Posted: Thursday, February 1, 2024
Squamous cell carcinoma of the eyelid is a rare and aggressive type of skin cancer, requiring the expertise of a multidisciplinary medical team for effective treatment. In the Japanese Journal of Clinical Oncology, Yasuyoshi Sato, MD, PhD, of the University of Tokyo Hospital, and colleagues performed an extensive exploration into this type of skin cancer, sharing information on its pathogenesis, diagnosis, and recommended treatment strategies as well as noting the need for constructing a clinical evidence base.
Treatment of eyelid cancers is uniquely tricky, according to the researchers, as it greatly impacts a patient’s vision and quality of life. Eyelid squamous cell carcinoma typically presents as a mass that continues to grow painlessly despite various treatment options. Unlike its more common counterpart, basal cell carcinoma eyelid cancers, treating advanced stages of squamous cell carcinoma poses challenges. For advanced cases, collaboration from a team of specialists—including ocular oncologists, medical oncologists, radiation oncologists, pediatricians, and psychologists—is critical for a patient’s success, the investigators noted.
According to the study authors, there are three options for treating locally advanced eyelid squamous cell carcinomas: surgery, definitive radiotherapy, and adjuvant radiotherapy. The choice of radiotherapy is contingent on lymph node metastasis results obtained from a biopsy of the lesion, they added. Eyelid squamous cell carcinoma may also manifest in situ. Treatment for in situ lesions includes surgical resection, local chemotherapy, cryotherapy, and photodynamic therapy. In rare cases where eyelid squamous cell carcinomas have become metastatic, chemotherapy has been considered. However, no randomized controlled trial has yet provided a standardized care method.
Patients require long-term follow-up care, even if resection margins are negative. The current recommended frequency of follow-up is 5 years for squamous cell carcinoma, in which the recurrence rate has been reported to be 2.4% to 36.9%.
Disclosure: For full disclosures of the study authors, visit academic.oup.com.