Japanese Journal of Ophthalmology

, Volume 63, Issue 4, pp 344–351 | Cite as

Survival outcomes of eye-sparing surgery for adenoid cystic carcinoma of lacrimal gland

  • Ju-Yi Hung
  • Yi-Hsuan Wei
  • Chu-Hsuan Huang
  • Lily-Wei Chen
  • Chiou-Shann Fuh
  • Shu-Lang LiaoEmail author
Clinical Investigation



To survey adenoid cystic carcinoma of lacrimal glands in Asian population and investigate the predictability in prognosis following the 8th edition American Joint Committee on Cancer (AJCC) staging guideline.

Study design

Retrospective study.


The clinical entities and surgical outcomes of the patients who were histologically confirmed with a diagnosis of lacrimal adenoid cystic carcinoma in National Taiwan University Hospital between January 1995 and December 2015 were retrospectively reviewed.


Enrolled were 11 patients. The median follow-up was 7.2 years. Eight patients (72.7%) were diagnosed as T1 or T2 disease, and three patients (27.3%) were diagnosed as T3 or T4 disease according to the AJCC 8th edition guideline. Eye-sparing surgery with radiotherapy was performed in nine patients. Local recurrence was noted in six patients (54.5%) with median disease-free interval of 23.5 months. Six patients (54.5%) developed distant metastases, including lung, bone, and cranial invasions. Overall survival rate during the study period was 54.6%. Five-year overall survival was 81.8% and ten-year overall survival was 68.2%. The Log-rank test for overall survival and disease-free survival between patients with less than T3 disease (p=0.001) and patients with T3 or T4 disease (p=0.006) revealed significant differences.


This study highlighted the aggressive nature of adenoid cystic carcinoma of lacrimal glands. Eye-sparing surgery with adjunctive radiotherapy may achieve relatively optimal disease control in diseases staged T1 or T2, but in advanced disease metastasis and mortality are usually inevitable.


Adenoid cystic carcinoma Lacrimal gland tumor AJCC staging 


Conflicts of interest

J.-Y. Hung, None; Y.-H. Wei, None; C.-H. Huang, None; L.-W. Chen, None; C.-S. Fuh, None; S.-L. Liao, None.


  1. 1.
    Woo KI, Yeom A, Esmaeli B. Management of lacrimal gland carcinoma: lessons from the literature in the past 40 years. Ophthal Plast Reconstr Surg. 2016;32:1–10.CrossRefGoogle Scholar
  2. 2.
    Shields JA, Shields CL, Scartozzi R. Survey of 1264 patients with orbital tumors and simulating lesions: The 2002 Montgomery Lecture, part 1. Ophthalmology. 2004;111:997–1008.CrossRefGoogle Scholar
  3. 3.
    Wang XN, Qian J, Yuan YF, Zhang R, Zhang YQ. Space-occupying lesions of the lacrimal gland at one tertiary eye center in China: a retrospective clinical study of 95 patients. Int J Ophthalmol. 2012;5:208–11.Google Scholar
  4. 4.
    Ng DS, Chan E, Yau K, Chan CW. Clinicopathological survey of 23 patients with lacrimal fossa lesions in Hong Kong. Int J Ophthalmol. 2011;4:311–3.Google Scholar
  5. 5.
    Bernardini FP, Devoto MH, Croxatto JO. Epithelial tumors of the lacrimal gland: an update. Curr Opin Ophthalmol. 2008;19:409–13.CrossRefGoogle Scholar
  6. 6.
    Esmaeli B, Ahmadi MA, Youssef A, Diba R, Amato M, Myers JN, et al. Outcomes in patients with adenoid cystic carcinoma of the lacrimal gland. Ophthal Plast Reconstr Surg. 2004;20:22–6.CrossRefGoogle Scholar
  7. 7.
    Woo KI, Kim YD, Sa HS, Esmaeli B. Current treatment of lacrimal gland carcinoma. Curr Opin Ophthalmol. 2016;27:449–56.CrossRefGoogle Scholar
  8. 8.
    Ahmad SM, Esmaeli B, Williams M, Nguyen J, Fay A, Woog J, et al. American Joint Committee on Cancer classification predicts outcome of patients with lacrimal gland adenoid cystic carcinoma. Ophthalmology. 2009;116:1210–5.CrossRefGoogle Scholar
  9. 9.
    Amin MB, Greene FL, Edge SB, Compton CC, Gershenwald JE, Brookland RK et al. The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging. CA Cancer J Clin. 2017;67:93–9.Google Scholar
  10. 10.
    Chen AM, Bucci MK, Weinberg V, Garcia J, Quivey JM, Schechter NR, et al. Adenoid cystic carcinoma of the head and neck treated by surgery with or without postoperative radiation therapy: prognostic features of recurrence. Int J Radiat Oncol Biol Phys. 2006;66:152–9.CrossRefGoogle Scholar
  11. 11.
    Li N, Xu L, Zhao H, El-Naggar AK, Sturgis EM. A comparison of the demographics, clinical features, and survival of patients with adenoid cystic carcinoma of major and minor salivary glands versus less common sites within the Surveillance, Epidemiology, and End Results registry. Cancer. 2012;118:3945–53.CrossRefGoogle Scholar
  12. 12.
    Tellado MV, McLean IW, Specht CS, Varga J. Adenoid cystic carcinomas of the lacrimal gland in childhood and adolescence. Ophthalmology. 1997;104:1622–5.CrossRefGoogle Scholar
  13. 13.
    Weis E, Rootman J, Joly TJ, Berean KW, Al-Katan HM, Pasternak S, et al. Epithelial lacrimal gland tumors: pathologic classification and current understanding. Arch Ophthalmol. 2009;127:1016–28.CrossRefGoogle Scholar
  14. 14.
    Gamel JW, Font RL. Adenoid cystic carcinoma of the lacrimal gland: the clinical significance of a basaloid histologic pattern. Hum Pathol. 1982;13:219–25.CrossRefGoogle Scholar
  15. 15.
    Gomez DR, Hoppe BS, Wolden SL, Zhung JE, Patel SG, Kraus DH, et al. Outcomes and prognostic variables in adenoid cystic carcinoma of the head and neck: a recent experience. Int J Radiat Oncol Biol Phys. 2008;70:1365–72.CrossRefGoogle Scholar
  16. 16.
    Garden AS, Weber RS, Morrison WH, Ang KK, Peters LJ. The influence of positive margins and nerve invasion in adenoid cystic carcinoma of the head and neck treated with surgery and radiation. Int J Radiat Oncol Biol Phys. 1995;32:619–26.CrossRefGoogle Scholar
  17. 17.
    Esmaeli B, Golio D, Kies M, DeMonte F. Surgical management of locally advanced adenoid cystic carcinoma of the lacrimal gland. Ophthal Plast Reconstr Surg. 2006;22:366–70.CrossRefGoogle Scholar
  18. 18.
    Esmaeli B, Yin VT, Hanna EY, Kies MS, William WN Jr, Bell D, et al. Eye-sparing multidisciplinary approach for the management of lacrimal gland carcinoma. Head Neck. 2016;38:1258–62.CrossRefGoogle Scholar
  19. 19.
    Gensheimer MF, Rainey D, Douglas JG, Liao JJ, Laramore GE, Jian-Amadi A, et al. Neutron radiotherapy for adenoid cystic carcinoma of the lacrimal gland. Ophthal Plast Reconstr Surg. 2013;29:256–60.CrossRefGoogle Scholar
  20. 20.
    Orlandi E, Takanen S, Giandini T, Iannacone E, Fontanella W, Locati L, et al. Postoperative radiotherapy with volumetric modulated arc therapy of lacrimal gland carcinoma: two case reports and literature review. Future Oncol. 2014;10:2111–20.CrossRefGoogle Scholar
  21. 21.
    Tse DT, Kossler AL, Feuer WJ, Benedetto PW. Long-term outcomes of neoadjuvant intra-arterial cytoreductive chemotherapy for lacrimal gland adenoid cystic carcinoma. Ophthalmology. 2013;120:1313–23.CrossRefGoogle Scholar
  22. 22.
    Williams MD, Al-Zubidi N, Debnam JM, Shinder R, DeMonte F, Esmaeli B. Bone invasion by adenoid cystic carcinoma of the lacrimal gland: preoperative imaging assessment and surgical considerations. Ophthal Plast Reconstr Surg. 2010;26:403–8.CrossRefGoogle Scholar

Copyright information

© Japanese Ophthalmological Society 2019

Authors and Affiliations

  • Ju-Yi Hung
    • 1
    • 2
  • Yi-Hsuan Wei
    • 3
  • Chu-Hsuan Huang
    • 3
  • Lily-Wei Chen
    • 4
    • 5
  • Chiou-Shann Fuh
    • 2
  • Shu-Lang Liao
    • 3
    • 6
    Email author
  1. 1.Department of OphthalmologyTaipei Medical University HospitalTaipei CityTaiwan
  2. 2.Department of Computer Science and Information EngineeringNational Taiwan UniversityTaipei CityTaiwan
  3. 3.Department of OphthalmologyNational Taiwan University HospitalTaipei CityTaiwan
  4. 4.College of MedicineUniversity of MassachusettsBostonUSA
  5. 5.University of MassachusettsWorcesterUSA
  6. 6.College of MedicineNational Taiwan UniversityTaipei CityTaiwan

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