Survival Analysis and Prognostic Factors for Peri-ocular Malignancies in Malaysia
https://doi.org/10.47836/mjmhs.20.1.9
- Author:
Dhashani Sivaratnam
1
;
Radzlian Othman
2
;
Navin Kumar Devaraj
3
;
Yap Ming Teck
1
;
Vincent Ng Teng Fung
1
;
Ew Shao Chen
1
;
Ramizah Md Rozi
1
;
Nur Najlaa Baharudin
1
;
Kirbashini Kanasan
1
;
Abdul Hanif Khan Yusof Khan
4
;
Vasudevan Ramachandran
5
,
6
;
Siew Moi Ching
3
Author Information
1. Department of Ophthalmology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
2. Department of Ophthalmology, Serdang Hospital, Jalan Puchong, 43000, Selangor, Malaysia
3. Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
4. Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
5. Faculty of Health Sciences, University College of MAIWP International, Taman Batu Muda, 68100 Batu Caves, Kuala Lumpur, Malaysia&
6. Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
- Publication Type:Journal Article
- Keywords:
Orbital exenteration, peri-ocular malignancy;
adjuvant, overall survival
- From:Malaysian Journal of Medicine and Health Sciences
2024;20(No.1):60-69
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: This study aims to determine the prognostic factors and survival outcomes of patients that underwent
this surgery. Method: A retrospective review of 43 patients who underwent exenteration for periocular malignancies
over a 14-year period was carried out. Patient demographics, tumour histology, treatment details, surgical margins’
status and post-operative survival were recorded. The survival outcome examined was the overall survival (OS)
rate. Cox regression and Kaplan-Meier analysis were used to evaluate post-exenteration survival. Results: In total,
20 females and 23 males with a median age of 62 ± 17.3 years were identified. The most common indication for
exenteration was basal cell carcinoma (20.9%), followed by squamous cell carcinoma (18.6%), adenocystic carcinoma (14%), malignant melanoma (14%) and sebaceous gland carcinoma (11.6%). The independent predictors for
worse OS on multivariate analysis were Chinese ethnicity (adjusted hazard ratio [aHR] 4.95, p =0.017), sebaceous
gland carcinoma (aHR 57.61 p=0.006), adenocystic carcinoma (aHR 45.87, p=0.008), clear surgical margins (aHR
5.41, p=0.025), receiving only chemotherapy (aHR 169.13, p=0.004), and receiving both adjuvant chemotherapy
and radiotherapy (aHR 41.51, p=0.010). Conclusion: We recommend targeted public health initiatives for Chinese
patients due to their increased mortality risk from peri-ocular malignancies. In addition, we advise comprehensive
adjuvant therapy for all patients regardless of whether a clear surgical margin is achieved. Basal cell carcinoma and
adenocystic carcinoma may also benefit from genetic research. We advocate more training for ophthalmologists to
identify periocular malignancies earlier for better treatment options and increased chances of survival.
- Full text:11.2024my1713.pdf
