Abstract
BackgroundThe optimal treatment for lacrimal gland cancer remains unclear. Eye-preserving surgery, as opposed to exenteration, followed by adjuvant radiotherapy (RT), has recently been reported to deliver satisfactory outcomes, but evidence is sparse. The aim of the present study was to evaluate outcomes in patients with lacrimal gland cancer treated at two tertiary medical centers.MethodsWe retrospectively examined data from patients with lacrimal gland cancer who had received eye-preserving surgical treatment followed by adjuvant RT with or without chemotherapy, or (if the tumor was inoperable) needle biopsy with definitive RT with or without chemotherapy. Baseline clinical and pathological characteristics were considered. Outcomes of interest included post-treatment complications, overall survival (OS), locoregional progression-free survival (LPFS), and distant metastasis-free survival (DMFS).ResultsEighteen patients were included. Two-year OS, LPFS, and DMFS rates were 69.0, 76.7, and 71.4%, respectively. Patients with early-stage (T1–T2) lacrimal gland cancer had significantly better outcomes than those with advanced-stage disease (T3–T4). Two-year OS, LPFS, and DMFS rates were each 100% in patients with disease stages T1–T2, and 37.5, 50, and 37.5%, respectively, in those with disease stages T3–T4 (P < 0.05). Orbital complications were well tolerated.ConclusionsEye-sparing surgery with adjuvant RT can achieve satisfactory results in patients with T1–T2 lacrimal gland carcinoma. Disease stage T3 and above was associated with poor outcomes even with post-operative RT, likely due to distant metastasis. Adding neoadjuvant chemotherapy or adjuvant chemotherapy to current treatment strategies might be a suitable choice for this group of patients.
Highlights
Lacrimal gland tumors are among the rarest types of head and neck cancers, accounting for approximately 10% of all orbital tumors [1]
No guidelines on standard treatment for lacrimal gland carcinomas have been developed due to the rarity of these diseases, which are conventionally treated with orbital exenteration followed by radiotherapy (RT) [5, 10]
We examined clinical outcomes associated with either eye-preserving surgery followed by adjuvant RT, or needle biopsy followed by definitive RT, in a cohort of 18 patients with lacrimal gland carcinoma
Summary
Lacrimal gland tumors are among the rarest types of head and neck cancers, accounting for approximately 10% of all orbital tumors [1]. Epithelial lesions, including benign pleomorphic adenoma and malignant tumors, account for 20–30% of all lacrimal gland tumors. Non-epithelial lesions, such as inflammation, lymphoid tumors, plasmacytoma, histiocytoma, lipoma, and hemangioma account for 70–80% of all lacrimal gland tumors [2, 4, 6,7,8]. No guidelines on standard treatment for lacrimal gland carcinomas have been developed due to the rarity of these diseases, which are conventionally treated with orbital exenteration followed by radiotherapy (RT) [5, 10]. The aim of the present study was to evaluate outcomes in patients with lacrimal gland cancer treated at two tertiary medical centers
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