Treatment and prognosis in a series of primary extranodal lymphomas of the ocular adnexa

Baldini, Luca; Blini, M.; Guffanti, Andrea; Fossati, V.; Colombi, M.; Targia, M.L. La; Bertoni, Francesco; Alietti, A.; Neri, Antonino; Bertoni, G.

doi:10.1023/a:1008327301372

Cited by 71 publications

(54 citation statements)

References 11 publications

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“…5,18 Indeed, follicular lymphoma was not diagnosed in the present study, while studies of Western populations report follicular lymphoma is the second most common subtype. 6,19 A high MALT lymphoma frequency in the current and previous studies suggests extranodal predominance might be a characteristic of malignant lymphomas in Korea. Such findings might be related to the high prevalence of Helicobacter pylori infection in Korea.…”

Section: Discussionsupporting

confidence: 55%

Prognosis for Patients in a Korean Population with Ocular Adnexal Lymphoproliferative Lesions

Yoon¹,

Tak²,

Kim³

et al. 2007

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: To analyze the clinical features, treatment outcomes, and prognostic factors associated with lymphoproliferative lesions of the ocular adnexa in a Korean population.Methods: Data from 69 patients treated for adnexal lymphoproliferative disease in the 12-year period from 1991 to 2002 were retrospectively evaluated.Results: The 69 patients had a median age of 46 years (range, 15-73 years); 60 of these patients were diagnosed with extranodal marginal zone B cell lymphomas (MALT lymphomas) and had 10 year cause specific survival and relapse free survival rates of 95.6% and 82.6%, respectively. Of 6 patients (8.7%) with concurrent systemic lymphoma, including 4 diagnosed with stage IV disease, 3 died from lymphoma. Only one patient with a primary ocular adnexal MALT lymphoma developed systemic lymphoma, which was treated with surgical resection. Local recurrence either at the primary site or in the fellow eye occurred in 11.6% of patients at a median follow-up time of 102 months (range, 79 -132 months), and was controlled using repeat irradiation in all cases. Statistical analysis showed the presence of concurrent systemic lymphoma, bilateral disease, and an advanced stage at diagnosis, were linked to lymphoma-related death (Log-rank test, p Ͻ 0.05) and systemic progression (Fisher's exact test, p Ͻ 0.05), and that the tumor location was not a prognostic factor for lymphoma-related death or relapse at any site.Conclusions: Ocular adnexal lymphoproliferative disease in Koreans occurred at a relatively young age, and was mostly orbitally located and of the MALT subtype, which is highly localized and rarely associated with extraorbital relapse. Primary or secondary status, stage at presentation, and bilaterality were found to be prognostic factors.

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Section: Discussionsupporting

confidence: 55%

Prognosis for Patients in a Korean Population with Ocular Adnexal Lymphoproliferative Lesions

Yoon¹,

Tak²,

Kim³

et al. 2007

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…Several case series have included patients who did not undergo any additional treatment after surgical excision. 4,[11][12][13]48,[61][62][63][64][65] Although several patients may remain free of recurrence during the subsequent surveillance period, we, like most authors, conclude that this approach is inferior.…”

Section: Surgical Resectionmentioning

confidence: 45%

Extranodal marginal zone lymphoma of the ocular adnexa

Stefanovic

Lossos

2009

Blood

199

214

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“…18,42 However, this approach has not been fully evaluated; the outcome was clearly indicated for only 8 patients in these reports. 13,36,45,46,91 Two (25%) of these 8 patients did not experience relapse, 3 (37.5%) experienced local recurrence at the initial ophthalmologic site, and 3 (37.5%) contracted disseminated extra-ophthalmologic disease. More recently, Matsuo and Yoshino 92 reported a series of 8 patients with MALT lymphoma who did not undergo complementary treatment after surgical biopsy, 7 of whom experienced spontaneous tumor regression between 1 and 5 years.…”

Section: Surgical Excision and Wait-and-see Policymentioning

confidence: 99%

“…Metastatic involvement of the eye or central nervous system is rarely observed with low-grade ocular adnexal lymphoma, and central nervous system (CNS) prophylaxis with radiotherapy or chemotherapy is considered unnecessary. 37 A number of studies 11,13,18,16,27,30,36,39,[41][42][43][44][45][46][47]83,91 have reported treatment with chemotherapy alone or in combination with other modalities, but few have reported the response rates obtained with these treatments. 11,46,47,84,85 Lee et al 47 reported 3 patients who underwent CHOP chemotherapy, 2 of whom experienced complete remission.…”

Section: Chemotherapy Regimens and Oalmentioning

confidence: 99%

“…Several publications have reported a total of 80 patients in whom no complementary treatment, and particularly no radiotherapy, was performed after surgical excision. 11,13,18,36,37,39,42,44,45,47,91 Some of these studies indicated that local relapse occurred more frequently after simple surgical excision than after radiotherapy. 18,42 However, this approach has not been fully evaluated; the outcome was clearly indicated for only 8 patients in these reports.…”

Section: Surgical Excision and Wait-and-see Policymentioning

confidence: 99%

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Ocular adnexal lymphoma: a review of clinicopathologic features and treatment options

Decaudin

Crémoux

Vincent‐Salomon

et al. 2006

Blood

133

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IntroductionLymphoproliferations of the eye, including intraocular and ocular adnexal non-Hodgkin lymphoma (NHL), constitute a heterogeneous group of neoplasms that represent less than 1% of all NHLs 1 and 5% to 15% of all extranodal sites. 2 First described in 1952, 3 they are the most frequent malignant tumors of the eye and ocular adnexae; in fact, in the Florida cancer registry, they represent up to 55% of all orbital tumors. 4 As for all NHLs, a marked increase of the incidence of ocular adnexal NHL has also been observed. 4 The clinical features and natural history of ocular adnexal lymphoma (OAL) is completely different from those of intraocular lymphoma, which emphasizes the need to distinguish between the therapeutic management of both. Intraocular lymphoma is a subset of primary central nervous system lymphoma, 5-7 and intraocular involvement is found in approximately 15% of affected patients. 8 The histologic subtype of intraocular lymphoma is almost always high grade 9,10 and it can occur in the context ofAIDS-related lymphoproliferations. In contrast, OALs-including lesions of the conjunctiva, lacrimal gland, orbit, and eyelids-are mainly low-grade tumors not associated with HIV infection. 11 Although combination chemotherapy with highdose methotrexate is the basis of treatment of primary central nervous system and intraocular lymphomas, 10,12 radiotherapy has been the standard treatment for low-grade ophthalmologic lymphomas. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] However, other treatment options, such as therapy with monoclonal anti-CD20 antibody, 31,32 may constitute a promising alternative to external beam irradiation and its potential toxicity. In addition, some reports have suggested a possible value of anti-Chlamydia psittaci antibiotic therapy. 33,34 In this review, which is exclusively focused on ophthalmologic lymphomas, we first present the pathologic, clinical, and prognostic factors of these lymphomas and then discuss all available treatment options in terms of safety and efficacy and their respective indications. Biology of ophthalmologic lymphomas Diagnosis of OALAs for all other forms of nodal and extranodal NHL, confirming a positive diagnosis of OAL is often long and difficult because the tumor is very small in most patients. Positive diagnosis must be based on histologic examination of a sufficient tumor sample obtained by surgical biopsy that is large enough to allow rigorous definition of lymphoproliferative disease according to the World Health Organization (WHO) classification. 35 Histopathologic examination consists of morphologic examination of cellular proliferation (cellular appearance and architectural pattern), usually combined with immunohistochemical analysis and molecular analysis.The exact modalities of biopsy depend on the anatomic site of the lesion and its relation to the eye: biopsy may be performed of the conjunctiva, an eyelid lesion, an orbital mass, or the lacrimal gland. However, sometimes patients have nodal involvement, an...

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Treatment and prognosis in a series of primary extranodal lymphomas of the ocular adnexa

Abstract: Regardless of histology, prognosis was excellent when surgery plus RT was adopted, and CT seems to be a valid alternative to RT. Surgery alone may be sub-optimal.

Cited by 71 publications

References 11 publications

Prognosis for Patients in a Korean Population with Ocular Adnexal Lymphoproliferative Lesions

Prognosis for Patients in a Korean Population with Ocular Adnexal Lymphoproliferative Lesions

Extranodal marginal zone lymphoma of the ocular adnexa

Ocular adnexal lymphoma: a review of clinicopathologic features and treatment options

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