A Population-Based Analysis of Orbital Lymphoma

Objective: To outline the epidemiology and analyze factors determinant of survival in patients with orbital lymphoma, using the Surveillance Epidemiology and End Results (SEER) database.

Study Design: retrospective analysis of SEER database.

Methods: A total of 4,733 patients with orbital lymphoma were identified using the most recent SEER database entry from 1976 to 2016. Demographic information, Ann Arbor stage, tumor histopathology and location were collected. Multivariate analysis was used to analyze patient and tumor characteristics associated with survival.

Results: The mean age of the patients studied was 62.4 years, 45.1% of the subjects were male and 81% were white. The orbit was the most common location of lymphoma followed by the conjunctiva comprising 52.3 and 25.8% of the reported cases. The lacrimal gland was the third most common location comprising 12.5% of cases and 48.5% of those patients had a mucosal associated lymphoma (MALT). Overall 12.0% of patients died secondary to their orbital lymphoma. Patient’s whose lymphoma originated in the retina had the worst prognosis, with 44.4% of patients expiring as a result of their disease, although primary retinal lymphoma comprised only 0.4% of all tumors. The most common pathology was a MALT lymphoma comprising 44.1% of all orbital lymphomas. The second most common was a follicular lymphoma comprising 10.5% of reported cases. Patients with peripheral T cell lymphoma had the worst prognosis of all histologic subtypes with 54.5% of patients expiring as a result of their disease. The second most lethal malignancy was diffuse large B cell lymphoma with 25.5% of patients passing as a result of their disease.

Conclusion: MALToma is the most common orbital lymphoma and has a good prognosis. Patients with T cell tumors had the worst prognosis. The most common location is the orbit followed by the conjunctiva. Early diagnosis and treatment can potentially improve survival.