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2018 ; 18
(1
): 186
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Factors related to survival outcomes following orbital exenteration: a
retrospective, comparative, case series
#MMPMID30055580
Aryasit O
; Preechawai P
; Hirunpat C
; Horatanaruang O
; Singha P
BMC Ophthalmol
2018[Jul]; 18
(1
): 186
PMID30055580
show ga
BACKGROUND: Orbital exenteration is a disfiguring procedure that aims to achieve
local control. It is commonly a part of the management of malignant orbital tumor
which is a life-threatening condition. It is necessary to determine predictive
factors associated with overall survival (OS) following orbital exenteration.
METHODS: This was a retrospective, comparative, case series of 39 patients with
malignant tumors who underwent orbital exenteration. Patient records were
reviewed for age, clinical presentation, preoperative visual acuity (VA), tumor
size, surgical margin, tumor invasiveness, recurrent disease, and status of
distant metastasis. Kaplan-Meier curves were used to assess OS and event-free
survival (EFS). The predictive factors related to OS were identified using
multivariate analysis. RESULTS: The mean age was 62.9 years (range, 5.5 to
89.7 years), 68.4% presented with VA 20/400. The mean size of all tumors was
32?±?18 mm. Distant metastasis at diagnosis was reported in 11 patients (28.2%).
Twenty-two patients died during follow-up. The median OS and EFS were 3.89 years
and 3.01 years, respectively. The predictive factors for worse OS on multivariate
analysis were preoperative VA 20/400 (adjusted hazard ratio [aHR] 4.67,
P?=?0.003), tumor size larger than 20 mm (aHR 3.14, P?=?0.022,) and positive
distant metastasis at diagnosis (aHR 15.31, P? 0.001). CONCLUSIONS: The
prognostic factors for poor survival outcome following orbital exenteration were
a preoperative VA 20/400, tumor size >?20 mm, and distant metastasis at
diagnosis mostly due to patient negligence.