Associations among Socioeconomic Factors, Lag Time, and High-Risk Histopathologic Features in Eyes Primarily Enucleated for Retinoblastoma

Abstract

Purpose/Aim: To determine the associations among socioeconomic factors, delay in management, and high-risk histopathologic features in eyes primarily enucleated for retinoblastoma. Materials and Methods: A single-Eyes primarily enucleated for unilateral retinoblastoma were reviewed for the presence of high-risk histopathologic features. Information on clinical characteristics, socioeconomic factors, and lag time were collected during hospitalization. Results: Of the 138 children analyzed, 60 (43.5%) carried high-risk histopathologic features. Compared to children with a standard risk, those with a high risk had a longer median lag time before treatment (21.5 vs 15.0 days, P = .007), but their overall lag time (54.0 vs 50.0 days, P = .062) and delay in the initial visit (7.0 vs 10.0 days, P = .782) were comparable. Logistic regression analysis showed that children with a lag time ≥ 30 days were at a significantly higher risk of extraocular invasion (odds ratio [OR] = 2.38 and 95% confidence interval [CI] = 1.08-5.37 for treatment delay; OR = 2.12 and 95% CI = 1.01-4.62 for overall delay). Neither high-risk histopathologic features nor lag time was associated with any demographic or major socioeconomic factors, including sex, age at diagnosis or enucleation, ethnicity, household income, parents' education level, medical insurance coverage, and left-behind status. Conclusions: For children with advanced unilateral retinoblastoma, there is no statistical difference in overall lag time between standard and high-risk groups. Major socioeconomic parameters have little impact on the delay and histopathologic outcomes, thus implying that children with varied socioeconomic status may be at a similar risk of advanced tumor invasion. ARTICLE HISTORY

Clinical Features of Children with Retinoblastoma and Neuroblastoma

“…In the retinoblastoma cohort, delayed diagnosis longer than 2.5 months was an adverse prognostic factor, which is in agreement with the results of other studies [16,19]. Xiao et al [19] found that high-risk retinoblastoma had a longer interval from symptom presentation to enucleation than standard-risk retinoblastoma. According to Soliman et al [16], delayed diagnosis is significantly associated with advanced disease in both unilateral and bilateral retinoblastomas.…”

“…According to Soliman et al [ 16 ], delayed diagnosis is significantly associated with advanced disease in both unilateral and bilateral retinoblastomas. Moreover, children with a delay of diagnosis longer than 30 days are at a significantly higher risk of extraocular invasion [ 19 ]. Early diagnosis in retinoblastoma is a key concern.…”

Parent Knowledge of Screening and Genetic Testing in Retinoblastoma

“…Such positive correlation between parent education and diseaserelated knowledge was also documented in other studies, such as in sleep disorders [14]. In retinoblastoma management, our former study indicated that higher parental education was associated with a shorter lag time of treatment [15]. Taken together, these findings suggest that emphasis should be made on less-educated parents when carrying out retinoblastoma specific educational campaigns.…”

Influence of socioeconomic factors on cancer incidence and stage of melanoma in China

“…The educational status was categorized into two groups: middle school and below; high school and above(13). Monthly household income was categorized into two levels: <3000 CNY (approximate 430 USD); ≥3000 CNY(14). In this cohort, there was no patient whose occupation was professor or semi-professor, thus occupational status was categorized into two levels: unemployed and employed(15).…”