Canadian journal of ophthalmology. Journal canadien d'ophtalmologie · 2024
Personalized treatment for patients with lacrimal sac squamous cell carcinoma.
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Wang Jie, Zhang Qi, Yi Xiuqian, Tang Tianci, Wang Tian, Song Xinmao
Аннотация
OBJECTIVE: Lacrimal sac squamous cell carcinoma (LSSCC) is a rare and poor prognosis malignancy. We aimed to investigate the predictive factors for prognosis and to discuss the optimal treatment mode.
METHODS: This retrospective study comprised 84 patients with LSSCC who accepted multidisciplinary treatment. We analyzed the potential prognostic factors and the efficiency of different treatment modes in univariate and multivariate analyses.
RESULTS: The 5-year overall survival (OS), progression-free survival (PFS), regional failure-free survival (RFS), and distant metastasis-free survival (DMFS) rates for the entire cohort were 83.7%, 76.3%, 77.2%, and 83.7%, respectively. On univariate analysis, orbital bone erosion, lymph node metastasis, and advanced clinical stage were poor prognostic factors. Multivariate Cox regression analysis showed that orbital bone erosion was a uniquely poor predictor for OS; orbital bone erosion, positive cervical lymph nodes, and old age were poor predictors for PFS. Chemotherapy significantly improved the 5-year OS (90.4% vs. 69.6%, p = 0.03), PFS (82.1% vs. 63.6%, p = 0.036), and DMFS (90.4% vs. 69.6%, p = 0.013), except for RFS (82.5% vs. 65.6%, p = 0.15). Surgery did not improve the 5-year OS (85.6% vs. 79.3%, p = 0.062), PFS (76.0% vs. 76.2%, p = 0.41), RFS (76.1% vs. 79.5%, p = 0.54), and DMFS (85.6% vs. 79.5%, p = 0.096). However, the pre-operative radiotherapy conferred a slightly better OS (p = 0.13) and DMFS (p = 0.16) than post-operative radiotherapy and definitive radiotherapy, but without statistical significance.
CONCLUSIONS: Orbital bone erosion and lymph node metastasis were poor prognostic factors in LSSCC. Chemoradiotherapy was vital and effective. Although surgery did not improve survival, multidisciplinary treatment, including surgery, was recommended for LSSCC.
METHODS: This retrospective study comprised 84 patients with LSSCC who accepted multidisciplinary treatment. We analyzed the potential prognostic factors and the efficiency of different treatment modes in univariate and multivariate analyses.
RESULTS: The 5-year overall survival (OS), progression-free survival (PFS), regional failure-free survival (RFS), and distant metastasis-free survival (DMFS) rates for the entire cohort were 83.7%, 76.3%, 77.2%, and 83.7%, respectively. On univariate analysis, orbital bone erosion, lymph node metastasis, and advanced clinical stage were poor prognostic factors. Multivariate Cox regression analysis showed that orbital bone erosion was a uniquely poor predictor for OS; orbital bone erosion, positive cervical lymph nodes, and old age were poor predictors for PFS. Chemotherapy significantly improved the 5-year OS (90.4% vs. 69.6%, p = 0.03), PFS (82.1% vs. 63.6%, p = 0.036), and DMFS (90.4% vs. 69.6%, p = 0.013), except for RFS (82.5% vs. 65.6%, p = 0.15). Surgery did not improve the 5-year OS (85.6% vs. 79.3%, p = 0.062), PFS (76.0% vs. 76.2%, p = 0.41), RFS (76.1% vs. 79.5%, p = 0.54), and DMFS (85.6% vs. 79.5%, p = 0.096). However, the pre-operative radiotherapy conferred a slightly better OS (p = 0.13) and DMFS (p = 0.16) than post-operative radiotherapy and definitive radiotherapy, but without statistical significance.
CONCLUSIONS: Orbital bone erosion and lymph node metastasis were poor prognostic factors in LSSCC. Chemoradiotherapy was vital and effective. Although surgery did not improve survival, multidisciplinary treatment, including surgery, was recommended for LSSCC.