Ocular Adnexal Lymphoma Classified using the WHO Classification: Not only Histology and Stage, but also Gender is a Predictor of Outcome

Abstract

Introduction: Ocular adnexal lymphomas (OAL) belong to the most common malignancies of the orbit and eyelids and are now classified according to the WHO classification system. MALT lymphoma appears to be the most frequent OAL. Histology type and stage of OAL have been found predictors of patient survival. Purpose: To evaluate the outcome of a cohort of patients with OAL using the WHO classification and to compare outcome predictors with those of other studies using the WHO classification. Design: Retrospective, cohort study. Materials and methods: Clinical profile at presentation, initial complaints and findings, classification and stage, treatment and outcome of 54 patients with biopsy proven and re-analyzed OAL seen between 1 January 1992 and 1 January 2002 at the UMC Utrecht, NL, were evaluated. Kaplan-Meier survival analysis and multivariate Cox-regression survival analysis were applied to assess predictors of outcome. Results: Forty nine patients were found to have primary and five secondary lymphomas. Of those with primary OAL, 27 had MALT, eight diffuse large B-cell, six mantle cell and eight follicular cell lymphoma. Histology and stage showed a significant association with survival (Log-rank test: p = 0.001 and p = 0.002, respectively). A multivariate Cox-regression survival analysis showed histological type to be the only significant predictor for outcome. Looking at the dichotomy full remission versus not completely cured, gender was found to be a significant predictor (Log-rank test: p = 0.005). Conclusion: This study showed that not only histology type and stage, but also gender is a predictor of outcome.

KEYWORDS:

• Non-hodgkin lymphoma
• WHO-classification
• MALT lymphoma
• staging
• histology