Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/54734
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Type: Journal article
Title: American Joint Committee on cancer classification predicts outcome of patients with lacrimal gland Adenoid Cystic Carcinoma
Author: Ahmad, S.
Esmaeli, B.
Williams, M.
Nguyen, J.
Fay, A.
Woog, J.
Selvadurai, D.
Rootman, J.
Weis, E.
Selva-Nayagam, D.
McNab, A.
De Angelis, D.
Calle, A.
Lopez, A.
Citation: Ophthalmology, 2009; 116(6):1210-1215
Publisher: Elsevier Science Inc
Issue Date: 2009
ISSN: 0161-6420
1549-4713
Statement of
Responsibility: 
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: PURPOSE: 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. DESIGN: Retrospective chart review. PARTICIPANTS: Consecutive patients with adenoid cystic carcinoma of the lacrimal gland treated at 8 institutions between January 1986 and December 2007. METHODS: Clinical records, including pathology reports and imaging studies, were reviewed. MAIN OUTCOME MEASURES: AJCC classification, histologic subtype, local recurrence rate, and survival. RESULTS: 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. CONCLUSIONS: In patients with lacrimal gland adenoid cystic carcinoma, AJCC >T3 disease at initial diagnosis correlates with worse outcomes than does AJCC <T3 disease. FINANCIAL DISCLOSURE(S): 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.
RMID: 0020090810
DOI: 10.1016/j.ophtha.2008.12.049
Appears in Collections:Opthalmology & Visual Sciences publications

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