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Maxwell Elia, Charles Tuggle, Javier Servat, Flora Levin; Primary Epithelial Malignancies of the Lacrimal Gland: Trends in Survival. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5445.
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To determine the trends in incidence, treatment, and survival of primary epithelial malignancies of the lacrimal gland in the United States from 1988 to 2010 using a systemic review of the National Cancer Institute Surveillance, Epidemiology and End Results (SEER) database.
One hundred and thirty-two cases of primary epithelial malignancy of the lacrimal gland were identified in the Surveillance, Epidemiology, and End Results (SEER) program database in the United States from 1988 to 2010. Survival rates were calculated by the Kaplan-Meier method and significance was determined using chi-squared testing.
There were 132 cases of primary epithelial lacrimal gland tumors with histopathologic confirmation in the SEER database. The most common tumor types were adenoid cystic carcinoma (51.5%), mucoepidermoid carcinoma (17.4%), adenocarcinoma in situ (15.1% ). The majority of tumors (61%) presented as locally invasive disease. The remainder, were confined to a tumor capsule (35%) or metastatic at presentation (4%). Most tumors were 2-4 cm in size at diagnosis (68%), with 19% less than 2cm and 13% greater than 4cm (13%). Surgery was the treatment of choice in 90% of patients, with 58% receiving radiation therapy (RT). There was a statistically significant improvement in survival among patients undergoing surgery versus those without surgical treatment (8.24 years vs. 1.0 year; p< 0.0001). Those undergoing radiation therapy fared poorer (2.25 years vs. 8.94 years; p = 0.02). Patients with advanced disease were significantly more likely to be treated with radiation therapy alone (70% regionally invasive or metastatic vs. 45% locally invasive; p<0.01). Patients with a history of prior malignancy had worse survival (5.3 years vs. 9.6 year; p = 0.014). There was no significant gender, age, or race predilection. There has been no significant improvement in survival between the 1988-1997 group and the 2004-2010 group (9.6 years vs. 8.36 years, p=0.77).
Surgery confers a statistically significant improvement in survival among patients diagnosed with primary epithelial tumors of the lacrimal gland and should remain an important tool in disease management. The SEER data demonstrates that there has been no significant improvement in survival among patients diagnosed with primary epithelial malignancies of the lacrimal gland during the period of data collection.
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