Abstract
Purpose
To investigate the pathology, clinical manifestations, and potential risk factors associated with the prognosis of malignant lacrimal sac tumors. In addition, the treatment outcomes and complications were also evaluated.
Methods
Ninety cases of malignant lacrimal sac tumors were retrospectively analyzed at our hospital. Pathological classifications, clinical manifestations, risk factors, and follow-up time were documented. The outcomes and complications were evaluated and compared among the various treatment modalities.
Results
The median follow-up time was 50 months (range, 3–258 months). The 5-year overall survival (OS) and progression-free survival (PFS) for all cases were 85.7 and 77.9%, respectively. The 5-year OS and PFS for 69 cases of squamous cell carcinoma were 87.6 and 76.3%, and which were 80.4 and 72.4% for 21 cases of non-squamous cell carcinoma, respectively. There was no difference of 5-year OS and PFS between squamous cell carcinoma and non-squamous cell carcinoma (p = 0.350 and p = 0.946). Positive lymph node status was associated with worse OS (p < 0.001) and PFS (p = 0.020). For the 23.3% of cases (21/90) treated with the definitive radiotherapy, the outcomes were equivalent to that of surgery combined with radiotherapy, with the incidence of treatment-related visual acuity complication not being significant. The addition of chemotherapy to the treatment course had a marginal and non-significant improvement in OS and distant metastasis-free survival.
Conclusions
Lymph node status was found to be a key factor for prognosis. Advanced tumors could benefit from multimodality treatment, with radiotherapy playing an important role. However, the role of chemotherapy requires further investigation.
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The authors declare that they have no conflict of interest.
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The study was approved by the Medical Ethical Committee of the EENT Hospital. Research was performed in accordance with the Declaration of Helsinki.
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Informed consent was obtained from all individual participants included in the study.
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Xinmao Song and Jie Wang contribute equally to this work, and they are co-first authors.
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Song, X., Wang, J., Wang, S. et al. Clinical analysis of 90 cases of malignant lacrimal sac tumor. Graefes Arch Clin Exp Ophthalmol 256, 1333–1338 (2018). https://doi.org/10.1007/s00417-018-3962-4
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DOI: https://doi.org/10.1007/s00417-018-3962-4