Epidemiological Trends in Malignant Lacrimal Gland Tumors

Objective To describe epidemiological trends in lacrimal gland malignancies in the United States. Study Design Retrospective database review. Setting Multicenter registry. Subjects and Methods A total of 702 malignant tumors of the lacrimal gland from the Surveillance, Epidemiology, and End Results database were included in the study. Disease-specific and overall survival were the primary outcome measures. Kaplan-Meier survival curves were generated for multiple patient and tumor characteristics, including race, histology, TNM tumor stage, age at diagnosis, radiotherapy, gender, and tumor grade. Cox proportional hazards regression was performed to assess the impact of patient and tumor characteristics on survival. Results Lymphoma (58.0%), adenoid cystic carcinoma (13.4%), adenocarcinoma (3.8%), and mucoepidermoid carcinoma (3.6%) accounted for most tumors. Lymphoma was associated with more favorable survival rates, while adenocarcinoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma were associated with worse prognosis. There was a steady increase in the proportion of lymphoma diagnosed since 1973. In a multivariate Cox proportional hazards regression model, tumor histology remained as the only covariate correlated with disease-specific survival. Conclusion Patient characteristics and survival rates differ between lymphoma, adenoid cystic carcinoma, adenocarcinoma, and mucoepidermoid carcinoma. The proportion of lacrimal gland cancer diagnosed as lymphoma has steadily increased over time. Cox proportional hazards regression analysis demonstrated tumor histology as one of the most important factors in patient survival. These results augment our understanding of the expected disease course of lacrimal gland malignancies.