Prediagnostic Intervals in Retinoblastoma: Experience at an Oncology Center in Brazil

Mattosinho, Clarissa; Grigorovski, Nathalia; Lucena, Evandro; Ferman, Sima Ester; Moura, Anna Tereza Miranda Soares de; Portes, Arlindo Freire

doi:10.1200/jgo.2016.005595

Cited by 13 publications

(15 citation statements)

References 36 publications

(51 reference statements)

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“…RB is usually diagnosed at later ages in developing countries. In our study, the mean age of RB cases was 21.8 months similar to the results from the study of Mattosinho et al from Brasil with a mean age of 21.7 months [ 5 ]. On the other hand, Gallie et al reported that the mean age at diagnosis was 12 and 9 months for North America and Europe, respectively [ 6 ] and Shields et al reported a mean age of 18 months from USA [ 7 ].…”

Section: Discussionsupporting

confidence: 90%

A 20-year audit of retinoblastoma treatment outcomes

Gündüz

Mirzayev

Temel

et al. 2020

Eye

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Objectives To evaluate the long-term treatment outcomes in intraocular retinoblastoma (RB) including the associated factors for eventual treatment with external beam radiotherapy (EBRT) and enucleation as well as to analyse the risk factors for metastasis and death in extraocular RB. Methods Retrospective analysis of 390 eyes from 256 (89.8%) intraocular RB and 29 (10.2%) extraocular RB cases diagnosed and treated between October 1998 and May 2018 at one of the largest tertiary care centers in Turkey. Results Of 351 intraocular RB eyes, 53.3% had group D/E disease at presentation. 75 (21.4%) of 351 eyes underwent primary enucleation. Of the remaining 276 eyes undergoing eye-conserving treatments, 201 (72.8%) were salvaged. Most of these eyes were treated using intravenous chemotherapy and/or focal treatments [transpupillary thermotherapy (TTT) and cryotherapy] initially. EBRT was eventually required in 48 (17.4%) eyes and secondary enucleation in 75 (27.2%) eyes. At mean follow-ups of 76.7 and 39.7 months for intraocular and extraocular RB cohorts, respectively, 180 (46.2%) eyes underwent primary/secondary enucleation and exenteration. Overall, 13 cases developed metastasis and 9 died. Two patients with trilateral RB also expired. Multivariable risk factors for enucleation were the presence of vitreous seeds ( p < 0.001), absence of EBRT administration ( p = 0.033), 5–9 TTT applications compared with no TTT ( p = 0.031), and each 1 mm increase in tumour base diameter ( p < 0.001). Univariate factors predictive of metastasis were the presence of extraocular RB detected by imaging methods ( p < 0.001) and extrascleral/optic nerve cut end involvement at histopathological examination ( p < 0.001). Conclusions In our series, 72.8% of the intraocular RB eyes undergoing eye-conserving treatments were saved. The globe salvage rate for all intraocular and extraocular RB eyes was 53.8% and the overall survival rate was 96.1%.

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Section: Discussionsupporting

confidence: 90%

A 20-year audit of retinoblastoma treatment outcomes

Gündüz

Mirzayev

Temel

et al. 2020

Eye

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“…There were 46 patients (50.5%) with parents of middle social status, and 45 patients (49.5%) with middle to low social status. In developed countries such as America, Britain, and other European countries, this malignancy is diagnosed earlier in childhood less <2 years [5,6]. In developing countries, RB is diagnosed in older children.…”

Section: Discussionmentioning

confidence: 99%

“…The RB incidence varies according to the sociodemographics of each country [3-5] Parental education, low socioeconomic conditions, and inadequate health facilities may result in delays of diagnosis and management of RB in developing countries. In developed countries such as America, Britain, and other European countries, this malignancy is diagnosed earlier in childhood <2 years [6].The RB incidence is 1: 15.000-20.000 per birth rate. This cancer generally occurred unilaterally, the mean age when diagnosed was two years in 60% of cases [4].…”

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confidence: 99%

Clinical Findings and Demography of Retinoblastoma in a Tertiary Hospital in a Remote Area in a Developing Country

Simanjuntak

2018

Asian Pac J Cancer Care

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Purpose: To report clinical characteristics and demography of retinoblastoma managed in a tertiary eye hospital in a remote area in a developing country.Methods: This is a descriptive retrospective study. Clinical characteristics were gender, age, tumor growth, onset, severity, laterality, nutritional status, and prominent clinical signs. The socioeconomic demographics of the patient’s families were grouped into work and economic conditions, and education. Management and its outcome were recorded.Results: There were 91 samples, distributed evenly in five years. The frequency was even between middle income 45 patients (49.5%) and lower middle income 46 patients (50.5%). The mean age at diagnosis was 3-5 year with 49 patients (53,8%), ranging from 1 to 12 years. Male to female ratio was 1:1. Less nutritional status were 64 patients (70.3%). All cases occurred unilaterally without family history of RB, and laterality was equal between right and left eye, with 1:1 ratio. Those patients who mainly presented with extra ocular involvement numbered 73 patients (80.2%) and those with clinical symptoms of protruded numbered 70 patients (76.9%). Patients generally presented in stage IV of 70 cases (76.9%). The mean onset was 1-2 years in 43 cases (47.2%). The therapeutic management was chemotherapy. After treatment, all patients followed up in two weeks.Conclusion: RB patients referred to a tertiary hospitalin a remote area are more likely to come in advanced stage, from middle-income group parents. More extraocular cases seen with major clinical features of protruded eye with an onset of 2-3 years.

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“…17 In Brazil, maternal education carried a significant difference with outcomes (advanced stage at diagnosis, enucleation and survival). 18 Interestingly, low SES per se was not associated with poorer outcomes.…”

Section: Discussionmentioning

confidence: 95%

Role of ethnicity and socio-economic status (SES) in the presentation of retinoblastoma: findings from the UK

Bourkiza

Cumberland

Abeysekera

et al. 2019

Preprint

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2 3 Purpose: The aim of this study was to investigate if there was a relationship between ethnicity 4 or socioeconomic status and the presentation of advanced non-familial retinoblastoma in the 5 UK. 6 7 Methods: A cross sectional study based at the two centres providing retinoblastoma care in the 8 UK. Non-familial cases of retinoblastoma (Rb) presenting between January 2006 and December 9 2011 were included. Data collected included: age at diagnosis , gender, child's ethnicity, 10 International Intraocular Retinoblastoma Classification (IIRC) stage with Groups D and E being 11 considered advanced, laterality, treatment, and postcodes. Individual postcode (ZIP code) data 12 was used to obtain the Index of Multiple Deprivation (IMD) score. A postal questionnaire was 13 sent to participants' parents to collect further, person-level, information on languages spoken 14 and household socioeconomic position. Measures of severity of retinoblastoma also included: 15 requirement for primary enucleation; the use of adjuvant chemotherapy; and mortality. 16 17 Results: 189 cases were analyzed. 98 (52%) male and 91 (48%) female. Median age at 18 diagnosis was 16 months [IQR 8 -34 months]. 153/189 (81%) of cases presented with 19 advanced retinoblastoma; 75 (40%) group E, 78 (41%) group D. 134 (72%) of cases were 20 treated with enucleation. 21 Multivariable analysis showed that older age at presentation was associated with enucleation 22 and bilateral disease was associated with adjuvant chemotherapy. There was some indication 23 that South Asian ethnicity and being in the most deprived IMD quintile were associated with a 24 higher likelihood of presentation with advanced disease, but these estimates did not reach 25 statistical significance. 26 27 Conclusions: In this first national UK study of patients with non-familial retinoblastoma, there 28 was no evidence of an association of ethnicity or socio-economic status and the risk of 29 presenting with advanced disease. This may reflect equality in access of health care in the UK. 30 As a result, awareness campaigns should continue. 31 32 33 34 35 36 37 38 128 (93%) of whom had advanced disease. Those presenting with advanced retinoblastoma and 129 those treated with enucleation were similarly distributed by demographic and socioeconomic 130 factors to all cases (Table 1), as were those receiving adjuvant chemotherapy (68, 50% of those 131 that were enucleated). 133Multivariable analysis showed children 2 years or older and those with bilateral retinoblastoma 134 were more likely to present with advanced disease (Table 2). Older age at presentation was 135 associated with enucleation and bilateral disease with receipt of adjuvant chemotherapy. There 157(enucleation rate and adverse histopathology). Of note, there was no statistically significant 158 association between the factors listed in Table 3 and advanced disease (IIRC Groups D and 159 E).160 161 162 163 164 165 166 167 168 169 170 201 surgeon may have played a part. In addition, statistical significance was noted in mo...

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Prediagnostic Intervals in Retinoblastoma: Experience at an Oncology Center in Brazil

Cited by 13 publications

References 36 publications

A 20-year audit of retinoblastoma treatment outcomes

A 20-year audit of retinoblastoma treatment outcomes

Clinical Findings and Demography of Retinoblastoma in a Tertiary Hospital in a Remote Area in a Developing Country

Role of ethnicity and socio-economic status (SES) in the presentation of retinoblastoma: findings from the UK

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