Analysis of survival and prognostic factors in lacrimal gland adenoid cystic Carcinoma

Lacrimal gland adenoid cystic carcinoma (LGACC) is a rare, highly malignant tumor with poor prognosis. To identify prognostic factors associated with local recurrence, distant metastasis, and disease-specific survival (DSS), we conducted a retrospective study of 88 patients with LGACC. A comprehensive LGACC dataset was constructed by integrating 7 cases treated at our institution with 81 additional cases identified through a systematic literature review. Associations between clinicopathologic variables and survival outcomes were evaluated using Kaplan–Meier survival analysis with log-rank testing, as well as univariate and multivariate Cox proportional hazards regression models. A total of 88 patients with LGACC were included. The age at diagnosis ranged from 9 to 86 years, with a slight male predominance. Median DSS was 60 months, median local-recurrence-free survival was 36 months, and median distant-metastasis-free survival was 49 months. The lung was the most frequent site of distant metastasis. Significant differences in DSS were observed across age groups, T categories, and surgical approaches ( P < 0.05). For local recurrence, survival curves differed significantly among T categories ( P < 0.05). With respect to distant metastasis, significant differences were identified between age groups, T categories, adjuvant chemotherapy groups, surgical approaches, and histopathologic subtypes ( P < 0.05). T category is an independent prognostic factor for patient mortality, local recurrence, and distant metastasis in LGACC. Surgical approach independently influences DSS, while histopathologic subtype is an independent risk factor for distant metastasis.