Outcomes of malignant orbital tumors: a 22-year Norwegian single-center series

To evaluate outcome data for patients with malignant orbital tumors treated at Haukeland University Hospital over a 22 year period and compare them with existing literature.

Patients were identified by searching for relevant codes in the Hospital's database. Medical records from patients with malignant orbital tumors treated from 1999 to 2020 were retrieved. Clinical features, management, and outcome was recorded. Incidence was estimated from yearly population data provided by Statistics Norway.

We included 76 patients, 41 (54%) females and 35 (46%) males corresponding to a yearly incidence in Western Norway of 0.30 per 100 000 inhabitants. Median age at time of diagnosis was 64 years (3-97 years). Secondary invading tumors were most frequently seen (46%), followed by lymphoproliferative (24%), metastatic (16%) and primary orbital tumors (14%). Biopsy and histopathologic confirmation were obtained in 73 out of 76 patients (96%). Of 40 different histological subgroups, squamous cell carcinoma from paranasal sinuses was the most common (16%). A total of 42 patients (55%) had their tumor surgically removed, of which 23 patients (55%) underwent exenteration. Local radiotherapy was administrated to 55 (72%) patients and 29 (38%) patients received chemotherapy. One or more local/regional relapses or distant metastases were seen in 32 (42%) patients. Overall disease specific 5-year survival was 59%, with significant differences between subgroups; lymphoproliferative diseases 82%, primary orbital tumors 80%, secondary invading tumors 46%, and orbital metastases 39%.

The spectrum of malignant orbital tumors, treatment modalities, and survival rates aligned closely with international literature. While our findings demonstrate that high-quality care is feasible at a low-volume center, further studies on the volume-outcome relationship in orbital oncology is warranted.