Multimodal treatment with Neoadjuvant chemotherapy for eyelid and periocular sebaceous gland carcinoma: Long-term outcomes.

Purpose: To report the long-term outcomes of multimodal treatment with intravenous cisplatin and 5-fluorouracil-based neoadjuvant chemotherapy (NACT) for advanced eyelid and periocular sebaceous gland carcinoma (eSGC). Observations: Three patients of eSGC with 10-year follow-up were reviewed. The mean age at presentation of eSGC was 50 years (median, 50 years; range, 41-59 years). The lower eyelid was the tumor epicenter in two (66 %) patients and the medial canthus in one (33 %) patient. The mean tumor basal diameter was 27 mm (median, 30 mm, range, 20-30 mm). Orbital extension was present in all patients. By the 8th edition of AJCC classification, tumors belonged to T4aN0M0 in 2 patients and T4aN1M0 in 1 patient. NACT with 5-Fluorouracil and cisplatin was administered in all patients for a mean of 3 cycles (median, 3; range, 2 to 3). The mean percentage of clinical tumor volume reduction after neoadjuvant chemotherapy was 93 % (median, 100 %; range, 80 %-100 %). Three months after NACT, two patients underwent excisional biopsy of residual tumor, all 3 underwent external beam radiotherapy to the orbit and adjuvant systemic chemotherapy, and 1 with lymph node metastasis at presentation received EBRT to the lymph node area. At a mean follow-up period of 11 years (median, 11 years; range, 10-11 years) after NACT initiation, tumor control, life salvage, and globe salvage were achieved in all patients. No events of tumor recurrence, metastasis, or death were noted. Conclusions and importance: The long-term outcomes in patients with eyelid and periocular SGC who achieve tumor control with platinum-based NACT seem promising.