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. 2005 Nov;89(11):1445-8.
doi: 10.1136/bjo.2005.072892.

Mortality following exenteration for malignant tumours of the orbit

I Rahman  1 , A Maino, A E Cook, B Leatherbarrow
Affiliations

Mortality following exenteration for malignant tumours of the orbit

I Rahman et al. Br J Ophthalmol. 2005 Nov.

Abstract

Background: Orbital exenteration is a rare, but disfiguring procedure reserved for the treatment of locally invasive malignancy or potentially life threatening orbital neoplasms, when less destructive techniques are inadequate. The authors report their experience and analyses of 64 cases of orbital exenteration performed over a 13 year period, looking specifically at key factors affecting mortality associated with such a destructive surgical procedure.

Methods: Records were reviewed retrospectively of all patients who had undergone exenteration of the orbit from 1 January 1991 to 1 April 2004 inclusive, at the Manchester Royal Eye Hospital. In all cases of deceased individuals, the cause of death was determined by liaison with the general practitioner and local health authority. Duplicate death certificates were requested for all deceased patients from the Registrar for Births, Deaths, and Marriages, Southport, UK. Kaplan-Meier analysis was used to estimate survival following exenteration.

Results: Overall, 1 year survival post-exenteration was high at 93%. After 3 years this had fallen to 67%, followed by 57% after 5 years, and 37% at 10 years. 13 patients died as a direct result of the orbital tumour. A further nine died of unrelated medical conditions, and two patients succumbed to malignant processes originating elsewhere in the body. There was no difference in survival rate at 3 years (p=0.99) and 5 years (p=0.454) between those with clear resection margins and those without.

Conclusion: In this study it was found that there was an overall mortality rate of 38% over 12 years. The presence of clear surgical margins, although reassuring for the surgeon, should not be regarded as an indication of cure. However, an overall 1 year survival of 93% and a 10 year survival of 37% are reassuring in that a proportion of individuals achieve surgical cure following exenteration. 38% of patients died as a result of other medical causes over the 12 year follow up.

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Figures

Figure 1
Figure 1
Survival rate in 64 cases of exenteration for orbital malignancy.
Figure 2
Figure 2
Survival curve comparing clear excision margins to unclear margins. (1 = clear excision margin group, 2 = residual tumour group.)
Figure 3
Figure 3
Survival curves comparing BCC patients with non-BCC patients.
See this image and copyright information in PMC

References

    1. Mohr C, Esser J. Orbital exenteration: surgical and reconstructive strategies. Graefes Arch Clin Exp Ophthalmol 1997;235:288–95. - PubMed
    1. Naquin HA. Exenteration of the orbit. Arch Ophthalmol 1954;51:850–62. - PubMed
    1. Rathbun JE, Beard C, Quickert MH. Evaluation of 48 cases of orbital exenteration. Am J Ophthalmol 1971;72:191–9. - PubMed
    1. Levin PS, Dutton JJ. A 20 year series of orbital exenteration. Am J Ophthalmol 1991;112:496–501. - PubMed
    1. Bartley GB, Garrity JA, Waller RR, et al. Orbital exenteration at the Mayo Clinic 1967–1986. Ophthalmology 1989;96:468–74. - PubMed

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