Lag time, high-risk histopathological features, metastasis, and survival interrelation in retinoblastoma: a perspective from lower-middle income country

Abstract

AIM: To investigate the impact of lag time to metastasis and survival rates among patients with retinoblastoma. METHODS: This retrospective study was conducted with 52 patients from the Department of Ophthalmology and the Department of Pediatrics of Dr. Sardjito General Hospital, between 1st January 2014 and 31st December 2020. Lag time was defined as the time delay between the first sign of retinoblastoma to the diagnosis of retinoblastoma. The subjects with lag time > one year were included in the case group, while the subjects with lag time < one year were included in the control group. RESULTS: The lag time was significantly correlated with American Joint Committee on Cancer and Intraocular Classification of Retinoblastoma staging of retinoblastoma (P=0.005 and P=0.006, respectively). The lag time was also significantly correlated with both metastasis event [odds ratio (OR): 5.06, 95%Cl: 1.56-16.44, P=0.006] and mortality (OR: 4.54, 95%Cl: 1.37-15.07, P=0.011). The follow-up was continued for 32 subjects for 3y after initial diagnoses. Survival analysis revealed a significant difference among these two groups (P=0.021). Furthermore, lag time was significantly correlated with survival of retinoblastoma (r=-0.53, P=0.046). CONCLUSION: The study highlights the importance of lag time between the onset of first symptoms and the time of retinoblastoma diagnosis which significantly contribute to metastasis and mortality of patients with retinoblastoma. Examinations for the early detection of retinoblastoma should be performed for individuals at-risk to minimize lag time and improve the outcomes.

Epidemiological aspect of retinoblastoma in the world: a review of recent advance studies

“…Among Asian countries, the highest incidence was reported in India followed by China [5] . Table 1 [1,[6][7][8][9][10][11][12][13][14][15][16] presents a summary of some epidemiological aspects of Rb. The incidence of Rb not only varies between different countries but there are also different reports in the same country.…”

“…Mutations in the RB1 gene [6,8] RB1 gene composition 27 exons and 26 introns [9] Environmental risk factor In vitro fertilization; insect sprays; poor living conditions [7,10] Survival rate 90% in developed countries [11][12]…”

Emerging Role of Circular RNAs in the Pathogenesis of Retinoblastoma

“…Management of children with Rb involves establishing a balance between patient survival with globe salvage and a consideration of the ultimate visual potential; in this regard, there is an urgent need for more effective novel therapies that carry less risk of toxicity [6]. Notably, conservation of the eyeball and the survival of patients with Rb are dependent to a large extent on the stage of the tumor at the time of diagnosis, with early diagnosis and timely intervention being critical factors for preventing visual loss and the metastasis of Rb [8]. In this context, newly discovered biomarkers may contribute to early molecular detection, timely diagnosis, determination of potential prognosis, and the establishment of new treatment options for Rb [6].…”