Título

RECURRENCE OF OCULAR SURFACE SQUAMOUS NEOPLASIA (OSSN) AFTER TREATMENT IN A TERTIARY HOSPITAL IN SAO PAULO

Objetivo

To evaluate recurrence of Ocular Surface Squamous Neoplasia (OSSN) cases after treatment with topical chemotherapy, surgery or neoadjuvant chemotherapy at the ocular oncology outpatient clinic of Federal University of São Paulo (UNIFESP).

Método

Medical records of OSSN cases that underwent treatment and follow-up between 2013 and 2019 were reviewed retrospectively. Patients with insufficient data or loss of follow up were excluded from analysis. Data regarding age, sex and treatment modalities were analyzed. In addition, comorbidities such as diabetes, hypertension, dyslipidemia, immunosuppression, smoking, or alcoholism were evaluated.

Resultado

A total of 162 cases of ocular surface tumors were selected for the study. Recurrence was observed in 11 cases (6.79%), figure 1 is an illustrative example. Median time of recurrence since treatment was 18.79±19.0 months. No statistically significant difference were found in sex, age at treatment, hypertension, diabetes, dyslipidemia, immunosuppression, smoking and alcoholism among participants who had or did not have recurrency (p> 0.05). There was a statistically significant difference (p=0.010) in recurrence rates according to the treatment applied, with higher rates in laser treatment (20.00%) followed by neoadjuvant chemotherapy (11.90%) and surgical exeresis (7.55%). No recurrence was observed in treatment with any of the 3 types of chemotherapy (table 1) Firth multiple logistic regression shows that cases treated with laser were 33 times more likely to have recurrence than cases treated with topical chemotherapy (OR=33.82; 95% CI: 1.49 - 766.45; p=0.027).

Conclusão

Our results (6.8%) showed better outcome than international literature as several studies report OSSN recurrence rates ranging from 13% to 37%. Our study showed lower incidence of recurrence, especially with topical chemotherapy as monotherapy. In addition, cases treated with laser had 33 times increased chance of recurrence when compared to cases treated with topical chemotherapy.