title: Clinical outcome of advanced squamous cell carcinoma of the conjunctiva.
abstract: BACKGROUND
  To evaluate the outcome of surgical management of advanced squamous cell carcinoma (SCC) of the conjunctiva (American Joint Committee Cancer-classification >III) and the rate of recurrences after treatment during follow-up. Second, to investigate the incidence of orbital exenteration during follow-up.
  
  
  METHODS
  Thirty-eight cases with SCC >grade T3 AJCC were retrospectively analysed at a University Eye Hospital Munich. Tumour stage, type of treatment, follow-up time, risk factors and--if present--recurrence were documented.
  
  
  RESULTS
  The mean follow-up was 24.2 months (22.3-71 months). The most frequent surgical procedure was local tumour excision (n=25 patients, 71%). Orbital exenteration was performed in 10 patients (28%). Twenty patients (57%) did not show a progressive disease during follow-up. Of the patients with primary local excision, 13 (52%) had recurrence. Average time to recurrence for all treated patients was 24 months in the mean (minimum 4 months, maximum 68 months, SD, 22). Patients following orbital exenteration had recurrence of disease in 20% (n=2). None of the patients with primarily local tumour excision required an orbital exenteration.
  
  
  CONCLUSIONS
  Advanced-stage SCC can be treated surgically. An extensive surgical approach is sometimes inevitable. Patients with surgical excision of advanced-stage disease should be reviewed closely as recurrences may occur and even after more than 5 years. However, on early detection, most of these recurrences can be handled by local excision.
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians-Universität, München, Germany.
authors.forename: C V
authors.initials: CV
authors.lastname: Miller
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians-Universität, München, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Wolf
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians-Universität, München, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Klingenstein
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians-Universität, München, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Decker
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians-Universität, München, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Garip
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians-Universität, München, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Kampik
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians-Universität, München, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Hintschich
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D003230:Conjunctival Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009367:Neoplasm Staging; D013508:Ophthalmologic Surgical Procedures; D017233:Orbit Evisceration; D012189:Retrospective Studies; D016896:Treatment Outcome