{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T18:20:22Z","timestamp":1787682022360,"version":"build-2784847793"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Primary ocular-adnexal non-Hodgkin lymphoma (POANHL) is a rare malignancy, but the most common tumor of the ocular adnexa. Data on real-world outcomes in Hispanic-Latino populations are limited, despite potential geographic and biologic differences. We describe the treatment and outcomes of POANHL in a Peruvian cohort and identify factors associated with survival outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study including all patients diagnosed with localized POANHL (stage I and II) at a tertiary referral center between 2000 and 2017. Survival outcomes were estimated using Kaplan\u2013Meier methods, and Cox proportional hazards models were used to identify prognostic factors for event-free survival (EFS) and overall survival (OS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 98 patients were included. The mean age was 58.0\u2009\u00b1\u200917.5 years. The orbit was the most frequently involved site (42.8%), followed by the eyelid (29.6%) and the conjunctiva (27.6%). The most common associated lymphomas were extranodal marginal zone lymphoma (50.0%), diffuse large B-cell lymphoma (23.5%), and follicular lymphoma (7.1%). Most patients presented with stage I disease (80.6%), good performance status (ECOG 0\u20131: 88.8%), and low international prognostic index (0\u20131: 69.6%). Treatment included chemotherapy (39.2%), radiotherapy (24.5%), combined modality therapy (12.2%), and observation\/no treatment (35.7%). Cyclophosphamide, vincristine, doxorubicin, and prednisone-based regimens were the most commonly used chemotherapy backbone. Complete response (CR) was 45.6% among treated patients. With a median follow-up of 20.2 years, 5-year OS and EFS were 94.8% and 79.2% for indolent lymphomas, and 59.7% and 42.8% for aggressive lymphomas respectively. On multivariable analysis, older age was independently associated with worse outcomes in indolent lymphoma, both for EFS (HR\u2009=\u20091.084, 95%CI 1.028\u20131.142) and OS (HR\u2009=\u20091.092, 95%CI: 1.037\u20131.150). In aggressive lymphoma, treatment modality was the only independent prognostic factor for DFS, with chemotherapy (HR 0.135, 95% CI 0.031\u20130.595; p\u2009=\u20090.008) and chemoradiotherapy (HR 0.112, 95% CI 0.023\u20130.547; p\u2009=\u20090.007) associated with improved outcomes vs. observation; radiotherapy showed a non-significant trend (HR\u2009=\u20090.200, 95%:CI 0.033\u20131.203). No variables were independently associated with OS in aggressive lymphoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We report real-world outcomes of POANHL in a Hispanic\u2013Latino cohort, demonstrating distinct clinical characteristics and survival outcomes compared with previously published series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0356381","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T17:35:48Z","timestamp":1787679348000},"page":"e0356381","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Primary ocular-adnexal non-Hodgkin Lymphoma in a Peruvian cohort: An 18-year experience"],"prefix":"10.1371","volume":"21","author":[{"given":"Renato","family":"Luque-Benavides","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4203-3890","authenticated-orcid":true,"given":"Gabriel De la","family":"Cruz Ku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Valcarcel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6502-8970","authenticated-orcid":true,"given":"Alejandro","family":"Garcia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiorella","family":"Davila Galecio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Luque","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Guadalupe","family":"Lujan Peche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0826-8928","authenticated-orcid":true,"given":"Deiby","family":"Cruzado Sanchez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Enriquez-Vera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"issue":"3","key":"pone.0356381.ref001","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1182\/blood-2016-05-714584","article-title":"Long-term course of patients with primary ocular adnexal MALT lymphoma: a large single-institution cohort study","volume":"129","author":"A Desai","year":"2017","journal-title":"Blood"},{"issue":"3","key":"pone.0356381.ref002","doi-asserted-by":"crossref","first-page":"416","DOI":"10.2478\/raon-2024-0048","article-title":"Ocular adnexal lymphoma - 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