Clinical and histopathological correlation: A study on 334 eyes with retinoblastoma from Vietnam

Abstract

Purpose: To elucidate the clinical features which predict high-risk histopathological factors for subsequent metastatic disease as well as to report the incidence of these high-risk histopathological factors in a cohort of Asian patients with retinoblastoma.
 Design: A retrospective and non-randomized sequential cases series.
 Methods: A retrospective study was done on 334 eyes with retinoblastoma at Vietnam National Institute of Ophthalmology during a 10 year period (January 2004 – December 2013). All pathology specimens and medical records were reviewed and assessed for invasion and clinical signs.
 Results: Among 334 eyes, 225 (67.4%) had high-risk retinoblastoma and 109 (22.6%) had non-high-risk features on histopathology. The high-risk histopathological features included anterior chamber seeding (48.2%), iris infiltration (14.7%), ciliary body involvement (14.1%), massive choroidal invasion (29.9 %), post-laminar optic nerve invasion (21.2%), invasion of optic nerve transection (9.6 %), combined choroidal and optic nerve invasion (9.6 %), scleral invasion (3.3%), and extra-scleral infiltration (11.4%). The significant clinical features in high-risk group versus non-high-risk group included hyphema (19.6% vs 3.7%, p < 0.001), pseudohypopyon (19.1% vs 6.4%, p = 0.001), iris neovascularization (25.3% vs 5.5%, p < 0.001), vitreous seeding (72.4% vs 37.6%, p < 0.001), staphyloma (24% vs 4.6%, p < 0.001) and scleritis (20% vs 3.7%, p < 0.001).
 Conclusions: Clinical signs including hyphema, pseudohypopyon, iris neovascularization, vitreous seeding, staphyloma, and scleritis were significantly associated with high-risk features on histopathology. Globe preserving methods should be used with caution in patients with these signs.

Clinical features and outcome of retinoblastoma at the Vietnam National Cancer Hospital

“…tion and survival outcomes of children affected by RB vary widely across studies around the world. 1 In our study, the median age of onset was 18.9 months (range: 1-63 months), which was older than some previous studies in Japan (13.5 13 Older age was also found in some studies in other countries, including Malaysia (24.2 months), India (29 months), Ghana (36 months), and Kenya (37.5 months). 14 The mean age in the bilateral RB group was usually younger, although some studies from the United States and India showed a higher incidence of unilateral disease than bilateral disease.…”

“…In our study, the median age of onset was 18.9 months (range: 1–63 months), which was older than some previous studies in Japan (13.5 months), Colombia (8.7 months), and Thailand (8 months) 11,12 . However, an older age of onset has been reported by Nguyen et al., with 334 RB eyes with primary removed from 2004 to 2013 at the National Eye Hospital in Vietnam, the mean age was 25.4 months 13 . Older age was also found in some studies in other countries, including Malaysia (24.2 months), India (29 months), Ghana (36 months), and Kenya (37.5 months) 14 .…”