Recurrence of Ocular Surface Squamous Neoplasia Treated With Excisional Biopsy and Cryotherapy
Recurrence of Ocular Surface Squamous Neoplasia Treated With Excisional Biopsy and Cryotherapy
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DOI：
10.1016/j.ajo.2015.04.027
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发表时间：
2015-08-01
影响因子：
4.2
通讯作者：
Udell, Ira J.
中科院分区：
文献类型：
--
作者：
Li, Albert S.;Shih, Carolyn Y.;Udell, Ira J.
目的：评价眼表鳞状细胞瘤(OSSN)手术切除和冷冻治疗后的复发率，并确定复发的相关因素。设计：回顾性干预病例系列。方法：回顾1998-2013年间所有行切除活检和辅助冷冻治疗的OSSN病例。记录临床特征，包括病变大小、位置和不典型特征。记录所有OSSN切除和冷冻治疗后的复发情况，并根据临床特征、病理分级和边缘侵犯情况对其进行分类。结果：42例OSSN患者43例，平均随访29个月。共有32.6%的受试者有不典型增生，67.4%的受试者有鳞状细胞癌(SCC)。共有83.7%的受试者同时有角膜和结膜受累，而16.3%的受试者只有结膜受累。总体而言，观察到3次复发，均有切缘受累；然而，大多数未完全切除的OSSN(25/28)没有复发。术后6个月复发率为2.3%。1年、2年、5年复发率稳定在7.1%。结论：手术切除加冷冻治疗OSSN是一种有效的治疗方法，即使在边缘有肿瘤病理证据的病例中也是如此，1年、2年、5年的总复发率为7.1%。((C)2015年，爱思唯尔公司。保留所有权利。)
PURPOSE: To evaluate the recurrence rate of ocular surface squamous neoplasias (OSSN) after excision and cryotherapy in an academic cornea practice and to determine factors associated with recurrence.DESIGN: Retrospective interventional case series.METHODS: All cases of OSSN from 1998 through 2013 that were treated with excisional biopsy and adjunctive cryotherapy were retrospectively reviewed. Clinical characteristics upon presentation including size of lesion, location, and atypical features were noted. All recurrences of OSSN after excision and cryotherapy were noted and categorized in relation to clinical characteristics, pathologic grade, and margin involvement.RESULTS: Forty-three cases of OSSN from 42 patients were analyzed with a median follow-up of 29 months. A total of 32.6% of subjects had dysplasia and 67.4% had squamous cell carcinoma (SCC). A total of 83.7% of subjects had both corneal and conjunctival involvement while 16.3% had conjunctival involvement only. Overall, 3 recurrences were observed, all of which had margin involvement; nonetheless, the majority of incompletely excised OSSN (25/28) showed no recurrence. The recurrence rate at 6 months was 2.3%. Recurrence at 1 year, 2 years, and 5 years remained stable at 7.1%.CONCLUSIONS: Excision with cryotherapy is an effective treatment for the majority of OSSN cases, even among cases with pathologic evidence of tumor at the margin, with an overall recurrence rate of 7.1% at 1 year, 2 years, and 5 years. ((C) 2015 by Elsevier Inc. All rights reserved.)