Analysis of Clinical Features and Prognostic Factors of Ocular Surface Squamous Neoplasia

Hyun Ho Jung; Jee Myung Yang; Kyung Chul Yoon

doi:10.3341/jkos.2014.55.4.506

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Jung, Yang, and Yoon: Analysis of Clinical Features and Prognostic Factors of Ocular Surface Squamous Neoplasia

Original Article

J Korean Ophthalmol Soc 2014;55(4):506-512.

Published online: 7 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.4.506

Analysis of Clinical Features and Prognostic Factors of Ocular Surface Squamous Neoplasia

Hyun Ho Jung, MD, Jee Myung Yang, MD, Kyung Chul Yoon, MD, PhD

Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea

Address reprint requests to Kyung Chul Yoon, MD, PhD Department of Ophthalmology, Chonnam National University Hospital, #42 Jebong-ro, Dong-gu, Gwangju 501-757, Korea, Tel: 82-62-220-6741, Fax: 82-62-227-1642 E-mail: kcyoon@jnu.ac.kr

Received 13 July 201315 September 2013 Accepted 15 March 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To analyze the clinical features and prognostic factors of ocular surface squamous neoplasia (OSSN).

Methods

A total of 31 eyes of 31 patients with suspected OSSN who were treated with excision and biopsy were retrospectively reviewed. Clinical features such as patient symptoms, invasion type, morphologic feature and size of lesion were analyzed. All patients were treated with simple excision or mitomycin C combination therapy. Factors affecting recurrence were evaluated.

Results

The most common symptom, invasion type, morphological feature, lesion size and histological diagnosis were foreign body sensation (38.7%), combined conjunctiva and cornea type (71.0%), gelatinous type (74.2%), 5 - 10 mm in largest diameter (45.2%) and intraepithelial neoplasia (51.6%), respectively. Age, sex, morphological features, lesion size and histological diagnosis had no effect on recurrence. Mitomycin C combination therapy was significantly associated with decreased recurrence compared to simple excision (p < 0.05).

Conclusions

In OSSN, intraepithelial neoplasia was the most common subtype. Mitomycin C combination therapy was effective in decreasing recurrence.

Keywords: Mitomycin C, Ocular surface squamous neoplasia

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Figure 1.

Frequency of symptoms and signs of ocular surface squamous neoplasia. The patients’ most common symptom was foreign body sensation (38.7%).

Figure 2.

Characteristics of ocular surface squamous neoplasia. (A) Frequency distribution of the tumor invasion type. The most common type was the combined conjunctiva and cornea type (71.0%). (B) Frequency distribution of macroscopic appearance. The most common type was the gelatinous type (74.2%). (C) Frequency distribution of the tumor size based on the largest diameter. The most common size was 5 to 10 mm in the largest diameter (45.2%). (D) Frequency distribution of the histologic diagnosis. The most common type was intraepithelial neoplasia (51.6%).

Table 1.

Demographics of 31 patients with ocular surface squamous neoplasia

Age (years)
Mean ± SD	70.1 ± 10.6
Range	35-94
Sex (Male : Female)	20:11
Systemic disease (number)	8 (25.8%)
Diabetes mellitus	3
Hypertension	3
Leukemia	2
Sun exposure	4 (12.9%)
Smoking	7 (22.6%)
Interval between symptom onset and treatment (days)
Mean ± SD	51.2 ± 48.0
Range	7-180
Follow up duration (months)
Mean ± SD	28.9 ± 15.3
Range	6-50

Values are presented as mean ± SD.

SD = standard deviation.

Table 2.

Univariate analysis for factors affecting recurrence in patients with ocular surface squamous neoplasia

Variables	Number of patients		p-value
Variables	Recurrence group	Non-recurrence group	p-value
Age			0.464^*
Mean ± SD (years)	69.9 ± 4.9	70.3 ± 11.7
Sex			0.095^†
Male/Female	3/5	17/6
Macroscopic appearance			0.915^†
Gelatinous	6	17
Papilliform	1	4
Leukoplakic	1	2
Tumor size (largest diameter)			0.878^†
<5 mm	3	7
5-10 mm	3	11
>10 mm	2	5
Operation method			0.045^†
Surgical excision	7	10
Surgical excision + 0.02% mitomycin C chemotherapy	1	13
Histologic diagnosis			0.354^†
Squamous hyperplasia	0	4
Intraepithelial neoplasia	5	11
Squamous cell carcinoma	3	5
Squamous papilloma	0	3

Values are presented as mean ± SD.

SD = standard deviation.

^* Mann-Whitney U-test

^† Chi-square test.

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