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|Title:||American Joint Committee on cancer classification predicts outcome of patients with lacrimal gland Adenoid Cystic Carcinoma|
De Angelis, D.
|Citation:||Ophthalmology, 2009; 116(6):1210-1215|
|Publisher:||Elsevier Science Inc|
|S. Mehdi Ahmad, Bita Esmaeli, Michelle Williams, John Nguyen, Aaron Fay, John Wood, Deepan Selvadurai, Jack Rootman, Ezekiel Weis, Dinesh Selva, Alan McNab, Dan DeAngelis, Alberto Calle and Adriana Lopez|
|Abstract:||<h4>Purpose</h4>To investigate whether American Joint Committee on Cancer (AJCC) classification at initial diagnosis of lacrimal gland adenoid cystic carcinoma predicts outcome of treatment on local recurrence.<h4>Design</h4>Retrospective chart review.<h4>Participants</h4>Consecutive patients with adenoid cystic carcinoma of the lacrimal gland treated at 8 institutions between January 1986 and December 2007.<h4>Methods</h4>Clinical records, including pathology reports and imaging studies, were reviewed.<h4>Main outcome measures</h4>AJCC classification, histologic subtype, local recurrence rate, and survival.<h4>Results</h4>AJCC classification at initial diagnosis was assessable for 53 patients and was as follows: T1N0M0, 7 patients; T2N0M0, 8 patients; T3aN0M0, 14 patients; T3aNxM0, 1 patient; T3aN0M1, 1 patient; T3bN0M0, 13 patients; T3bN0M1, 1 patient; T4aN0M0, 2 patients; T4bN0M0, 4 patients; T4bN0M1, 1 patient; and T4bNXM0, 1 patient. Thirty-eight (72%) of the 53 patients had >T3 tumors at presentation. Of the 38 patients with >T3 tumors, 20 were treated with orbital exenteration and postoperative adjuvant radiotherapy (RT), 6 were treated with orbital exenteration without RT, and 12 were treated with globe-preserving surgery (10 with RT and 2 without RT). Of the 15 patients with <T3 tumors, 6 were treated with globe-preserving surgery and RT, 2 were treated with globe-preserving surgery without RT, 6 were treated with orbital exenteration with bone removal and RT, and 1 was treated with orbital exenteration with bone removal without RT. Only 1 patient with a <T3 tumor, had local recurrence. Among patients with >T3 tumors, the risk of local recurrence (in the orbit or skull base) was higher in patients treated with conservative surgery as opposed to orbital exenteration and RT. Only 4 (20%) of the 20 patients treated with orbital exenteration and RT had local recurrence, compared with 3 (50%) of the 6 patients treated with orbital exenteration without RT and 8 (67%) of the 12 patients treated with globe-preserving surgery. Overall, 17 (45%) of the 38 patients with >T3 tumors and only 1 (7%) of the 15 patients with <T3 tumors died of disease during the study period.<h4>Conclusions</h4>In patients with lacrimal gland adenoid cystic carcinoma, AJCC >T3 disease at initial diagnosis correlates with worse outcomes than does AJCC <T3 disease.<h4>Financial disclosure(s)</h4>The author(s) have no proprietary or commercial interest in any materials discussed in this article.|
|Keywords:||Humans; Carcinoma, Adenoid Cystic; Eye Neoplasms; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Lacrimal Apparatus Diseases; Neoplasm Staging; Treatment Outcome; Combined Modality Therapy; Radiotherapy; Ophthalmologic Surgical Procedures; Survival Rate; Retrospective Studies; Adolescent; Adult; Aged; Middle Aged; Child; Societies, Medical; United States; Female; Male|
|Description:||Copyright © 2009 American Academy of Ophthalmology Published by Elsevier Inc.|
|Appears in Collections:||Opthalmology & Visual Sciences publications|
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