Treatment and Survival for Patients with Localized Primary Ocular Adnexal Mucosa-Associated Lymphoid Tissue Lymphoma

Abstract Despite the favorable prognosis of primary ocular adnexal mucosa-associated lymphoid tissue lymphoma (POAML), the impact of baseline characteristics and various treatment approaches on the disease outcome and toxicities remains unclear. In this cohort, 262 patients with Ann-Arbor stage IE POAML were grouped by first-line treatment: observation (n = 81), surgery (n = 70), systemic treatment (chemotherapy and/or immunotherapy [CT/IT], n = 29), or radiotherapy (RT, n = 82). With a median follow-up period of 66 months, five-year overall survival (OS), lymphoma-specific mortality, and non-lymphoma-specific mortality rates were 96.8%, 0.4%, and 2.3%, respectively. Standardized mortality ratio (SMR) was 1.02 (P = 0.963). OS, relative survival, and SMR were similar across the treatment groups; however, the risk of failure was significantly lower with RT (11.0%, P = 0.006) than with observation (33.3%), surgery (28.6%), and CT/IT (24.1%). The patient-reported Ocular Surface Disease Index questionnaire showed that RT with a definitive dose caused a slightly higher incidence of dry eye. In conclusion, patients with localized POAML exhibit very favorable survival outcomes regardless of the treatment. Radical RT may be associated with a lower rate of failure and minor ocular adverse effects.