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Annals of Oncology Advance Access published online on October 19, 2005
Annals of Oncology, doi:10.1093/annonc/mdj025
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© 2005 European Society for Medical Oncology
Received May 23, 2005
Revised August 9, 2005
Accepted August 23, 2005

original article

Long-term follow-up results of no initial therapy for ocular adnexal MALT lymphoma

K. Tanimoto 1, A. Kaneko 2, S. Suzuki 2, N. Sekiguchi 1, D. Maruyama 1, S. W. Kim 1, T. Watanabe 1, Y. Kobayashi 1, Y. Kagami 3, A. Maeshima 4, Y. Matsuno 4, and K. Tobinai 1*

1 Hematology and Stem Cell Transplantation Division, National Cancer Center Hospital and Research Institute, Tokyo, Japan
2 Ophthalmology Division, National Cancer Center Hospital and Research Institute, Tokyo, Japan
3 Radiation Oncology Division, National Cancer Center Hospital and Research Institute, Tokyo, Japan
4 Pathology Division, National Cancer Center Hospital and Research Institute, Tokyo, Japan

* To whom correspondence should be addressed.
K. Tobinai, E-mail: ktobinai{at}ncc.go.jp


  Abstract

Background: The majority of lymphomas in the ocular adnexa are low-grade B-cell lymphomas of mucosa-associated lymphoid tissue (MALT lymphoma). Although radiotherapy is the most frequently applied management, cataract and dry eye are problematic complications.

Patients and methods: Between 1973 and 2003, the clinical features of 36 patients with ocular adnexal MALT lymphoma with no symptoms who were managed with no initial therapy after biopsy or surgical resection were retrospectively analyzed.

Results: The median patient age was 63 years (range 22-84) and all patients had stage I disease, consisting of 31 unilateral cases and five bilateral cases. With a median follow-up of 7.1 years, 25 (69%) did not require treatment. The median time until the initiation of treatment in the remaining 11 patients (31%) was 4.8 years. Six patients (17%) died, and among them only two (6%) died due to progressive lymphoma. Seventeen patients (47%) progressed, but histologic transformation was recognized in only one (3%). The estimated overall survival rates of the 36 patients after 5, 10 and 15 years were 94%, 94% and 71%, respectively.

Conclusions: In selected patients with ocular adnexal MALT lymphoma, no initial therapy might be an acceptable approach, because 70% of patients remained untreated at a median of 8.6 years, and their survival was comparable to that of reports on immediate therapy.

Keywords: MALT lymphoma; ocular adnexa; no initial therapy; prognosis.
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