Abstract：
There are no large studies reporting oncological or survival outcomes for patients diagnosed with perineural spread (PNS) of cutaneous squamous cell carcinoma (cSCC) via the ophthalmic nerve (V1). Where orbital exenteration may be necessary for curative treatment, it is critical to have survival data with which the morbidity associated with surgical treatment can be justified. Furthermore, with the emerging treatment option of immunotherapy, current standard of care outcomes are needed to help guide future trial design and eventually changed management guidelines.
To determine the oncological and survival outcomes observed in patients with PNS of cSCC via V1.
Retrospective analysis of prospectively maintained cohort of patients with PNS of cSCC via V1 treated in a tertiary Australian head and neck oncology/skull base referral center. Consecutive sample of 53 patients managed between March 1, 1999 and April 30, 2020. Follow-up closure date was September 1, 2021. Curative-intent surgery, curative-intent radiotherapy, or palliative care was undertaken. Endpoints included five-year overall, disease-specific, and disease-free survival from the date of treatment.
Five-year Kaplan-Meier overall survival was 61.9% (95% CI 46.2%-74.3%), with disease-specific survival of 74.6% (95% CI 58.8%-85.3%), and disease-free survival 62.1% (95% CI 46.5%-74.3%). Survival was superior in patients treated via surgery and adjuvant radiotherapy than in those receiving surgery alone or definitive radiotherapy. Survival was superior among patients with less advanced disease as assessed by the Williams zonal staging system; patients with Zone 1 disease had disease-specific survival of 94.1% at 5 years with 82.5% disease-free survival.
Five-year oncological and survival outcomes in this cohort were favorable. Superior survival was observed in patients treated with curative-intent surgery and adjuvant radiotherapy. Less extensive disease as delineated by the Williams zonal staging system was associated with improved survival.
Surgical resection with adjuvant radiotherapy confers favourable oncological and survival outcome in patients with V1 PNS, particularly with early disease limited to Zone 1.
To determine the oncological and survival outcomes observed in patients with PNS of cSCC via V1.
Retrospective analysis of prospectively maintained cohort of patients with PNS of cSCC via V1 treated in a tertiary Australian head and neck oncology/skull base referral center. Consecutive sample of 53 patients managed between March 1, 1999 and April 30, 2020. Follow-up closure date was September 1, 2021. Curative-intent surgery, curative-intent radiotherapy, or palliative care was undertaken. Endpoints included five-year overall, disease-specific, and disease-free survival from the date of treatment.
Five-year Kaplan-Meier overall survival was 61.9% (95% CI 46.2%-74.3%), with disease-specific survival of 74.6% (95% CI 58.8%-85.3%), and disease-free survival 62.1% (95% CI 46.5%-74.3%). Survival was superior in patients treated via surgery and adjuvant radiotherapy than in those receiving surgery alone or definitive radiotherapy. Survival was superior among patients with less advanced disease as assessed by the Williams zonal staging system; patients with Zone 1 disease had disease-specific survival of 94.1% at 5 years with 82.5% disease-free survival.
Five-year oncological and survival outcomes in this cohort were favorable. Superior survival was observed in patients treated with curative-intent surgery and adjuvant radiotherapy. Less extensive disease as delineated by the Williams zonal staging system was associated with improved survival.
Surgical resection with adjuvant radiotherapy confers favourable oncological and survival outcome in patients with V1 PNS, particularly with early disease limited to Zone 1.
摘要：
背景：没有大型研究报告诊断为皮肤鳞状细胞癌（cSCC）经眼神经（V1）神经周围扩散（PNS）的患者的肿瘤或生存结果。如果眼眶切除术可能需要治愈性治疗，有生存数据证明与手术治疗相关的发病率是至关重要的.此外，随着免疫疗法的新兴治疗选择，需要当前的护理结局标准来帮助指导未来的试验设计和最终改变管理指南.
目的：确定cSCCPNS患者通过V1的肿瘤学和生存结果。
方法：回顾性分析在澳大利亚三级头颈部肿瘤/颅底转诊中心通过V1治疗的cSCCPNS患者的前瞻性维持队列。在1999年3月1日至2020年4月30日期间对53名患者进行了连续采样。后续关闭日期为2021年9月1日。治疗性手术，治愈性放射治疗，或进行姑息治疗。终点包括五年总体，疾病特异性,和从治疗之日起无病存活。
结果：五年Kaplan-Meier总生存率为61.9%（95%CI46.2%-74.3%），疾病特异性生存率为74.6%（95%CI58.8%-85.3%），无病生存率62.1%（95%CI46.5%-74.3%）。通过手术和辅助放疗治疗的患者的生存率优于仅接受手术或确定性放疗的患者。根据Williams分区分期系统评估，疾病进展较轻的患者的生存率较高；1区疾病患者5年的疾病特异性生存率为94.1%，无病生存率为82.5%。
结论：该队列的5年肿瘤和生存结局是有利的。在接受根治性手术和辅助放疗治疗的患者中观察到了较高的生存率。威廉姆斯分区分期系统描述的较少广泛的疾病与生存率的提高有关。
结论：手术切除联合辅助放疗对V1PNS患者具有良好的肿瘤学和生存结局，特别是早期疾病仅限于1区。
目的：确定cSCCPNS患者通过V1的肿瘤学和生存结果。
方法：回顾性分析在澳大利亚三级头颈部肿瘤/颅底转诊中心通过V1治疗的cSCCPNS患者的前瞻性维持队列。在1999年3月1日至2020年4月30日期间对53名患者进行了连续采样。后续关闭日期为2021年9月1日。治疗性手术，治愈性放射治疗，或进行姑息治疗。终点包括五年总体，疾病特异性,和从治疗之日起无病存活。
结果：五年Kaplan-Meier总生存率为61.9%（95%CI46.2%-74.3%），疾病特异性生存率为74.6%（95%CI58.8%-85.3%），无病生存率62.1%（95%CI46.5%-74.3%）。通过手术和辅助放疗治疗的患者的生存率优于仅接受手术或确定性放疗的患者。根据Williams分区分期系统评估，疾病进展较轻的患者的生存率较高；1区疾病患者5年的疾病特异性生存率为94.1%，无病生存率为82.5%。
结论：该队列的5年肿瘤和生存结局是有利的。在接受根治性手术和辅助放疗治疗的患者中观察到了较高的生存率。威廉姆斯分区分期系统描述的较少广泛的疾病与生存率的提高有关。
结论：手术切除联合辅助放疗对V1PNS患者具有良好的肿瘤学和生存结局，特别是早期疾病仅限于1区。
