Purpose

To evaluate whether the long-term clinical and oncological outcomes of eyelid squamous cell carcinoma (SCC) have improved over a 10-year period, with 5-year follow-up.

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Methods

A retrospective cohort study was undertaken of patients with biopsy-proven eyelid SCC managed at a tertiary referral centre between February 2011 and February 2021. Only cases with 5-year follow-up were included. Demographic, clinical, histological, management and outcome data were collected. Patients were divided into two chronological cohorts to assess changes in outcomes over time. Primary outcomes included margin status, local recurrence, regional or distant metastasis, and 2- and 5-year disease-specific and overall survival.

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Results

A total of 43 patients with eyelid SCC were identified, comprising 22 males and 21 females, with a mean age at diagnosis of 77 years. Tumours most frequently involved the upper eyelid (48.8%), followed by the lower eyelid (30.2%), medial canthus (14.0%), and lateral canthus (7.0%). Local recurrence was rare, occurring in 1 patient (2.3%). Overall survival was 79.1% at 2 years and 65.1% at 5 years. Disease-specific survival remained 95.3% at both 2 and 5 years of follow-up. Factors associated with poorer survival included nodal metastasis at presentation, higher tumour T category and perineural invasion on histology. Comparison between the two chronological cohorts demonstrated improved overall survival in the later cohort at both 2 years (85.7% vs 72.7%) and 5 years (71.4% vs 59.1%). Kaplan-Meier survival analysis further supported a trend towards improved overall survival over time.

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Conclusion

Eyelid SCC was associated with favourable disease-specific survival in this cohort. There was a trend in improving survival outcomes over time, potentially reflecting advances in diagnosis, multidisciplinary management and surveillance. Nodal metastasis at presentation, higher tumour T category, and perineural invasion were associated with poorer survival and may help identify patients who warrant more aggressive multimodal treatment approach, closer monitoring and more intensive follow-up.

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Additional Authors

First name	Last name	Base Hospital / Institution
Seohyun	Lee	University Hospitals of Leicester
Agni	Mokka	University Hospitals of Leicester
Eman	Daoud	University Hospitals of Leicester
Joyce	Burns	University Hospitals of Leicester
Antonella	Berry-Brincat	University Hospitals of Leicester
Raghavan	Sampath	University Hospitals of Leicester

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