Orbital Exenteration for Advanced Periocular Adnexal Malignancies: Curative Versus Palliative Surgical Intent.
Ophthalmic Plast Reconstr Surg
; 38(4): 387-392, 2022.
Article
in En
| MEDLINE
| ID: mdl-35093991
ABSTRACT
PURPOSE:
To evaluate the survival benefit of orbital exenteration in periocular malignancy, taking account of preoperative intent. PATIENTS ANDMETHODS:
Patients undergoing exenteration had retrospective chart review for demographics, clinical features, radiology, histology, and outcome. Based on systemic tumor status, the patient was either "Class I" (with absent or well-controlled systemic disease) or "Class II" (incurable active metastatic disease), and based on the extent of orbital disease and exenteration intent , was classed as either "Group A" (locally curative) or "Group B" (locally palliative).RESULTS:
One hundred thirty-three patients (78 females; 59%) underwent exenteration at an average age of 61 years (median 64; range 5-91) for sebaceous, squamous and basal cell carcinomas, or for melanoma (22%, 19%, 11%, and 28%, respectively). There were 20% systemically incurable patients (26/133; Class II), and incurable local disease ("Group B") in 5% (5/107) of Class I and 15% (4/26) Class II patients. The overall survival (OS) was 88% at 12 months, 57% at 5 years, and 41% at 10 years, prognosis being worse with age more than 70 years ( p = 0.005), prior local radiotherapy ( p = 0.005) or positive resection margins ( p = 0.002). The mean OS for Type IA exenteration (145 months; 95% CI 122-168) was significantly different to 50 months for Type IB (95% CI 22-79; p = 0.02); likewise, OS for Type IIA procedures (31 months; 95% CI 11-51) was different to Type IIB (19 months; 95% CI 2-36) ( p = 0.001).CONCLUSION:
Exenteration confers a significant survival with advanced periocular malignancies, even in patients with uncontrollable systemic disease, or where the local disease is deemed incurable.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Orbital Diseases
/
Skin Neoplasms
/
Carcinoma, Basal Cell
Type of study:
Observational_studies
Limits:
Aged
/
Female
/
Humans
/
Middle aged
Language:
En
Journal:
Ophthalmic Plast Reconstr Surg
Journal subject:
OFTALMOLOGIA
Year:
2022
Document type:
Article
Affiliation country:
United kingdom