Long-Term Outcomes of Eye-Sparing Surgery for Adenoid Cystic Carcinoma of Lacrimal Gland.

Abstract

PURPOSE:

This study's primary purpose is to assess the long-term outcomes of patients who have undergone eye-sparing surgery and adjuvant radiotherapy for adenoid cystic carcinoma of the lacrimal gland.

METHODS:

In this retrospective analysis, clinical records were reviewed of all patients diagnosed with adenoid cystic carcinoma of the lacrimal gland, at a single institution, between March 1998 and November 2012. Ten patients were identified as having undergone eye-sparing surgery and adjuvant radiotherapy for adenoid cystic carcinoma of the lacrimal gland. Preoperative radiographic findings, treatment modalities, histological results, and patient outcomes were analyzed.

RESULTS:

There were 6 male and 4 female patients. The patients' tumors were staged according to the 8th American Joint Committee on Cancer staging system, and were as follows: 1 patient was classified as T1aN0M0; 6 patients were classified as T2aN0M0; 1 patient was classified as T2cN0M0; 2 patients were classified as T3aN0M0. All patients had a histologically confirmed diagnosis of lacrimal gland adenoid cystic carcinoma, which was confined to the orbit, and was without extension into adjacent bone marrow or other organs. All patients underwent eye-sparing tumor excision followed by postoperative radiotherapy, with a median dose of 6000 cGy (range: 5000-6600 cGy). At the last follow up, 8 patients were alive without evidence of disease. One patient was deceased at 58 months post-surgery, due to esophageal carcinoma; this was unrelated to the lacrimal gland tumor. The final patient experienced tumor recurrence in the medial orbit 53 months post-surgery, and exenteration was performed. This patient was alive, without disease recurrence, at 90 months following exenteration. The median follow-up time was 89.5 months (range: 37-217 months). Systemic metastasis did not occur in any patient.

CONCLUSIONS:

Eye-sparing surgery and adjuvant radiotherapy have demonstrated favorable local control and long-term survival outcomes in patients with orbit-confined lacrimal gland adenoid cystic carcinoma. Consequently, eye-sparing surgery with adjuvant radiotherapy can be considered as a viable treatment option for orbit-confined lacrimal gland adenoid cystic carcinoma.

• Authors: Jisang Han, Yoon-Duck Kim, Kyung In Woo, Deepak Sobti
• Journal: Ophthalmic plastic and reconstructive surgery (Ophthalmic Plast Reconstr Surg) 2018 Jan/Feb Vol. 34 Issue 1 Pg. 74-78 ISSN: 1537-2677 [Electronic] United States
• PMID: 28221296 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Biopsy
• Carcinoma, Adenoid Cystic (diagnosis, surgery)
• Child
• Eye Neoplasms (diagnosis, surgery)
• Female
• Follow-Up Studies
• Humans
• Lacrimal Apparatus (pathology, surgery)
• Lacrimal Apparatus Diseases (diagnosis, surgery)
• Male
• Middle Aged
• Neoplasm Staging
• Ophthalmologic Surgical Procedures (methods)
• Retrospective Studies
• Time Factors
• Treatment Outcome
• Young Adult