Clinical Outcomes of Orbital Exenteration in Korean Patients with Orbital Malignancies

Abstract

Purpose: We report the clinical outcomes of Korean patients who were diagnosed with orbital malignancies and underwent orbital exenteration.Methods: We retrospectively reviewed the tumor origins, histopathological diagnoses, local/regional recurrences, distant metastases, surgical margin clearances, overall and event-free survivals, and adjuvant chemotherapy or radiation therapy statuses of 14 patients who underwent orbital exenteration in our center from February 2009 to March 2020.Results: We enrolled seven men and seven women of mean age at the time of exenteration of 68 years (range, 37 to 80 years). The mean follow-up period was 44.6 months (range, 10 to 133 months). Most tumors had arisen in the eyelid (seven cases, 50.0%). The most common pathological diagnosis was malignant melanoma (five cases, 35.7%). We observed no local or regional recurrence after exenteration, but distant metastases developed in seven cases, of which four were malignant melanomas (80% of all melanomas). Positive surgical margins were observed in six cases (42.9%). The distant metastasis rate was 42.9%; the overall survival rate was 60%. The 1-year overall survival rate was 100%, the 2-year survival rate was 81.8%, and the 5-year survival rate was 56.1%. The 1-year event-free survival (EFS) rate was 100%, the 2-year EFS rate was 72.7%, and the 5-year EFS rate was 49.9%. Nine patients received adjuvant radiation or chemotherapy and six patients received combined chemoradiation.Conclusions: Patients underwent orbital exenteration to treat orbital malignancies and received postoperative chemotherapy and/or radiation exhibited differences in clinical outcomes and survival rates depending on the tumor type.