Carcinoma of Skin of the Eyelid
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Carcinoma of Skin of the Eyelid (ICD‐O C44.1)
There should be histological confirmation of the disease and division of cases by histological type – for example, basal cell, squamous cell, sebaceous carcinoma. Melanoma of the eyelid is classified with skin tumours, see page 142. The following are procedures for assessing T, N, and M categories: T categories Physical examination N categories Physical examination M categories Physical examination and imaging
Regional Lymph Nodes The regional lymph nodes are the preauricular, submandibular, and cervical lymph nodes.
TNM Clinical Classification T – Primary Tumour T0 No evidence of primary tumour Tis Carcinoma in situ
T1 Tumour 10 mm or less in greatest dimension T1a Not invading the tarsal plate or eyelid margin T1b Invades tarsal plate or eyelid margin T1c Involves full thickness of eyelid T2 Tumour >10 mm, but 20 mm or less in greatest dimension T2a Not invading the tarsal plate or eyelid margin T2b Invades the tarsal plate or eyelid margin T2c Involves full thickness of eyelid T3 Tumour > 20 mm, but more than 30 mm in greatest dimension T3a Not invading the tarsal plate or eyelid margin T3b Invades tarsal plate or eyelid margin T3c Involves full thickness of eyelid
Skin
Rules of Classification
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Skin Tumours
T4 Any eyelid tumour that invades adjacent ocular, or orbital, or facial structures T4a Tumour invades ocular or intraorbital structures T4b Tumour invades (or erodes through) the bony walls of orbit or extends to paranasal sinuses or invades the lacrimal sac/ nasolacrimal duct or brain
N – Regional Lymph Nodes NX Regional lymph nodes cannot be assessed N0 No evidence of lymph node involvement N1 Metastasis in a single ipsilateral regional lymph node, 3 cm or less in greatest dimension N2 Metastasis in a single ipsilateral lymph node more than 3 cm in greatest dimension or in bilateral or contralateral lymph nodes
M – Distant Metastasis M0 No distant metastasis M1 Distant metastasis
pTNM Pathological Classification The pT and pN categories correspond to the T and N categories. For pM see page 8.
Stage Stage 0 Stage IA Stage IB Stage IIA Stage IIB Stage IIIA Stage IIIB Stage IV
Tis T1 T2a T2b, T2c, T3 T4 Any T Any T Any T
N0 N0 N0 N0 N0 N1 N2 Any N
M0 M0 M0 M0 M0 M0 M0 M1
Carcinoma of Skin of the Eyelid
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Prognostic Factor Grid – Eyelid Prognostic factors for survival for eyelid cancers Host related
Essential
Location (worse prognosis if tumour involves the orbit or sinus)
Immunosuppression Perauricular and/or cervical lymph node involvement Systemic metastatic disease at presentation
Additional
BCC: nodular better than morpheaform type Sebaceous tumours have a worse prognosis than BCC or SCC
New and promising
Improvements in local control have been associated with less systemic recurrence
Environment related
Source: UICC Manual of Clinical Oncology, Ninth Edition. Edited by Brian O’Sullivan, James D. Brierley, Anil K. D’Cruz, Martin F. Fey, Raphael Pollock, Jan B. Vermorken and Shao Hui Huang. © 2015 UICC. Published 2015 by John Wiley & Sons, Ltd.
Skin
Prognostic Tumour related factors