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Jazmin Lucero Pedro Aguilar, Diana Alvarez-Melloni, Yvette Uribe-Martinez, Arturo J Ramirez-Miranda, Alejandro Navas, Aida Jimenez-Corona, Enrique O Graue; TEN-YEAR CLINICOPATHOLOGICAL REVIEW OF OCULAR SURFACE SQUAMOUS NEOPLASIA IN AN OPHTHALMOLOGICAL CENTER IN MEXICO CITY. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1492.
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To evaluate clinical and histopathologic factors of squamous conjunctival neoplasia associated with recurrence.
Retrospective, clinical case series. A systematical revision of the clinical records of 358 patients who underwent excisional biopsy for OSSN were analyzed, at the Instituto de Oftalmologia “Conde de Valenciana” in Mexico City from January 2003 to October 2013.
There were 110 eyes of 108 patients (62 men and 48 women), with an age range of 6-93 years (mean, 59.3 years). 49 eyes (44.5%) had lesions in the right eye; 57 eyes (51.8%) had lesions in nasal quadrant. The most common histologic report was carcinoma in situ (39%), followed by actinic keratosis (21%), squamous papilloma (15.4%), mild dysplasia (9%), squamous cell carcinoma (SCC, 4.5%) and pseudoepitheliomatous hyperplasia (1.8%). Recurrences were seen in 5% for benign lesions, 28.2% in preinvasive lesions and none of the tumors in the invasive, occurring 38 and 9.3 months after primary treatment for benign and preinvasive lesions respectively. Recurrence was not correlated significantly to age, gender, location, clinical appearance, or size of the tumor at presentation. However, tumors with both corneal and conjunctival involvement and positive margins were associated to higher risk of recurrence (P= 0.03 and 0.04 respectively). In addition, age over 50-years (HR= 3.23, 95% Confidence Interval, P=0.22) increased the risk of tumor recurrence. Treatment with adjuvant cryotherapy not demonstrated to be a predictor of recurrence.
Tumors with limbal involvement and positive margins were at higher risk for recurrence. Based on outcomes of our surgical procedures, we proposed a diagnostic and treatment algorithm for the management of OSSN in order to standardize diagnostic and therapeutic criteria, and construct recommendations focused on our population to improve the success in the treatment and prognosis of this group.
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