Abstract
Purpose :
Ocular surface squamous neoplasia (OSSN) is a spectrum of malignancies that generally includes conjunctival intraepithelial neoplasia (CIN) and squamous cell carcinoma (SCC). OSSN can be treated with topical therapies including interferon α-2b (IFN), mitomycin-C (MMC), or 5-fluorouracil 1% (5FU). Recently, due to unavailability of IFN and MMC associated toxicity, therapy has shifted towards 5FU. Herein, we compare the use of 5FU 1% as a primary versus (vs.) secondary treatment regimen in eyes with moderate to extensive OSSN.
Methods :
Retrospective cohort study of 73 consecutive patients with unilateral moderate to extensive OSSN treated with 5FU 1% (4 times daily for 2 weeks with an option for 2-weekly extension) at a single tertiary ocular oncology center from 2016 to 2023.
Results :
In the 73 patients analyzed, a comparison (primary vs. secondary treatment) revealed no difference in mean tumor basal dimension (19.6 vs. 17.2 mm, p=0.46), thickness (3.7 vs. 3.4 mm, p=0.64), or tumor extent (4.4 vs. 4.5 clock hours, p=0.92). The primary treatment group showed greater complete tumor control (77% vs. 38%, p=0.04). Multivariable comparative analysis (primary vs. secondary treatment) showed primary treatment more likely to achieve complete tumor control (p=0.01). There was no difference in the complication rate from 5FU treatment between the groups. There was no difference in visual outcome, tumor-related metastasis (0%) or death (0%).
Conclusions :
Topical 5FU 1% is efficacious and safe as a primary or secondary topical treatment modality for moderate to extensive OSSN. It is an efficient replacement of IFN and MMC, with excellent outcomes and often complete resolution in patients with moderate to extensive OSSN.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.