title: American Joint Committee on Cancer T category for eyelid sebaceous carcinoma correlates with nodal metastasis and survival.
abstract: OBJECTIVE
  To determine whether T category of the American Joint Committee on Cancer (AJCC) TNM staging system for eyelid carcinoma, 7th edition, correlates with lymph node metastasis, distant metastasis, and survival in patients with sebaceous carcinoma of the eyelid.
  
  
  METHODS
  Retrospective, cohort study.
  
  
  METHODS
  Fifty consecutive patients treated by 1 author (BE) for eyelid sebaceous carcinoma between May 1999 and August 2010.
  
  
  METHODS
  Each tumor was staged according to the AJCC 7th edition TNM criteria. The Kaplan-Meier method was used to determine associations between disease-specific survival and (1) T category at presentation, (2) lymph node metastasis, and (3) distant metastasis.
  
  
  METHODS
  T category at presentation, nodal metastasis, survival.
  
  
  RESULTS
  The study included 37 women and 13 men (median age, 68.5 years; range, 44-86 years). Forty-four patients were white, 5 were Hispanic, and 1 was Asian. TNM designations were TXN0M0, 7 patients; T1N0M0, 4 patients; T2aN0M0, 12 patients; T2bN0M0, 11 patients; T2bN1M0, 2 patients; T2bN1M1, 1 patient; T3aN0M0, 2 patients; T3aN1M0, 5 patients; T3bN0M0, 1 patient; T3bN1M0, 1 patient; T3bN0M1, 2 patients; T4N0M0, 1 patient; and T4N0M1, 1 patient. T category at presentation was significantly associated with lymph node metastasis (P = 0.0079). No tumors with T category better than T2b or smaller than 9 mm in greatest dimension were associated with nodal metastasis. Five patients (10%) died of disease during follow-up. Their TNM designations were T2bN1M1, 1 patient; T3bN0M1, 2 patients; T4N0M0, 1 patient; and T4N0M1, 1 patient. No tumors smaller than 12 mm in greatest dimension were associated with distant metastasis or death. T category was significantly associated with disease-specific survival (P = 0.0009). Disease-specific survival was poorer among patients with T category of T3a or worse (P = 0.035).
  
  
  CONCLUSIONS
  T category in the 7th edition of the AJCC TNM staging system for eyelid carcinoma correlates with outcomes in patients with sebaceous carcinoma of eyelid. On the basis of the present findings, it seems reasonable to recommend sentinel lymph node biopsy or at least strict regional lymph node surveillance for patients with eyelid sebaceous carcinoma with tumors of T category T2b or worse or 10 mm or more in greatest dimension.
authors.affiliation: Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. besmaeli@manderson.org
authors.forename: Bita
authors.initials: B
authors.lastname: Esmaeli
authors.forename: Qasiem J
authors.initials: QJ
authors.lastname: Nasser
authors.forename: Hilda
authors.initials: H
authors.lastname: Cruz
authors.forename: Melissa
authors.initials: M
authors.lastname: Fellman
authors.forename: Carla L
authors.initials: CL
authors.lastname: Warneke
authors.forename: Doina
authors.initials: D
authors.lastname: Ivan
mesh_terms: D018266:Adenocarcinoma, Sebaceous / Q000145:classification / Q000401:mortality / Q000556:secondary*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005142:Eyelid Neoplasms / Q000145:classification / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008495:Medical Oncology / Q000458:organization & administration / Q000592:standards; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012626:Sebaceous Gland Neoplasms / Q000145:classification / Q000401:mortality / Q000473:pathology*; D021701:Sentinel Lymph Node Biopsy; D015996:Survival Rate; D014481:United States