Background Metastasis dominates the prognosis of eyelid sebaceous carcinoma (SC). This study aimed to explore risk factors for nodal metastasis and develop a nomogram to predict nodal metastasis in patients with eyelid SC. Methods A retrospective case–control study was performed, comprising 320 patients with eyelid SC. Cox analyses were employed to investigate predictors of metastasis-free survival (MFS), and a nomogram was established and validated by the bootstrap method. Results Forty patients (12.5%) developed nodal metastasis during a median follow-up of 48.0 months, and the median period between the initial treatment and first nodal metastasis was 18.5 months (range 6.0–80.0 months). The 1-year, 3-year and 5-year nodal metastasis rates were 5.5%, 12.5% and 15.4%, respectively. Diffuse pattern (HR: 4.34, 95% CI 1.75 to 10.76, p=0.002), orbital invasion at presentation (HR: 3.22, 95% CI 1.42 to 7.33, p=0.005), perineural invasion (HR: 3.24, 95% CI 1.11 to 9.49, p=0.032) and high Ki-67 percentage (HR: 1.03, 95% CI 1.01 to 1.05, p<0.001) were identified as independent risk factors for nodal metastasis. A nomogram that integrated these four factors had a C-index of 0.785, demonstrating a strong power in predicting nodal metastasis of eyelid SC. Conclusions We identified risk factors for nodal metastasis and developed a nomogram to provide individualised estimates of nodal metastasis for eyelid SC patients and guide postoperative management. This nomogram contained clinicopathological factors besides the T category of the TNM staging system and suggesting great clinical value. All data relevant to the study are included in the article or uploaded as supplementary information. All datasets generated for this study are included in the article.

中文翻译：

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弥漫型、眼眶浸润、神经周围浸润和Ki-67与眼睑皮脂腺癌患者的淋巴结转移相关

背景 转移决定了眼睑皮脂腺癌 (SC) 的预后。本研究旨在探讨淋巴结转移的危险因素，并开发列线图来预测眼睑 SC 患者的淋巴结转移。方法 进行了一项回顾性病例对照研究，包括 320 名眼睑 SC 患者。采用 Cox 分析来研究无转移生存期 (MFS) 的预测因子，并建立了列线图并通过 bootstrap 方法进行了验证。结果 40 名患者 (12.5%) 在中位随访 48.0 个月期间发生淋巴结转移，初始治疗与第一次淋巴结转移之间的中位时间为 18.5 个月（范围 6.0-80.0 个月）。1年、3年和5年淋巴结转移率分别为5.5%、12.5%和15.4%。弥散模式（HR：4.34，95% CI 1.75 至 10.76，p=0.002），眼眶侵犯（HR：3.22，95% CI 1.42 至 7.33，p=0.005）、神经周围侵犯（HR：3.24，95% CI 1.11 至 9.49，p=0.032）和高 Ki-67 百分比（HR：1.03， 95% CI 1.01 至 1.05，p<0.001) 被确定为淋巴结转移的独立危险因素。综合这四个因素的诺模图的 C 指数为 0.785，表明在预测眼睑 SC 的淋巴结转移方面具有强大的能力。结论 我们确定了淋巴结转移的危险因素并开发了列线图以提供眼睑 SC 患者淋巴结转移的个体化估计并指导术后管理。该列线图包含除 TNM 分期系统的 T 类之外的临床病理因素，表明具有重要的临床价值。所有与研究相关的数据都包含在文章中或作为补充信息上传。