Retrospective investigation of retinoblastoma in Chinese patients

Abstract

This is a retrospective investigation of patients with Retinoblastoma (RB) conducted from 2013 to 2016 at the Quanzhou Maternal and Child Health Hospital (China). Demographic and clinical characteristics, treatment outcomes, and risk factors were studied.In total, 436 patients were included in the study. Most of the findings obtained in this study are consistent with other previous reports. The male: female ratio was 1.41:1, and the unilateral: bilateral ratio was 1.51:1. Leukocoria was the most common presenting sign (79.44%), followed by strabismus (12.38%). While, the overall rates of enucleation (15.82%) and mortality (0.92%) were markedly lower than in other reports of RB in Chinese, and most of the patients received conservative therapy. There were signficant differences (p < 0.001) in the age of at first sign and diagnosis, and treatment modalities between patients with bilateral and unilateral RB. The treatment modalities did not show a specific trend over the 3-year study period. Our results suggest that an incorrect initial diagnosis and long lag time may be risk factors for ineffective treatment and a poor prognosis in patients with RB.This was a comprehensive retrospective investigation in which the sample size exceeded most previous retrospective investigations of RB. Our study confirmed that early detection, accurate diagnosis, and active intervention are conducive to control of retention of patients’ vision. Fundus examinations, education regarding the early signs of RB, and optimization of the therapeutic strategy of RB may play important roles in ocular health.

Natural History of Untreated Retinoblastoma

“…The median age at diagnosis for children who abandoned treatment at diagnosis was nine months, significantly younger than previous studies on general clinical presentation of retinoblastoma in China (25 months) [21], Taiwan (26 months) [22], India (29 months) [23], Korea (21 months) [24], and Malaysia (22 months) [25]. The median lag period from first sign to diagnosis was 1.3 months, similar to two Chinese studies which reported lag periods of one month and two months, respectively [21,26]. This suggests that diagnosis of retinoblastoma is timely in China, but that advantage to cure that is lost when treatment at diagnosis is abandoned.…”

“…This suggests that diagnosis of retinoblastoma is timely in China, but that advantage to cure that is lost when treatment at diagnosis is abandoned. The proportion of children with bilateral disease in our cohort was 73%, higher than the 20% and 40% bilateral disease in two other Chinese studies [21,26]. We hypothesize that bilateral disease with poor visual prognosis in both eyes may predispose to treatment abandonment.…”

Clinical characteristics, treatment and prognosis of children with unilateral retinoblastoma and intracranial segment of Retrobulbar optic nerve invasion

“…China is the most populous country in the world and documents about 1000 new cases of RB every year, accounting for 1/8 of all cases worldwide [ 6 ]. Good medical conditions and modern technology have increased overall survival rate of RB to exceed 95% in developed countries [ 7 ]. However, in developing countries, patients with RB are mostly diagnosed at advanced stages [ 8 ].…”

A Review of Outstanding Retinoblastoma Researches on RB1 Genes: Focus on Treatment by Non-ionizing and Ionizing Radiation

“…Some studies have been carried out to check clinical outcomes and treatment in children in southwestern China with retinoblastoma and distinguish the predictive factors for bad outcomes. The study showed that parents' and physicians' education for early retinoblastoma symptoms such as leukocoria, therapeutic strategy, and retinoblastoma treatment outcomes might improve early detection, improvement of compliance, and disease outcome [22,23] . This study aims to investigate the effects of all types of radiation, both ionizing and non-ionizing, on RB treatment.…”