American Joint Committee on cancer classification predicts outcome of patients with lacrimal gland Adenoid Cystic Carcinoma

dc.contributor.authorAhmad, S.
dc.contributor.authorEsmaeli, B.
dc.contributor.authorWilliams, M.
dc.contributor.authorNguyen, J.
dc.contributor.authorFay, A.
dc.contributor.authorWoog, J.
dc.contributor.authorSelvadurai, D.
dc.contributor.authorRootman, J.
dc.contributor.authorWeis, E.
dc.contributor.authorSelva-Nayagam, D.
dc.contributor.authorMcNab, A.
dc.contributor.authorDe Angelis, D.
dc.contributor.authorCalle, A.
dc.contributor.authorLopez, A.
dc.date.issued2009
dc.descriptionCopyright © 2009 American Academy of Ophthalmology Published by Elsevier Inc.
dc.description.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.
dc.description.statementofresponsibilityS. 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
dc.identifier.citationOphthalmology, 2009; 116(6):1210-1215
dc.identifier.doi10.1016/j.ophtha.2008.12.049
dc.identifier.issn0161-6420
dc.identifier.issn1549-4713
dc.identifier.orcidSelva-Nayagam, D. [0000-0002-2169-5417]
dc.identifier.urihttp://hdl.handle.net/2440/54734
dc.language.isoen
dc.publisherElsevier Science Inc
dc.source.urihttps://doi.org/10.1016/j.ophtha.2008.12.049
dc.subjectHumans
dc.subjectCarcinoma, Adenoid Cystic
dc.subjectEye Neoplasms
dc.subjectNeoplasm Invasiveness
dc.subjectNeoplasm Recurrence, Local
dc.subjectLacrimal Apparatus Diseases
dc.subjectNeoplasm Staging
dc.subjectTreatment Outcome
dc.subjectCombined Modality Therapy
dc.subjectRadiotherapy
dc.subjectOphthalmologic Surgical Procedures
dc.subjectSurvival Rate
dc.subjectRetrospective Studies
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectChild
dc.subjectSocieties, Medical
dc.subjectUnited States
dc.subjectFemale
dc.subjectMale
dc.titleAmerican Joint Committee on cancer classification predicts outcome of patients with lacrimal gland Adenoid Cystic Carcinoma
dc.typeJournal article
pubs.publication-statusPublished

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