title: Ocular adnexal lymphoma staging and treatment: American Joint Committee on Cancer versus Ann Arbor.
abstract: OBJECTIVE
  To evaluate the prognostic utility of the American Joint Committee on Cancer (AJCC) staging system for ocular adnexal lymphoma (OAL).
  
  
  METHODS
  A multicenter, consecutive case series of patients with biopsy-proven conjunctival, orbit, eyelid, or lacrimal gland/sac lymphoma was performed. The electronic pathology and clinical records were reviewed for new or recurrent cases of ocular adnexal lymphoma. The main outcome measures included pathology and clinical staging (AJCC and Ann Arbor systems), treatment, and recurrence (local and systemic). Statistical analysis included demographic evaluations and the Kaplan-Meier survival probability method.
  
  
  RESULTS
  Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue were the most common (n=60/83, 72%). The most common Ann Arbor clinical stages were IE (76%) followed by IIE (17%) and IIIE (7%). Pathology identified 13 cases (15%) that were upstaged to group IV (p=0.017). Similarly, AJCC clinical stages were cT1NOMO (21.7%), cT2NOMO (44.6%), cT3N0M0 (5%), and cT4NOMO (2.4%). Local control was achieved in 75% of treated patients. There were 19 local recurrences from which 14 (74%) belonged to the non-radiation treatment groups. Lower-risk groups (T1 and T2 without lymph node involvement or metastatic disease of AJCC and IE of Ann Arbor) had longer disease-free survival than the higher-risk groups (AJCC T1, T2 with nodal involvement or metastatic disease, T3, and T4 as well as Ann Arbor II, III, and IV). The overall mean follow-up was 43.3 months (range 6-274).
  
  
  CONCLUSIONS
  Regardless of stage, recurrence and disease-free survival were more closely related to treatment and histopathology rather than tumor size or site-specific location.
authors: The New York Eye Cancer Center, 115 East 61st Street, New York, NY 10065, USA .
authors: Gerardo F
authors: GF
authors: Graue
authors: Paul T
authors: PT
authors: Finger
authors: Elizabeth
authors: E
authors: Maher
authors: David
authors: D
authors: Della Rocca
authors: Robert
authors: R
authors: Della Rocca
authors: Gary J
authors: GJ
authors: Lelli
authors: Tatyana
authors: T
authors: Milman
mesh_terms: D003230:Conjunctival Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D018572:Disease-Free Survival; D005134:Eye Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D005142:Eyelid Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007766:Lacrimal Apparatus Diseases / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008207:Lymphatic Metastasis; D008223:Lymphoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D009367:Neoplasm Staging; D009918:Orbital Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014481:United States; D014792:Visual Acuity / Q000502:physiology