Neoadjuvant Chemotherapy in Non-Metastatic Eyelid Sebaceous Gland Carcinoma: A Report in 10 Cases.

Introduction: Eyelid sebaceous gland carcinoma (SGC) is an aggressive malignancy. Surgical excision is the standard treatment for non-metastatic eyelid SGC. This study aimed to evaluate treatment outcomes with use of neoadjuvant chemotherapy (NACT) and any change in ease/difficulty of surgical treatment in such cases. Methods: This was a prospective interventional study conducted over 24-month period. Histopathologically, confirmed cases without any systemic metastasis were included. Clinico-demographic details were collected for 30 patients. 10 patients received NACT using cisplatin and 5-FU. Tumour response was evaluated using RECIST criteria. An ease of surgery questionnaire was used to assess difficulty of surgical treatment before and after NACT. Results: Of the 30 patients evaluated for recruitment, 37% had recurrent SGC and 72% had advanced tumour stage. Ten patients were recruited for NACT. There was partial response in 80% and complete response in 10% cases. Tumour T category downstaging was seen in 50% of cases. While tumour dimensions/volume reduced substantially, surgical ease improved in only 40% cases. Conclusion: A significant proportion of SGC patients evaluated in our study presented with recurrent and/or advanced disease. NACT caused tumour regression in 90% of cases. However, surgical ease improvement was limited, pointing to a need for surgical modification in such cases. Corneal ulceration was noted in 2 cases with large tumours causing a complete mechanical ptosis. Overall, the study introduced an ease of surgery questionnaire and provided insights into benefits and challenges of using NACT for eyelid SGC management.

Neoadjuvant Systemic Chemotherapy in Sebaceous Gland Carcinoma of the Eyelid: A Retrospective Study.

There are sparse data on neoadjuvant systemic chemotherapy (NACT) in eyelid sebaceous gland carcinoma (SGC). The aim of this study was to evaluate efficacy and outcomes with NACT in eyelid SGC. We retrospectively analyzed 8 patients who received platinum-based NACT. The median number of cycles per patient was 4 (range, 3-5). The mean percentage reduction of tumor diameter after NACT was 71% (range, 30-100%). Two patients had a radiological complete response (CR). After NACT, surgical treatment for residual tumor was performed in 5 cases. One patient had a pathological CR and is recurrence free for 11 years. After a mean follow-up period of 44.5 months (range, 9-109), tumor recurrence occurred in 4 cases. Among these 4 cases, 3 were rechallenged with the same regimen and all responded. Systemic NACT has a role in eyelid SGC, downstages the tumor, and allows less aggressive and organ-sparing surgeries, warranting a prospective study.