• Written By:
    Cornea/External Disease, Ocular Pathology/Oncology

    This retrospective study examined the characteristics and outcomes of patients with conjunctival squamous cell carcinoma (SCC).

    Study design

    Investigators identified 54 patients with histology-proven standard invasive SCC or microinvasive SCC (<0.2mm invasion of the chorion) who were treated at single-center between 2002 and 2017. Patients received surgical excision with the no-touch technique, with subgroups receiving adjunctive therapy with mitomycin C and/or proton beam radiation.


    Irradiation was the only factor associated with a lower risk for local relapse (HR 0.25, P=0.045). No patients with microinvasive SCC received proton therapy; the microinvasive group had slightly worse relapse rates compared with the standard SCC group (20% vs. 12%; P=0.079). Metastatic conjunctival carcinoma resulted in 2 deaths (3.7%).


    Given the study's retrospective nature and overall small sample size, the authors were unable to perform a multivariate analysis to determine the individual effects of mitomycin C and proton beam radiation. Although the greater recurrence of disease in the microinvasive SCC group is not a novel finding, it does raise the question as to the role for possible proton therapy, but this was not addressed in the study.

    Clinical significance

    The authors suggest a possible beneficial role for proton therapy for those with this potentially lethal disease. The role of mitomycin C remains unclear.