Retinoblastoma: A Three-Year-Study at a Brazilian Medical School Hospital

Abstract

OBJECTIVE: To present the characteristics and treatment outcomes of patients with retinoblastoma. METHODS: A retrospective case series was conducted to review the records of all new patients diagnosed with retinoblastoma between 2003 and 2005. Eyes with early disease, or advanced disease with potential vision were treated with chemotherapy (carboplatin and etoposide) in conjunction with early local therapy (laser or cryo). Radiotherapy was used in cases where the disease did not respond to the above protocols or in recurrent cases. Eyes in the late stage of disease with no potential vision in the initial examination or eyes and where conservative treatment had failed were enucleated. RESULTS: In total, we reviewed 28 new cases of retinoblastoma, 15 of which were unilateral and 13 of which were bilateral (46%). These data correspond to a mean of 9.3 new cases per year (0.77 case/ month). The mean age at diagnosis was 33.8 months for unilateral cases, and 19.15 months for bilateral cases (p=0.015). Leucocoria was the major presenting symptom (75%). All but one patient with unilateral disease had the affected eye enucleated due to advanced disease (mean follow-up: 39.91 months). Among the 13 bilateral cases, 13 eyes (50%) were enucleated, 11 eyes (42.4%) were saved with chemotherapy in conjunction with local therapy and 2 eyes (7.6%) were saved using external beam radiotherapy (mean follow-up: 41.91 months). In unilateral and bilateral disease, pathology data revealed choroid involvement in 50% and 30%, respectively, and optic nerve invasion in 92% and 50%, respectively. CONCLUSION: In this population, retinoblastoma was diagnosed too late and most eyes were consequently enucleated. In cases with bilateral disease, half of the eyes were preserved

Retinoblastoma: A Sixteen-Year Review of the Presentation, Treatment, and Outcome from a Tertiary Care Institute in Northern India

“…Our study shows a male predominance (62%), which is similar to the gender distribution shown in reports from Mexico [10] (52.4%), Mali [16] (54.5%), Egypt [17] (60.25), and Jordan [18] (70.0%). There is a definite regional bias in studies from our country as males were generally preferred for treatment in earlier studies as well [3].…”

“…HDI refers to a statistical measure of life expectancy, education, and income per capita used to rank the countries into 4 tiers of human development namely very high/high/medium/poor. In countries with very high HDI, the average age at presentation is earlier with increasing numbers of affected children less than 1 year of age [17,18]. The advanced age at presentation in our study can be attributed to the fact that nearly 12.9% of the patients belonged to the lower socioeconomic strata and more than 50% were from a rural population.…”

“…Eleven percent of patients were aged more than 5 years at presentation, which is higher than 3.5% reported from Brazil [17]. Gunalp et al [24] in their study on a Turkish population reported that diagnosis at older age is a common finding in developing countries.…”

Presentation of Retinoblastoma Patients in Malaysia

“…For unilateral disease, eyes falling under category D and E have neither potential for visual improvement nor conservative treatment options. Hence, enucleation remains the mainstay of treatment in most Southeast Asian settings (Aung et al, 2009, Bonanomi et al, 2009Reddy and Anusya, 2010), as was observed in the current study. Chemotherapy was administered post-enucleation in eyes with invasion into deep choroid and beyond.…”

Sporadic Retinoblastoma and Parental Smoking and Alcohol Consumption before and after Conception: A Report from the Children’s Oncology Group

“…This retinal tumor causes vision loss and can become life threatening if not treated [3,4]. The 10-year survival rate is 93% in the US [5], but ranges from 40% in low income countries to 79% in upper-middle income countries [6].…”