title: Patterns of lymphatic spread and the management of eyelid carcinomas.
abstract: OBJECTIVE
  Eyelid carcinomas are rare, and the management strategy of regional lymph node metastasis linked to eyelid carcinomas has not been standardized to date. The aim of the present study was to analyze the patterns of regional metastasis and to assess the optimal extent of surgical treatment for lymph node metastasis of eyelid carcinoma.
  
  
  METHODS
  This study was a retrospective review of patient data from a single institution. From a series of 268 eyelid carcinomas, we selected the 21 patients with lymph node metastasis, and we analyzed the patterns of lymphatic spread, approach to treatment and outcomes.
  
  
  RESULTS
  The most common histological type of eyelid carcinoma with regional metastasis was sebaceous carcinoma (17/21, 81.0%). Submandibular area metastases were seen only in the patients with the primary tumor originating in the medial half of the eyelid, but parotid area metastases were seen in both the patients whose tumors had a medial-half origin and those with a lateral-half origin. Although 11 of the 16 patients with parotid-area metastases underwent a tumorectomy or superficial parotidectomy (which resulted in four cases of recurrence in the parotid area), none of the five patients who underwent a total parotidectomy developed parotid-area recurrence. The incidence of regional recurrence of the patients who received adjuvant radiotherapy (14.3%) was lower than that of the patients without adjuvant radiotherapy (57.1%).
  
  
  CONCLUSIONS
  Continued surveillance and optimal management of regional lymph node metastases are important for the control and survival of eyelid carcinomas.
authors.affiliation: Department of Otolaryngology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. Electronic address: hkazuki@surgpath.med.kyushu-u.ac.jp.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Hashimoto
authors.affiliation: Department of Otolaryngology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Yasumatsu
authors.affiliation: Department of Otolaryngology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Toh
authors.affiliation: Department of Otolaryngology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Shiratsuchi
authors.affiliation: Department of Otolaryngology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors.forename: Takamasa
authors.initials: T
authors.lastname: Yoshida
authors.affiliation: Department of Otolaryngology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Nishiyama
authors.affiliation: Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshikawa
authors.affiliation: Department of Otolaryngology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors.forename: Torahiko
authors.initials: T
authors.lastname: Nakashima
authors.affiliation: Department of Otolaryngology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakagawa
mesh_terms: D018266:Adenocarcinoma, Sebaceous / Q000473:pathology* / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000473:pathology* / Q000628:therapy; D015266:Carcinoma, Merkel Cell / Q000473:pathology* / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000628:therapy; D005142:Eyelid Neoplasms / Q000473:pathology* / Q000628:therapy; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009333:Neck; D017233:Orbit Evisceration; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012626:Sebaceous Gland Neoplasms / Q000473:pathology* / Q000628:therapy; D012878:Skin Neoplasms / Q000473:pathology / Q000628:therapy; D000077195:Squamous Cell Carcinoma of Head and Neck; D013514:Surgical Procedures, Operative
keywords: Eyelid carcinoma; Lymph node metastasis; Sebaceous carcinoma; Squamous cell carcinoma; Therapeutic management