival for Chinese patients with eyelid sebaceous carcinomaResearch in context
Chuandi Zhou,
Yingyun Shi,
Peiwei Chai,
Fan Wu,
Wenwen Xia,
Xiaoyu He,
Yue Shi,
Hengye Huang,
Renbing Jia,
Xianqun Fan
Affiliations
Chuandi Zhou
Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
Yingyun Shi
Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
Peiwei Chai
Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
Fan Wu
Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
Wenwen Xia
Department of Pathology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Xiaoyu He
Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
Yue Shi
School of Public Health, Shanghai Jiao tong University School of Medicine, 200025 Shanghai, PR China.
Hengye Huang
School of Public Health, Shanghai Jiao tong University School of Medicine, 200025 Shanghai, PR China.; Corresponding author at: School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, PR China.
Renbing Jia
Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.; Corresponding authors at: Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No 639 Zhi Zao Ju Road, Shanghai 200011, PR China.
Xianqun Fan
Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.; Corresponding authors at: Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No 639 Zhi Zao Ju Road, Shanghai 200011, PR China.
Background: The prognosis of Chinese patients with eyelid sebaceous carcinoma (SC) has not been updated for >3 decades. The prognostic predictors are multifactorial, and there is no validated prognostic model for eyelid SC. Methods: This study included 238 consecutive patients with eyelid SC. All eligible patients were followed up for metastasis and mortality. The predictors of tumor-related survival were explored by Cox analyses. A prognostic nomogram was developed and validated using bootstrap resampling. The predictive accuracy and discriminative ability were compared between the nomogram and the Tumor, Node, Metastasis (TNM) staging system. Findings: After a median follow-up period of 55.5 months, 27 (11.3%) patients died of metastatic SC, with a median survival time of 48.0 months. The 5-year and 10-year tumor-related survival rates were 88.1% and 77.9%, respectively. Orbital involvement (HR: 3.11, p = .022), the greatest tumor basal diameter (HR: 1.06, p = .003), the presence of pagetoid spread (HR: 2.90, p = .017), and having lymph node metastasis at initial diagnosis (HR: 13.66, p < .001) were independent risk factors for tumor-related death. A nomogram integrating these 4 factors was developed with a C-index of 0.887, which is significantly better than that of the TNM staging system (p = .002). The risk groups stratified by nomogram scores (p < .001 (low vs intermediate risk); p = .001 (intermediate vs high risk)) displayed better discrimination ability than TNM staging (T1 vs T2: p = .358; T2 vs T3: p = .171; T3 vs T4: p < .001) in patients at an early stage. Interpretation: The prognosis of Chinese patients with eyelid SC has improved over the last 3 decades, and it is comparable to that of patients from other countries. This nomogram provides more accurate individualized estimates of survival for eyelid SC patients and may guide clinicians in their therapeutic decisions. Keywords: Eyelid sebaceous carcinoma, Nomogram, Tumor-related survival
