Epidemiology of sebaceous carcinoma of the head and neck: implications for lymph node management.

BACKGROUND The purpose of this study was to describe the incidence of nodal disease in sebaceous carcinoma and its impact on survival. METHODS Data from the 17 registries of the Surveillance, Epidemiology, and End Results (SEER) database was retrospectively collected for sebaceous carcinoma from 1973 to 2007. Information on location, histologic grade, stage of disease, and survival was gathered. RESULTS One thousand eight hundred thirty-six sebaceous carcinomas were diagnosed during the time period: 633 (34.5%) in the eyelid and 786 (42.8%) in the extraocular head and neck skin. Eyelid sebaceous carcinomas had higher histologic grade compared with tumors in extraocular sites (p < .001). Ocular sebaceous carcinomas had a higher incidence of regional or distant metastases at presentation (4.4%) compared with extraocular head and neck sites (0.9%; p = .03). There was a high incidence of N+ disease in poorly differentiated ocular sebaceous carcinomas (15.2%). CONCLUSION The incidence of nodal disease was higher with eyelid tumors. Sentinel lymph node biopsy can be considered for eyelid tumors, but not for non-eyelid head and neck tumors.