Predictors of ocular surface squamous neoplasia recurrence after excisional surgery

Anat Galor, Carol Karp, Patrick Oellers, Andrew A. Kao, Amany Abdelaziz, William J Feuer, Sander Dubovy

Research output: Contribution to journalArticle

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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. Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this article.

Original languageEnglish
Pages (from-to)1974-1981
Number of pages8
JournalOphthalmology
Volume119
Issue number10
DOIs
StatePublished - Oct 1 2012

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Recurrence
Neoplasms
Cryotherapy
Neoplasm Staging
Carcinoma in Situ
Disclosure
Nose
Interferons
Squamous Cell Carcinoma
Therapeutics
Outcome Assessment (Health Care)
Pathology
Biopsy

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Predictors of ocular surface squamous neoplasia recurrence after excisional surgery. / Galor, Anat; Karp, Carol; Oellers, Patrick; Kao, Andrew A.; Abdelaziz, Amany; Feuer, William J; Dubovy, Sander.

In: Ophthalmology, Vol. 119, No. 10, 01.10.2012, p. 1974-1981.

Research output: Contribution to journalArticle

Galor, Anat ; Karp, Carol ; Oellers, Patrick ; Kao, Andrew A. ; Abdelaziz, Amany ; Feuer, William J ; Dubovy, Sander. / Predictors of ocular surface squamous neoplasia recurrence after excisional surgery. In: Ophthalmology. 2012 ; Vol. 119, No. 10. pp. 1974-1981.
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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. Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this article.",
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T1 - Predictors of ocular surface squamous neoplasia recurrence after excisional surgery

AU - Galor, Anat

AU - Karp, Carol

AU - Oellers, Patrick

AU - Kao, Andrew A.

AU - Abdelaziz, Amany

AU - Feuer, William J

AU - Dubovy, Sander

PY - 2012/10/1

Y1 - 2012/10/1

N2 - 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. Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this article.

AB - 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. Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this article.

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