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High-Risk Retinoblastoma Based on International Classification of Retinoblastoma: Analysis of 519 Enucleated Eyes

Kaliki, Swathi, MD ; Shields, Carol L., MD ; Rojanaporn, Duangnate, MD ; Al-Dahmash, Saad, MD ; McLaughlin, John P., BS ; Shields, Jerry A., MD ; Eagle, Ralph C., MD

Ophthalmology (Rochester, Minn.), 2013-05, Vol.120 (5), p.997-1003 [Periódico revisado por pares]

United States: Elsevier Inc

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  • Título:
    High-Risk Retinoblastoma Based on International Classification of Retinoblastoma: Analysis of 519 Enucleated Eyes
  • Autor: Kaliki, Swathi, MD ; Shields, Carol L., MD ; Rojanaporn, Duangnate, MD ; Al-Dahmash, Saad, MD ; McLaughlin, John P., BS ; Shields, Jerry A., MD ; Eagle, Ralph C., MD
  • Assuntos: Child ; Child, Preschool ; Eye Enucleation ; Humans ; International Classification of Diseases ; Kaplan-Meier Estimate ; Logistic Models ; Neoplasm Invasiveness - pathology ; Ophthalmology ; Retinal Neoplasms - classification ; Retinal Neoplasms - mortality ; Retinal Neoplasms - pathology ; Retinoblastoma - classification ; Retinoblastoma - mortality ; Retinoblastoma - pathology ; Retinoblastoma - secondary ; Retrospective Studies ; Risk Factors
  • É parte de: Ophthalmology (Rochester, Minn.), 2013-05, Vol.120 (5), p.997-1003
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
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  • Descrição: Purpose To determine the correlation between the International Classification of Retinoblastoma (ICRB) and histopathologic high-risk retinoblastoma. Design Retrospective study. Participants A total of 519 patients. Intervention Primary enucleation. Main Outcome Measures High-risk retinoblastoma, metastasis, and death. Results Of 519 primarily enucleated eyes, 87 (17%) were classified as group D and 432 (83%) were classified as group E on the basis of the ICRB. High-risk retinoblastoma was identified in 23% (117/519) of enucleated eyes, including 17% (15/87) group D and 24% (102/432) group E eyes. High-risk histopathologic features of retinoblastoma included anterior chamber involvement (5/15 [33%] group D eyes, 31/102 [30%] group E eyes), isolated massive posterior uveal invasion ≥3 mm (7/15 [47%] group D eyes, 22/102 [22%] group E eyes), isolated post-laminar optic nerve invasion (2/15 [13%] group D eyes, 46/102 [45%] group E eyes), and any combination of posterior uveal invasion and optic nerve involvement (7/15 [47%] group D eyes, 37/102 [36%] group E eyes). On logistic regression analysis, massive posterior uveal invasion ≥3 mm was more common in group D eyes ( P = 0.0442), and post-laminar optic nerve invasion was more common in group E eyes ( P = 0.0390). Of 117 patients with high-risk retinoblastoma, systemic adjuvant chemotherapy was administered in 83 patients (71%). Systemic metastasis developed in 0% (0/15) of those with high-risk group D retinoblastoma and 10% (10/102) of those with high-risk group E retinoblastoma over a mean follow-up period of 78 months (median, 62 months; range, 1–419 months). There was no metastasis in any patient (n = 402) classified with non–high-risk retinoblastoma. Of the 10 patients who developed metastasis, 4 had received prior adjuvant chemotherapy and 6 had no prior adjuvant chemotherapy. There was no metastasis in high-risk patients treated with vincristine sulphate, etoposide phosphate, and carboplatin (VEC). Death from metastasis occurred in 4% of high-risk patients (5/117). Conclusions On the basis of the ICRB, 17% of group D and 24% of group E eyes are at increased risk for metastatic disease. In this study, 8% of patients developed metastasis. There was no metastasis in any patient classified with non–high-risk retinoblastoma. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
  • Editor: United States: Elsevier Inc
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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