Clinical management and outcomes of lacrimal sac squamous cell carcinoma

Head Neck. 2019 Apr;41(4):974-981. doi: 10.1002/hed.25529. Epub 2019 Jan 10.


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.

Keywords: lacrimal sac; radiotherapy; squamous cell carcinoma; staging; surgery.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy*
  • Chemotherapy, Adjuvant
  • Cohort Studies
  • Combined Modality Therapy
  • Disease Management
  • Disease-Free Survival
  • Eye Neoplasms / mortality*
  • Eye Neoplasms / pathology
  • Eye Neoplasms / therapy*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Logistic Models
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Nasolacrimal Duct / pathology*
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Taiwan
  • Treatment Outcome