title: Ocular adnexal diffuse large B-cell lymphoma: local disease correlates with better outcomes.
abstract: OBJECTIVE
  To describe the clinical, immunohistochemical and prognostic features, as well as outcomes of a large series of patients with orbital and periorbital diffuse large B-cell lymphoma (DLBCL).
  
  
  METHODS
  This study is a multicentre, retrospective non-comparative consecutive case series.
  
  
  METHODS
  The setting for this study was institutional. A total of 37 consecutive patients identified from the institutions' databases with periorbital and orbital DLBCL were enrolled in the study. A retrospective chart review was used for observation. The main outcome measures were patient demographics, clinical features, imaging, immunohistochemical and histopathological data, treatments administered, and survival.
  
  
  RESULTS
  A total of 20 out of 37 cases (54.1%) represented localised periorbital disease (group L), 11 of 37 (29.7%) had systemic disease at presentation with periorbital disease (group S1), and 6 of 37 (16.2%) had previous history of systemic lymphoma (group S2). In all, 28 out of 30 (93.3%) patients were CD20+, 5 of 25 (20%) were CD3+, and 11 of 11 (100%) were CD79a+ (varying denominators reflect the different numbers of patients tested). A total of 25 out of 32 patients (78.1%) received chemotherapy, 14 (43.8%) received rituxmab plus chemotherapy, and 19 (59.3%) received radiotherapy. Nine deaths occurred, one in group L (not lymphoma related), six in group S1, and two in group S2. Five-year Kaplan-Meier survival estimates were 55.9% for all cases, 90.9% for group L, 36.0% for group S1, and 0% for group S2. One-year progression-free survival estimates in groups S1 and S2 combined were 58.3% for patients treated with rituximab and 28.6% for those who were not.
  
  
  CONCLUSIONS
  To our knowledge, this report represents the largest series of patients with periorbital and orbital DLBCL in the literature. The difference in survival between groups L, S1 and S2 was striking, reflecting the grave prognosis of systemic DLBCL, but conversely the relatively optimistic outlook for patients with localised disease. Rituximab plus chemotherapy may be associated with increased survival.
authors: Discipline of Ophthalmology and Visual Sciences, University of Adelaide, and Discipline of Ophthalmology and Visual Sciences, Level 8, Royal Adelaide Hospital, Adelaide, South Australia, Australia. drsimonmadge@gmail.com
authors: S N
authors: SN
authors: Madge
authors: A
authors: A
authors: McCormick
authors: I
authors: I
authors: Patel
authors: E
authors: E
authors: Hatef
authors: V
authors: V
authors: Menon
authors: V C
authors: VC
authors: Prabhakaran
authors: L
authors: L
authors: Irion
authors: R
authors: R
authors: Bonshek
authors: S
authors: S
authors: Honovar
authors: B
authors: B
authors: Leatherbarrow
authors: B
authors: B
authors: Esmaeli
authors: D
authors: D
authors: Selva
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007155:Immunologic Factors; D016403:Lymphoma, Large B-Cell, Diffuse / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009918:Orbital Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D000069283:Rituximab
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D007155:Immunologic Factors; D000069283:Rituximab