Neoadjuvant Chemotherapy in Non-Metastatic Eyelid Sebaceous Gland Carcinoma: A Report in 10 Cases

Introduction: Eyelid sebaceous gland carcinoma (SGC) is an aggressive malignancy. Surgical excision is the standard treatment for non-metastatic eyelid SGC. This study aimed to evaluate treatment outcomes with use of neoadjuvant chemotherapy (NACT) and any change in ease/difficulty of surgical treatment in such cases.

Methods: This was a prospective interventional study conducted over 24-month period. Histopathologically, confirmed cases without any systemic metastasis were included. Clinico-demographic details were collected for 30 patients. 10 patients received NACT using cisplatin and 5-FU. Tumour response was evaluated using RECIST criteria. An ease of surgery questionnaire was used to assess difficulty of surgical treatment before and after NACT.

Results: Of the 30 patients evaluated for recruitment, 37% had recurrent SGC and 72% had advanced tumour stage. Ten patients were recruited for NACT. There was partial response in 80% and complete response in 10% cases. Tumour T category downstaging was seen in 50% of cases. While tumour dimensions/volume reduced substantially, surgical ease improved in only 40% cases.

Conclusion: A significant proportion of SGC patients evaluated in our study presented with recurrent and/or advanced disease. NACT caused tumour regression in 90% of cases. However, surgical ease improvement was limited, pointing to a need for surgical modification in such cases. Corneal ulceration was noted in 2 cases with large tumours causing a complete mechanical ptosis. Overall, the study introduced an ease of surgery questionnaire and provided insights into benefits and challenges of using NACT for eyelid SGC management.