Ocular adnexal lymphoma staging and treatment: A Multi-center Cooperative Study

By Paul T. Finger, MD

Research Reveals New Information about Lymphoma of the Eyelids and Orbit

The European Journal of Ophthalmology 2013 Apr 22;23(3):344-55.

Graue GF, Finger PT, Maher E, Della Rocca D, Della Rocca R, Lelli GJ Jr, Milman T.

The authors examined if the American Joint Committee on Cancer (AJCC) staging system for ocular adnexal lymphoma (OAL) could be used to predict local control and systemic disease. A multicenter, consecutive case series of patients with biopsy-proven conjunctival, orbit, eyelid, or lacrimal gland/sac lymphoma was performed.


  1. They found that extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue was the most common and AJCC clinical stages were cT1NOMO (21.7%), cT2NOMO (44.6%), cT3N0M0 (5%), and cT4NOMO (2.4%).
  2. Treatment was able to control the local tumor in 75% of patients.
  3. Of the 19 local recurrences, 74% (most) were found after non-radiation based treatments.
  4. The lower-risk “smaller tumor” AJCC T1 and T2 groups without lymph node involvement or metastatic disease had longer disease-free survival than the higher-risk AJCC T1, T2 with nodal involvement or metastatic disease, AJCC T3, and T4 as well as Ann Arbor II, III, and IV.


Regardless of stage, recurrence and disease-free survival were more closely related to having had radiation treatment and histopathology rather than site specific factors, such as tumor size or location around or behind the eye.

The research was supported by The Eye Cancer Foundation, Inc.

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