Objective  In this study, we aimed to explore the clinical features and factors affecting prognosis by collecting data from patients with ocular adnexal mucosa-associated lymphoid tissue lymphoma (OAML).

Methods Clinical data of 54 patients diagnosed with ocular adnexal lymphoma (OAL) at The Second Affiliated Hospital of Soochow University between September 2010 and October 2024 were retrospectively analyzed. Of these, 39 (72.2%) had mucosa-asso-ciated lymphoid tissue (MALT) lymphoma, which constituted the focus of this study. The Kaplan-Meier method was used to estimate the progression-free survival (PFS) and overall survival (OS) rates. The Log-rank test was applied to compare survival differences across pathological types and treatment groups. Correlation analysis and univariate Cox regression were conducted to assess the impact of various factors on PFS. Variables with P<0.050 were subsequently included in multivariate Cox regression analysis to identify independent risk factors.

Results Among the 39 patients, the median age at onset was 64 years. Thirty-two and seven patients had unilateral orbital involvement and bilateral orbital involvement, respectively. All the patients underwent surgery. After surgery, the 5-year PFS and the 5-year OS of patients with MALT lymphoma were 54.21% and 100%, respectively. Univariate Cox regression analysis indicated that lesion location (P=0.011, hazard ratio HR=0.07), remission status after the first treatment (P<0.001, HR=0.082), and EBV infection (P=0.011, HR=0.207) significantly affected PFS. Multivariate regression analysis showed that remission status after the first treatment (P=0.034, HR =0.193) was an independent risk factor for prognosis. Patients who had not achieved complete response (CR) had a worse prognosis.

Conclusions Remission status after the first treatment is an important prognostic indicator in patients with MALT lymphoma. Close follow-up should be performed for patients who have not achieved complete remission after the first treatment.