Treatment Outcome of Radiotherapy for Localized Primary Ocular Adnexal MALT Lymphoma--Prognostic Effect of the AJCC Tumor-Node-Metastasis Clinical Staging System.

AIM: To analyze the treatment outcome of radiotherapy for localized primary ocular adnexal mucosa-associated lymphoid tissue lymphoma (POAML) and evaluate the prognostic effect of the American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) clinical staging system for POAML. PATIENTS AND METHODS: Seventy-three patients with Ann Arbor stage IE POAML who were treated with radiotherapy alone were analyzed. T-Factor based on the AJCC staging system was T1 in 28, T2 in 33 and T3 in 12 patients. RESULTS: Out of nine patients with relapse, six had distant and three had contralateral ocular adnexal relapse. One patient died of lymphoma progression. The 5-year local control and progression-free survival (PFS) rates were 100% and 81.5%, respectively. T-Factor was not significantly associated with PFS. CONCLUSION: Radiotherapy achieved excellent local control and survival rates for stage IE POAML. The AJCC TNM clinical staging system was not significantly predictive for PFS of stage IE POAML.

Treatment strategy for cutaneous apocrine carcinoma.

BACKGROUND: Cutaneous apocrine carcinoma (CAC) is a rare adnexal carcinoma with only scattered reports about long-term follow-up. The aim of this study is to demonstrate clinical findings in the prognosis of CAC and discuss the treatment procedure. METHODS: The subjects were nine patients with a histological diagnosis of CAC who underwent wide excision and regional lymph node dissection as the initial treatment at Shizuoka Cancer Center Hospital. We examined the gender, age, site of involvement, additional treatment to prevent recurrence/metastasis, additional treatment after metastasis, and the follow-up data of the study patients. Then, we calculated the recurrence and 5-year (overall/recurrence-free) survival rates. RESULTS: The men-to-women ratio was 8:1. The patients ranged in age from 47 to 81 years (median, 67 years). The primary lesion was in the axilla in five patients and in the vulva in the other four patients. The follow-up period ranged from 9 to 204 months (median, 44 months). The recurrence-free 5-year survival rate was 63 %, and the overall 5-year survival rate was 75 %. CONCLUSIONS: We recommend wide local excision for a primary lesion and prophylactic regional lymph node dissection at initial therapy because of the high frequency of regional metastasis of CAC. Although CAC responds poorly to chemotherapy and radiotherapy, adjuvant radiotherapy may be used in advanced local or regional disease.

Extranodal marginal zone B cell lymphoma of mucosa-associated lymphoid tissue type of the ocular adnexa: retrospective single institution review of 95 patients.

CONTEXT: There are few reports on the management of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type (MALT), which are based on the experience of a single institution, as opposed to large multicenter randomized trials. AIM: The aim of this study was to report on the clinical experience of a single institution. MATERIALS AND METHODS: A retrospective review was undertaken of records of 95 patients with MALT lymphoma of the ocular adnexa. Histologic diagnosis of MALT lymphoma was made according to established criteria, and clinical staging was carried out to determine treatment modalities. All patients were treated by external beam irradiation (30.6-45.0 Gy) after biopsy. Additional chemotherapy was performed in accordance with the clinical stage of the disease. All the patients were treated by the same hemato-oncologist and radio-oncologist. RESULTS: Almost all patients showed complete response, except for four patients who showed partial response. In two of 95 patients, contralateral eye showed recurrence, and they were salvaged by additional radiotherapy. The 3-year overall survival and event-free survival rates were 100 and 97%, respectively, by Kaplan-Meier survival analysis. Moreover, there were no serious radiation-associated complications. CONCLUSIONS: Radiotherapy alone can be an important treatment modality for the local control and survival in patients with localized MALT lymphoma of ocular adnexa. Systemic chemotherapy should be considered in patients with advanced stage disease.

Primary retroperitoneal liposarcoma.

A retroperitoneal liposarcoma that marginally involved the right kidney and ovary was presented clinically as an adnexial mass in a 61-year-old woman. At laparatomy a large retroperitoneal mass in addition to the right kidney and ovary was removed totally. A well-differentiated retroperitoneal liposarcoma was detected in histological speciment. Adjuvant irradiation was given. The 5-year survival rate of retroperitoneal liposarcoma is low. Curative resection remains the main treatment for primary and recurrent liposarcomas.