Authors: Christian El-Hadad, Joshua R. Ford, Shiqiong Xu, Bita Esmaeli

Author Disclosure Block: C. El-Hadad: None. J.R. Ford: None. S. Xu: None. B. Esmaeli: None.

Abstract Body:

Purpose: To investigate correlations between AJCC 8^th edition TNM classification and local recurrence, nodal metastasis, distant metastasis and death from disease in patients with conjunctival squamous cell carcinoma.
Study Design: Retrospective chart review
Methods: Patients with a diagnosis of conjunctival squamous cell carcinoma who have been treated at M.D. Anderson Cancer Center between January 1999 through August 2018 were included in this study. Clinical data including age, gender, ethnicity, previous exposure to radiation, immunosuppression, AJCC TNM criteria, type of treatment, local recurrence, nodal metastasis, and distant metastasis were recorded.
Results: 44 patients (24 men, 20 women; median age: 63 years) had AJCC stage at presentation as follows: TisN0M0 (n=18; 41%), T2N0M0 (n=7; 16%); T3N0M0 (n=13; 30%); T4aN0M0 (n=5; 11%); T4bN1M0 (n=1; 2%). 5 patients had a history of chronic immunosuppression. 34 patients presented with primary tumors and 10 with recurrent tumors. Overall, 7 patients (16%) experienced local recurrence. T categories for these patients were: Tis (n=2), T2 (n=1), T3 (n=4). Time to local recurrence ranged from 4-44 months after definitive treatment (median 17 months). None of the patients presented with nodal metastasis at presentation; 3 patients developed nodal metastasis during the follow up period (at 11, 26 and 75 months); all had presented with T3 tumors. 11 patients had an exenteration: 8, at presentation and 3, after recurrence. T categories at presentation for these 11 patients were: Tis (n=1; diffuse involvement of anophthalmic socket), T2 (n=1; blind eye and diffuse conjunctival involvement), T3 (n=3), T4a (n=5), T4b (n=1). Two patients died of disease (T3N1M1 and T4aN1M1)
Conclusions: AJCC T category of T3 or more advanced was associated with a higher risk of local recurrence, orbital exenteration, nodal metastasis, and death from disease.