Clinical management and outcomes of lacrimal sac squamous cell carcinoma

Background To investigate the management and outcomes of patients with lacrimal sac squamous cell carcinoma (SCC). Methods This retrospective study examined 69 lacrimal sac SCC cases treated at our hospital between 1992 and 2017. The potential risk factors for prognosis, a new staging method, treatment outcomes, and complications were investigated. Results The 5-year overall survival (OS) and progression-free survival (PFS) were 87.6 +/- 4.8% and 76.3 +/- 6.4%, respectively. Positive lymph node was associated with worse OS and PFS. We divided lacrimal sac SCC into four clinical stages, with significant differences in OS (P = .026) and PFS (P = .042) among each stage. Definitive radiotherapy was equivalent to surgery plus radiotherapy in 26.1% (18/69) of cases, and the incidence of complications was not higher. Conclusions Lymph node status was a key factor in determining outcomes. Our staging method could effectively classify tumor stage and predict prognosis, which can contribute to optimizing treatment regimes. Radiotherapy played an important role in treatment.