Researchers say that the sluggish improvement in survival rates of lacrimal gland malignancies over the years points to an alarming need for improved diagnostics and therapeutics. Photo: Ashley Kay Maglione, OD, and Kelly Malloy, OD. Click image to enlarge.

Tumors involving the lacrimal gland are fortunately rare, but their scarcity makes them difficult to study. To gain insight into the epidemiology of lacrimal gland tumors in the United States, researchers analyzed data from the North American Association of Central Cancer Registries (NAACCR) from 1996 to 2018, hoping to identify trends that might guide care. They found that better diagnostics and treatments are needed urgently.

In total, 3,620 patients were included, of which 56.7% were female; 45% were between the ages of 60 and 79; 83% were white; and 52% had localized disease. The researchers reported that lymphomas made up almost 60% of lacrimal gland malignancies while 37% were carcinomas.

The cumulative age-adjusted incidence rate per million was 0.53 for all malignancies, and 0.31 and 0.2 for lymphomas and carcinomas, respectively, according to the researchers. Annual crude incidence rates increased steadily, with a significant average annual change of 1.24%, but age-adjusted rates didn’t mirror this trend. At five and 10 years, relative survival rates were 88.64 months and 80.26 months, respectively.

The researchers reported the following were associated with significantly worse outcomes: older age, non-lymphoma tumors and advanced stage at diagnosis. They also found that relative survival rates didn’t change significantly from 1995 to 2018, regardless of gender, race or treatment received.

Overall, lymphomas were the most prevalent type of lacrimal gland malignancies, followed by carcinomas. The researchers concluded that “epithelial malignant tumors tended to occur earlier (before the age of 60) than other subtypes. Lymphomas had the best survival outcomes while carcinomas had the worst. Lacrimal gland melanomas were rare and tended to have poor survival outcomes.”

They added that the increasing incidence “should prompt the prioritization of training programs designed to educate" the next generation of eyecare providers on diagnosing and treating lacrimal gland malignancies.