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Excision combined with ocular surface reconstruction followed by topical chemotherapy for ocular surface squamous neoplasia.

Authors :
Nakai, Hiroko
Ueda, Kosuke
Kitazawa, Koji
Fukuoka, Hideki
Inatomi, Tsutomu
Yokoi, Norihiko
Kinoshita, Shigeru
Horiguchi, Go
Teramukai, Satoshi
Sotozono, Chie
Source :
Japanese Journal of Ophthalmology. Oct2024, p1-10.
Publication Year :
2024

Abstract

Purpose: To investigate the visual prognosis of ocular surface squamous neoplasia (OSSN) after tumor resection and ocular surface reconstruction, and clarify factors that influence recurrence.Retrospective cohort study.Medical records of all patients who underwent surgical treatment for OSSN at our hospital between January 1996 and December 2019 were reviewed. Tumor size/location, histological classification, surgical procedure, intraoperative mitomycin-C use, and postoperative topical 5-fluorouracil (5-FU) administration were examined, and pre and postoperative visual acuity (VA) were compared to elucidate factors that influence disease recurrence.Tumor excision was performed in 70 eyes of 70 cases (43 men, 27 women; average age: 71.6 ± 12.6 years) with dysplasia (8 eyes), carcinoma in situ (26 eyes), and invasive squamous cell carcinoma (36 eyes). Tumors were found in the limbus (<italic>N</italic> = 59 eyes), palpebral conjunctiva (<italic>N</italic> = 8 eyes), and from the bulbar to palpebral conjunctiva (<italic>N</italic> = 3 eyes). Surgical procedures performed were limbal transplantation/keratoepithelioplasty (<italic>N</italic> = 29 eyes), cultivated oral mucosal epithelial transplantation (<italic>N</italic> = 3 eyes), and auto-conjunctival epithelium transplantation (<italic>N</italic> = 2 eyes). Ocular surface was reconstructed using amniotic membrane, donor cornea, or cultivated epithelial sheet. The mean follow-up was 38.6 ± 38.6 months (range, 2 months to 13.8 years). VA postoperatively improved in 25 (61.0%) cases. Recurrence occurred in 19 (27.1%) cases at from 2 to 50 months (median: 12.5 months) postoperative. Uni- and multivariate analyses revealed that presurgical tumor size and postoperative administration of 5-FU were significantly related to recurrence.Combined surgical excision and postoperative topical 5-FU administration effectively prevented OSSN recurrence, and ocular surface reconstruction contributed to improvement of VA.Study design: To investigate the visual prognosis of ocular surface squamous neoplasia (OSSN) after tumor resection and ocular surface reconstruction, and clarify factors that influence recurrence.Retrospective cohort study.Medical records of all patients who underwent surgical treatment for OSSN at our hospital between January 1996 and December 2019 were reviewed. Tumor size/location, histological classification, surgical procedure, intraoperative mitomycin-C use, and postoperative topical 5-fluorouracil (5-FU) administration were examined, and pre and postoperative visual acuity (VA) were compared to elucidate factors that influence disease recurrence.Tumor excision was performed in 70 eyes of 70 cases (43 men, 27 women; average age: 71.6 ± 12.6 years) with dysplasia (8 eyes), carcinoma in situ (26 eyes), and invasive squamous cell carcinoma (36 eyes). Tumors were found in the limbus (<italic>N</italic> = 59 eyes), palpebral conjunctiva (<italic>N</italic> = 8 eyes), and from the bulbar to palpebral conjunctiva (<italic>N</italic> = 3 eyes). Surgical procedures performed were limbal transplantation/keratoepithelioplasty (<italic>N</italic> = 29 eyes), cultivated oral mucosal epithelial transplantation (<italic>N</italic> = 3 eyes), and auto-conjunctival epithelium transplantation (<italic>N</italic> = 2 eyes). Ocular surface was reconstructed using amniotic membrane, donor cornea, or cultivated epithelial sheet. The mean follow-up was 38.6 ± 38.6 months (range, 2 months to 13.8 years). VA postoperatively improved in 25 (61.0%) cases. Recurrence occurred in 19 (27.1%) cases at from 2 to 50 months (median: 12.5 months) postoperative. Uni- and multivariate analyses revealed that presurgical tumor size and postoperative administration of 5-FU were significantly related to recurrence.Combined surgical excision and postoperative topical 5-FU administration effectively prevented OSSN recurrence, and ocular surface reconstruction contributed to improvement of VA.Methods: To investigate the visual prognosis of ocular surface squamous neoplasia (OSSN) after tumor resection and ocular surface reconstruction, and clarify factors that influence recurrence.Retrospective cohort study.Medical records of all patients who underwent surgical treatment for OSSN at our hospital between January 1996 and December 2019 were reviewed. Tumor size/location, histological classification, surgical procedure, intraoperative mitomycin-C use, and postoperative topical 5-fluorouracil (5-FU) administration were examined, and pre and postoperative visual acuity (VA) were compared to elucidate factors that influence disease recurrence.Tumor excision was performed in 70 eyes of 70 cases (43 men, 27 women; average age: 71.6 ± 12.6 years) with dysplasia (8 eyes), carcinoma in situ (26 eyes), and invasive squamous cell carcinoma (36 eyes). Tumors were found in the limbus (<italic>N</italic> = 59 eyes), palpebral conjunctiva (<italic>N</italic> = 8 eyes), and from the bulbar to palpebral conjunctiva (<italic>N</italic> = 3 eyes). Surgical procedures performed were limbal transplantation/keratoepithelioplasty (<italic>N</italic> = 29 eyes), cultivated oral mucosal epithelial transplantation (<italic>N</italic> = 3 eyes), and auto-conjunctival epithelium transplantation (<italic>N</italic> = 2 eyes). Ocular surface was reconstructed using amniotic membrane, donor cornea, or cultivated epithelial sheet. The mean follow-up was 38.6 ± 38.6 months (range, 2 months to 13.8 years). VA postoperatively improved in 25 (61.0%) cases. Recurrence occurred in 19 (27.1%) cases at from 2 to 50 months (median: 12.5 months) postoperative. Uni- and multivariate analyses revealed that presurgical tumor size and postoperative administration of 5-FU were significantly related to recurrence.Combined surgical excision and postoperative topical 5-FU administration effectively prevented OSSN recurrence, and ocular surface reconstruction contributed to improvement of VA.Results: To investigate the visual prognosis of ocular surface squamous neoplasia (OSSN) after tumor resection and ocular surface reconstruction, and clarify factors that influence recurrence.Retrospective cohort study.Medical records of all patients who underwent surgical treatment for OSSN at our hospital between January 1996 and December 2019 were reviewed. Tumor size/location, histological classification, surgical procedure, intraoperative mitomycin-C use, and postoperative topical 5-fluorouracil (5-FU) administration were examined, and pre and postoperative visual acuity (VA) were compared to elucidate factors that influence disease recurrence.Tumor excision was performed in 70 eyes of 70 cases (43 men, 27 women; average age: 71.6 ± 12.6 years) with dysplasia (8 eyes), carcinoma in situ (26 eyes), and invasive squamous cell carcinoma (36 eyes). Tumors were found in the limbus (<italic>N</italic> = 59 eyes), palpebral conjunctiva (<italic>N</italic> = 8 eyes), and from the bulbar to palpebral conjunctiva (<italic>N</italic> = 3 eyes). Surgical procedures performed were limbal transplantation/keratoepithelioplasty (<italic>N</italic> = 29 eyes), cultivated oral mucosal epithelial transplantation (<italic>N</italic> = 3 eyes), and auto-conjunctival epithelium transplantation (<italic>N</italic> = 2 eyes). Ocular surface was reconstructed using amniotic membrane, donor cornea, or cultivated epithelial sheet. The mean follow-up was 38.6 ± 38.6 months (range, 2 months to 13.8 years). VA postoperatively improved in 25 (61.0%) cases. Recurrence occurred in 19 (27.1%) cases at from 2 to 50 months (median: 12.5 months) postoperative. Uni- and multivariate analyses revealed that presurgical tumor size and postoperative administration of 5-FU were significantly related to recurrence.Combined surgical excision and postoperative topical 5-FU administration effectively prevented OSSN recurrence, and ocular surface reconstruction contributed to improvement of VA.Conclusion: To investigate the visual prognosis of ocular surface squamous neoplasia (OSSN) after tumor resection and ocular surface reconstruction, and clarify factors that influence recurrence.Retrospective cohort study.Medical records of all patients who underwent surgical treatment for OSSN at our hospital between January 1996 and December 2019 were reviewed. Tumor size/location, histological classification, surgical procedure, intraoperative mitomycin-C use, and postoperative topical 5-fluorouracil (5-FU) administration were examined, and pre and postoperative visual acuity (VA) were compared to elucidate factors that influence disease recurrence.Tumor excision was performed in 70 eyes of 70 cases (43 men, 27 women; average age: 71.6 ± 12.6 years) with dysplasia (8 eyes), carcinoma in situ (26 eyes), and invasive squamous cell carcinoma (36 eyes). Tumors were found in the limbus (<italic>N</italic> = 59 eyes), palpebral conjunctiva (<italic>N</italic> = 8 eyes), and from the bulbar to palpebral conjunctiva (<italic>N</italic> = 3 eyes). Surgical procedures performed were limbal transplantation/keratoepithelioplasty (<italic>N</italic> = 29 eyes), cultivated oral mucosal epithelial transplantation (<italic>N</italic> = 3 eyes), and auto-conjunctival epithelium transplantation (<italic>N</italic> = 2 eyes). Ocular surface was reconstructed using amniotic membrane, donor cornea, or cultivated epithelial sheet. The mean follow-up was 38.6 ± 38.6 months (range, 2 months to 13.8 years). VA postoperatively improved in 25 (61.0%) cases. Recurrence occurred in 19 (27.1%) cases at from 2 to 50 months (median: 12.5 months) postoperative. Uni- and multivariate analyses revealed that presurgical tumor size and postoperative administration of 5-FU were significantly related to recurrence.Combined surgical excision and postoperative topical 5-FU administration effectively prevented OSSN recurrence, and ocular surface reconstruction contributed to improvement of VA. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00215155
Database :
Academic Search Index
Journal :
Japanese Journal of Ophthalmology
Publication Type :
Academic Journal
Accession number :
180029140
Full Text :
https://doi.org/10.1007/s10384-024-01111-0