title: Sebaceous carcinoma in Japanese patients: clinical presentation, staging and outcomes.
abstract: OBJECTIVE
  To describe the clinical features, management and correlation of the American Joint Committee on Cancer tumour node metastasis (TNM) staging for eyelid carcinoma with outcomes in Japanese patients with sebaceous carcinoma.
  
  
  METHODS
  Multicentre retrospective review of 63 Japanese patients. Tumours were staged using the American Joint Committee on Cancer 7th edition TNM criteria.
  
  
  RESULTS
  A distinct mass was the initial presentation in 94% and correct initial diagnosis made in 57% patients. Most tumours (60%) presented at stage T2aN0M0. The remaining TNM stages were: T2bN0M0 (25%); T3aN0M0 (9%); T3bN0M0 (2%); T2bN1M0 (2%); T3bN1M1 (2%). Frozen section controlled excision was performed in 81%. One patient required an orbital exenteration. Median follow-up was 4.2 years. Local recurrence occurred in four patients treated with frozen section controlled excision. Five patients had regional nodal metastases, two of which had T2aN0M0 lesions. T3a tumours and greater were significantly associated with local recurrence but not regional nodal metastasis. One patient died due to disease. One patient is alive with disease, and remaining patients were alive without disease at last follow-up.
  
  
  CONCLUSIONS
  In this Japanese cohort, an eyelid mass was the main clinical presentation of sebaceous carcinoma. Contrary to previous reports, T2a tumours smaller than 10 mm were associated with regional nodal metastases.
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, , Kyoto, Japan.
authors.forename: Akihide
authors.initials: A
authors.lastname: Watanabe
authors.forename: Michelle T
authors.initials: MT
authors.lastname: Sun
authors.forename: Adnan
authors.initials: A
authors.lastname: Pirbhai
authors.forename: Kosuke
authors.initials: K
authors.lastname: Ueda
authors.forename: Nobutada
authors.initials: N
authors.lastname: Katori
authors.forename: Dinesh
authors.initials: D
authors.lastname: Selva
mesh_terms: D018266:Adenocarcinoma, Sebaceous / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005142:Eyelid Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D016896:Treatment Outcome
keywords: Orbit