1
|
Dockery PW, Ruben M, Duffner ER, Levin HJ, Lally SE, Shields JA, Shields CL. Likelihood of germline mutation with solitary retinoblastoma based on tumour location at presentation. Br J Ophthalmol 2023; 108:131-136. [PMID: 36414256 DOI: 10.1136/bjo-2022-321757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND/AIMS To evaluate the likelihood of germline mutation in patients presenting with solitary retinoblastoma based on tumour location at first examination. METHODS Retrospective analysis of solitary unilateral retinoblastoma for likelihood of germline mutation (family history of retinoblastoma and/or genetic testing indicating germline RB1 mutation and/or development of additional new or bilateral tumours) based on tumur location at presentation (macular vs extramacular). RESULTS Of 480 consecutive patients with solitary retinoblastoma, 85 were in the macula (18%) and 395 were extramacular (82%). By comparison (macular vs extramacular tumours), macular tumours had smaller basal diameter (12.7 mm vs 18.9 mm, p<0.001) and smaller tumour thickness (6.1 mm vs 10.7 mm, p<0.001). Patients with macular tumours demonstrated greater likelihood for germline mutation (23% vs 12%, OR=2.18, p=0.011), specifically based on family history of retinoblastoma (13% vs 2%, OR=4.64, p=0.004), genetic testing showing germline RB1 mutation (27% vs 15%, OR=2.04 (95% CI 1.04 to 4.01), p=0.039), development of new tumours (13% vs 3%, OR=5.16 (95% CI 2.06 to 12.87), p=0.001) and/or development of bilateral disease (9% vs 2%, OR=4.98 (95% CI 1.70 to 14.65), p=0.004). CONCLUSIONS Among patients with solitary unilateral retinoblastoma, those presenting with macular tumour (compared with extramacular tumour) show 2.18 times greater likelihood for germline mutation and an even higher likelihood of development of subsequent tumours. Solitary macular retinoblastoma should raise an index of suspicion for likely germline mutation and multifocal disease.
Collapse
Affiliation(s)
- Philip W Dockery
- Wills Eye Hospital Ocular Oncology Service, Philadelphia, Pennsylvania, USA
| | - Megan Ruben
- Wills Eye Hospital Ocular Oncology Service, Philadelphia, Pennsylvania, USA
| | - Emily R Duffner
- Wills Eye Hospital Ocular Oncology Service, Philadelphia, Pennsylvania, USA
| | - Hannah J Levin
- Wills Eye Hospital Ocular Oncology Service, Philadelphia, Pennsylvania, USA
| | - Sara E Lally
- Wills Eye Hospital Ocular Oncology Service, Philadelphia, Pennsylvania, USA
| | - Jerry A Shields
- Wills Eye Hospital Ocular Oncology Service, Philadelphia, Pennsylvania, USA
| | - Carol L Shields
- Wills Eye Hospital Ocular Oncology Service, Philadelphia, Pennsylvania, USA
| |
Collapse
|
2
|
van Hoefen Wijsard M, Serné SH, Otten RH, Bosscha MI, Dommering CJ, Fabius AW, Moll AC. At What Age Could Screening for Familial Retinoblastoma Be Discontinued? A Systematic Review. Cancers (Basel) 2021; 13:cancers13081942. [PMID: 33920538 PMCID: PMC8072927 DOI: 10.3390/cancers13081942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/09/2021] [Accepted: 04/14/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this systematic review is to assess the latest age at diagnosis for detection of familial retinoblastoma in order to evaluate at what age screening of at-risk children could be discontinued. Extended screening beyond this age would result in unnecessary patient burden and costs. However, discontinuing screening prematurely would have the adverse effect of missing tumors. We performed a literature search (PubMed, Embase, CINAHL and the Cochrane Library) up until February of 2021 and systematically included studies where patients had a family history of retinoblastoma, a known age at diagnosis, and who were ophthalmologically screened for retinoblastoma from birth. A total of 176 familial retinoblastoma patients from 17 studies were included in this review. Based on 48 months of age being the latest age of diagnosis, ophthalmological screening for familial retinoblastoma could safely be discontinued at age four years.
Collapse
Affiliation(s)
- Milo van Hoefen Wijsard
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The Netherlands; (S.H.S.); (M.I.B.); (A.W.F.); (A.C.M.)
- Correspondence:
| | - Saskia H. Serné
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The Netherlands; (S.H.S.); (M.I.B.); (A.W.F.); (A.C.M.)
| | - René H. Otten
- Medical Library, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands;
| | - Machteld I. Bosscha
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The Netherlands; (S.H.S.); (M.I.B.); (A.W.F.); (A.C.M.)
| | - Charlotte J. Dommering
- Department of Clinical Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands;
| | - Armida W. Fabius
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The Netherlands; (S.H.S.); (M.I.B.); (A.W.F.); (A.C.M.)
| | - Annette C. Moll
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, 1081 HV Amsterdam, The Netherlands; (S.H.S.); (M.I.B.); (A.W.F.); (A.C.M.)
| |
Collapse
|
3
|
Soliman SE, VandenHoven C, MacKeen LD, Gallie BL. Secondary Prevention of Retinoblastoma Revisited. Ophthalmology 2020; 127:122-127. [DOI: 10.1016/j.ophtha.2019.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/08/2019] [Accepted: 08/13/2019] [Indexed: 01/02/2023] Open
|
4
|
Abramson DH. Re: Skalet et al.: Screening children at risk for retinoblastoma: consensus report from the American Association of Ophthalmic Oncologists and Pathologists (Ophthalmology. 2018;125:453-458). Ophthalmology 2018; 125:e63-e64. [DOI: 10.1016/j.ophtha.2018.03.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 03/16/2018] [Indexed: 11/16/2022] Open
|
5
|
Kamihara J, Bourdeaut F, Foulkes WD, Molenaar JJ, Mossé YP, Nakagawara A, Parareda A, Scollon SR, Schneider KW, Skalet AH, States LJ, Walsh MF, Diller LR, Brodeur GM. Retinoblastoma and Neuroblastoma Predisposition and Surveillance. Clin Cancer Res 2018; 23:e98-e106. [PMID: 28674118 DOI: 10.1158/1078-0432.ccr-17-0652] [Citation(s) in RCA: 137] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 05/02/2017] [Accepted: 05/09/2017] [Indexed: 12/28/2022]
Abstract
Retinoblastoma (RB) is the most common intraocular malignancy in childhood. Approximately 40% of retinoblastomas are hereditary and due to germline mutations in the RB1 gene. Children with hereditary RB are also at risk for developing a midline intracranial tumor, most commonly pineoblastoma. We recommend intensive ocular screening for patients with germline RB1 mutations for retinoblastoma as well as neuroimaging for pineoblastoma surveillance. There is an approximately 20% risk of developing second primary cancers among individuals with hereditary RB, higher among those who received radiotherapy for their primary RB tumors. However, there is not yet a clear consensus on what, if any, screening protocol would be most appropriate and effective. Neuroblastoma (NB), an embryonal tumor of the sympathetic nervous system, accounts for 15% of pediatric cancer deaths. Prior studies suggest that about 2% of patients with NB have an underlying genetic predisposition that may have contributed to the development of NB. Germline mutations in ALK and PHOX2B account for most familial NB cases. However, other cancer predisposition syndromes, such as Li-Fraumeni syndrome, RASopathies, and others, may be associated with an increased risk for NB. No established protocols for NB surveillance currently exist. Here, we describe consensus recommendations on hereditary RB and NB from the AACR Childhood Cancer Predisposition Workshop. Clin Cancer Res; 23(13); e98-e106. ©2017 AACRSee all articles in the online-only CCR Pediatric Oncology Series.
Collapse
Affiliation(s)
- Junne Kamihara
- Dana-Farber Cancer Institute, Boston Children's Hospital, Boston, Massachusetts
| | | | - William D Foulkes
- Human Genetics, Medicine and Oncology, McGill University, Montreal, Québec, Canada
| | - Jan J Molenaar
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Yaël P Mossé
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Andreu Parareda
- Sant Joan de Deu, Barcelona Children's Hospital, Barcelona, Catalonia, Spain
| | | | | | - Alison H Skalet
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
| | - Lisa J States
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Lisa R Diller
- Dana-Farber Cancer Institute, Boston Children's Hospital, Boston, Massachusetts
| | | |
Collapse
|
6
|
King BA, Parra C, Li Y, Helton KJ, Qaddoumi I, Wilson MW, Ogg RJ. Spatiotemporal Patterns of Tumor Occurrence in Children with Intraocular Retinoblastoma. PLoS One 2015; 10:e0132932. [PMID: 26230335 PMCID: PMC4521796 DOI: 10.1371/journal.pone.0132932] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 06/21/2015] [Indexed: 01/11/2023] Open
Abstract
PURPOSE To accurately map the retinal area covered by tumor in a prospectively enrolled cohort of children diagnosed with retinoblastoma. METHODS Orbital MRI in 106 consecutive retinoblastoma patients (44 bilateral) was analyzed. For MRI-visible tumors, the polar angle and angle of eccentricity of points defining tumor perimeter on the retina were determined by triangulation from images in three orthogonal planes. The centroid of the mapped area was calculated to approximate tumor origin, and the location and cumulative tumor burden were analyzed in relation to mutation type (germline vs. somatic), tumor area, and patient age at diagnosis. Location of small tumors undetected by MRI was approximated with fundoscopic images. RESULTS Mapping was successful for 129 tumors in 91 eyes from 67 patients (39 bilateral, 43 germline mutation). Cumulative tumor burden was highest within the macula and posterior pole and was asymmetrically higher within the inferonasal periphery. Tumor incidence was lowest in the superotemporal periphery. Tumor location varied with age at diagnosis in a complex pattern. Tumor location was concentrated in the macula and superonasal periphery in patients <5.6 months, in the inferotemporal quadrant of the posterior pole in patients 5.6-8.8 months, in the inferonasal quadrant in patients 8.8-13.2 months, and in the nasal and superotemporal periphery in patients >13.2 months. The distribution of MRI-invisible tumors was consistent with the asymmetry of mapped tumors. CONCLUSIONS MRI-based mapping revealed a previously unrecognized pattern of retinoblastoma localization that evolves with age at diagnosis. The structured spatiotemporal distribution of tumors may provide valuable clues about cellular or molecular events associated with tumorigenesis in the developing retina.
Collapse
Affiliation(s)
- Benjamin A. King
- Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Sciences Center, Memphis, Tennessee, United States of America
- Department of Radiological Sciences, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Carlos Parra
- Department of Radiological Sciences, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
- Department of Biomedical Engineering, University of Memphis, Memphis, Tennessee, United States of America
| | - Yimei Li
- Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Kathleen J. Helton
- Department of Radiological Sciences, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Ibrahim Qaddoumi
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Matthew W. Wilson
- Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Sciences Center, Memphis, Tennessee, United States of America
- Department of Surgery, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Robert J. Ogg
- Department of Radiological Sciences, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
- * E-mail:
| |
Collapse
|
7
|
Abramson DH, Francis JH, Dunkel IJ, Marr BP, Brodie SE, Gobin YP. Ophthalmic artery chemosurgery for retinoblastoma prevents new intraocular tumors. Ophthalmology 2012. [PMID: 23177361 DOI: 10.1016/j.ophtha.2012.08.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To determine the incidence and timing of new intraocular tumor foci in genetic retinoblastoma cases after treatment with ophthalmic artery chemosurgery (OAC). DESIGN Single-center retrospective review of all genetic retinoblastoma cases managed at Memorial Sloan-Kettering Cancer Center/Weil-Cornell Medical School since May 2006. PARTICIPANTS Eighty-one patients (80 with bilateral disease and 1 with unilateral disease with a family history) with genetic retinoblastoma, with a total of 116 eyes treated with OAC since May 2006. METHODS Retrospective, single-institution review of patients with bilateral retinoblastoma and unilateral retinoblastoma with a positive family history. New tumors were assessed by clinical notes, retinal drawings, and RetCam digital imaging (Clarity Medical Systems, Pleasanton, CA). MAIN OUTCOME MEASURES New intraocular retinoblastoma tumors after treatment with OAC. RESULTS Forty-one eyes were treated primarily with OAC (treatment-naïve group) and 75 eyes were treated with OAC after prior treatment with systemic chemotherapy, external beam radiation, or both and focal techniques. Of the 41 treatment-naïve eyes, a new intraocular tumor (one focus) subsequently developed in 1 eye. Of the 75 previously treated eyes, new tumors (single focus in each eye) subsequently developed in 6 eyes. CONCLUSIONS Eyes receiving OAC demonstrate fewer new intraocular retinoblastomas after radiation or systemic chemotherapy than has been reported in the literature. This suggests that ophthalmoscopically undetectable tumors are present at the initial diagnosis and effectively are eliminated as a result of OAC.
Collapse
Affiliation(s)
- David H Abramson
- Department of Ophthalmology at Weill-Cornell Medical School, New York, New York; Ophthalmic Oncology Service at Memorial Sloan-Kettering Cancer Center, New York, New York.
| | - Jasmine H Francis
- Ophthalmic Oncology Service at Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Ira J Dunkel
- Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York; Department of Pediatrics, Weill-Cornell Medical Center, New York, New York
| | - Brian P Marr
- Ophthalmic Oncology Service at Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Scott E Brodie
- Ophthalmic Oncology Service at Memorial Sloan-Kettering Cancer Center, New York, New York; Department of Ophthalmology, Mount Sinai School of Medicine, New York, New York
| | - Y Pierre Gobin
- Ophthalmic Oncology Service at Memorial Sloan-Kettering Cancer Center, New York, New York; Department of Neurosurgery, Neurology, and Radiology at Weill-Cornell Medical, New York, New York
| |
Collapse
|
8
|
Huddleston S, McNall-Knapp RY, Siatkowski M, Odom C, Brennan R, Wilson MW. A novel translocation t(11;13) (q21;q14.2) in a child with suprasellar primitive neuroectodermal tumor and retinoblastoma. Ophthalmic Genet 2012; 34:97-100. [PMID: 22924820 DOI: 10.3109/13816810.2012.719058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To report on a novel translocation related to a suprasellar primitive neuroectodermal tumor (sPNET) and retinoblastoma. DESIGN Case report. METHODS A 6-year-old girl underwent genetic testing after developing unilateral retinoblastoma subsequent to treatment (surgery, chemotherapy, and stem-cell rescue) for a sPNET found at 1 year of age. RESULTS Genetic testing found the girl's karyotype to be 46,XX,t(11;13)(q21;q14.2); a novel translocation not previously reported in patients with either retinoblastoma or sPNET. CONCLUSIONS Our patient had a novel translocation affecting the retinoblastoma 1 (RB1) gene, 46,XX,t(11;13)(q21;q14.2) resulting in the late development of unilateral retinoblastoma. Although she only developed unilateral retinoblastoma, her central nervous system was affected at a very early age. How her complex mutation resulted in retinoblastoma and antecedent sPNET remains unknown.
Collapse
Affiliation(s)
- Stephen Huddleston
- The Hamilton Eye Institute, Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee 38163, USA
| | | | | | | | | | | |
Collapse
|
9
|
Tran HV, Schorderet DF, Gaillard MC, Balmer A, Munier FL. Risk assessment of recurrence in sporadic retinoblastoma using a molecular-based algorithm. Ophthalmic Genet 2011; 33:6-11. [DOI: 10.3109/13816810.2011.610859] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
|
10
|
Rothschild PR, Lévy D, Savignoni A, Lumbroso-Le Rouic L, Aerts I, Gauthier-Villars M, Esteve M, Bours D, Desjardins L, Doz F, Lévy-Gabriel C. Familial retinoblastoma: fundus screening schedule impact and guideline proposal. A retrospective study. Eye (Lond) 2011; 25:1555-61. [PMID: 21921957 DOI: 10.1038/eye.2011.198] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
AIMS To assess if systematic fundus screening according to an 'intensive' schedule alters ocular outcome and to propose fundus screening schedule guidelines for children related to a retinoblastoma patient. METHODS For children with a positive family history of retinoblastoma, we perform fundus exams shortly after birth under general anaesthesia and then at regular intervals according to schedules based on the risk. Familial retinoblastoma cases seen at our institution from January 1995 to December 2004 were retrospectively classified as 'screened' or 'non-screened' (NS) and, among the 'screened' patients, as 'intensively screened' (IS) if screening matched our recommendations or 'non-intensively screened' (S). Groups were compared by Fisher exact test for categorical variables and Kruskal-Wallis test for continuous variables. RESULTS Among the 547 retinoblastoma patients managed at our institution during this period, 59 were familial cases. In all, 20 were in the NS group, 23 in the S group, and 16 in the IS group. The number of children enucleated was, respectively, 13, 2, and 0 (P<10(-4)); external beam radiation (EBRT) was required for, respectively, 6, 0, and 2 children (P<0.009). Chemotherapy burden and visual acuity were not significantly different between groups. CONCLUSION An 'intensive' fundus screening schedule decreased the need for enucleation and EBRT. Therefore, despite the heavy burden of the screening schedule, we recommend physicians and health-care professionals to better inform and refer children with a family history of retinoblastoma for genetic counselling and proper fundus screening in specialized centres.
Collapse
Affiliation(s)
- P-R Rothschild
- Department of Ocular Oncology, Institut Curie, Paris, France
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
National Retinoblastoma Strategy Canadian Guidelines for Care: Stratégie thérapeutique du rétinoblastome guide clinique canadien. Can J Ophthalmol 2010; 44 Suppl 2:S1-88. [PMID: 20237571 DOI: 10.3129/i09-194] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
12
|
Roche A, Mora J, Perez MDM, Gean E, Perez B, O'Callaghan M, Catala J, De Torres C, Cruz O, Prat J, Parareda A. Axenfeld-Rieger ocular anomaly and retinoblastoma caused by constitutional chromosome 13q deletion. Pediatr Blood Cancer 2010; 54:480-2. [PMID: 19927293 DOI: 10.1002/pbc.22354] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Axenfeld-Rieger (AR) ocular anomaly might be due to deletions of different chromosomes. No association between AR, mental retardation, and retinoblastoma has been described. We report a 2-month-old female with general development delay and dysmorphic features. AR anomaly was detected, and a retinoblastoma (RB) was diagnosed in a very early stage. De novo 13q deletion was identified. Systemic chemotherapy, focal cryotherapy, transpupillary thermotherapy, brachytherapy, and intra-arterial chemotherapy were needed to control the RB. This is the first report of an association of AR, 13q deletion, and retinoblastoma, to be disclosed in patients born with such ocular and dysmorphic features.
Collapse
Affiliation(s)
- Ana Roche
- Department of Child Neurology, Hospital Sant Joan de Déu, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Wiler JL, Price C, Fintak DR, Shields C. Leukocoria and irregular pupil. Am J Emerg Med 2010; 28:121.e5-8. [DOI: 10.1016/j.ajem.2009.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2009] [Accepted: 05/13/2009] [Indexed: 11/26/2022] Open
|
14
|
Kim JH, Yu YS. Incidence (1991~1993) and Survival Rates (1991-2003) of Retinoblastoma in Korea. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2010. [DOI: 10.3341/jkos.2010.51.4.542] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jeong Hun Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Young Suk Yu
- Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea
| |
Collapse
|
15
|
|
16
|
Chantada GL, Dunkel IJ, Qaddoumi I, Antoneli CBG, Totah A, Canturk S, Nawaiseh I, Fandiño A, Pífano I, Peksayar G, Ribeiro KB, Abramson DH. Familial retinoblastoma in developing countries. Pediatr Blood Cancer 2009; 53:338-42. [PMID: 19434730 DOI: 10.1002/pbc.21970] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Although screening for familial retinoblastoma has been shown to be beneficial we suspected that such screening programs may be less than optimal in developing countries (DC). METHODS Retrospective cohort study comparing patients with familial retinoblastoma from five centers in DC (Argentina, Brazil, Turkey, Jordan, and Venezuela) versus a reference center in the USA. RESULTS Ninety-two (32 from the USA and 60 from DC) patients were included. Forty-one (44.6%) patients avoided enucleation, 42 (45.7%) had 1 eye removed, and 9 (9.8%) underwent bilateral enucleation. Eleven (11.9%) had major pathology risk factors at enucleation. There were no cases of metastatic disease at diagnosis. Detection via screening was significantly less common in DC than in the USA (23.3% vs. 71.8%, P < 0.0001). Patients in DC were diagnosed at a significantly later age and with more advanced intraocular disease that led to increased risk of bilateral enucleation. Patients detected by screening in DC were significantly younger at diagnosis, had less advanced intraocular disease, better ocular preservation rates and survival results than those whose retinoblastoma was not detected via early screening. Five-year pEFS was 0.92 for the patients treated in the USA and 0.81 for the patients in DC (P = 0.42). Seven events occurred (extraocular relapse four in patients from DC and second malignancies in three). CONCLUSIONS Patients with familial retinoblastoma are less likely to be diagnosed by screening in DC and had higher morbidity and mortality caused by recurrent extraocular retinoblastoma.
Collapse
|
17
|
Imhof SM, Moll AC, Schouten-van Meeteren AYN. Stage of presentation and visual outcome of patients screened for familial retinoblastoma: nationwide registration in the Netherlands. Br J Ophthalmol 2006; 90:875-8. [PMID: 16613925 PMCID: PMC1857137 DOI: 10.1136/bjo.2005.089375] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND In the Netherlands a comprehensive programme for screening just after birth for familial retinoblastoma is taking place. In this report the stage of the disease at the time of detection, by way of screening, and the long term visual outcome in these patients was evaluated. METHODS A nationwide, retrospective study. From January 1992-July 2004, patients at risk for familial retinoblastoma were screened 1-2 weeks after birth, and investigated for laterality, Reese-Ellsworth classification/International Classification of Retinoblastoma, macular involvement, age of primary retinoblastoma, initial therapy, and visual outcome. RESULTS 17 patients were diagnosed with familial retinoblastoma. 88.3% developed bilateral, 11.7% unilateral retinoblastoma. Of the 34 eyes, 56% were R-E group I, 16% were group II A-B, 16% were group III A-B, 9% were group IV, 3% were group V. Using the International Classification of Retinoblastoma, 72% were group A, 19% were group B, 6% were group C, 3% were group E. The visual outcome revealed 73.5% of eyes with 20/20-20/40, 26.5% eyes with < or = 20/100-no light perception; 5.9% of eyes were enucleated, all other eyes were treated with local or conservative treatment methods. Of all eyes, 59% had extramacular retinoblastoma, 98% of patients had at least one eye with extramacular retinoblastoma. CONCLUSION Most familial retinoblastoma patients present as a R-E group I or group A when screened within 2 weeks after birth. Nearly 90% of patients had a long term visual acuity of 20/20-20/40. Despite the common occurrence of macula involvement, bilateral macula involvement was infrequent, and since most eyes were salvaged, good vision was obtained in the majority of patients.
Collapse
Affiliation(s)
- S M Imhof
- Department of Ophthalmology, VU University Medical Centre, Amsterdam, Netherlands.
| | | | | |
Collapse
|
18
|
Xu K, Rosenwaks Z, Beaverson K, Cholst I, Veeck L, Abramson DH. Preimplantation genetic diagnosis for retinoblastoma: the first reported liveborn. Am J Ophthalmol 2004; 137:18-23. [PMID: 14700639 DOI: 10.1016/s0002-9394(03)00872-9] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
PURPOSE To develop an accurate mutation analysis procedure for retinoblastoma gene (RB1) mutation, which is sensitive at the single-cell level, and to use in vitro fertilization (IVF) and preimplantation genetic diagnosis (PGD) to achieve pregnancies without retinoblastoma. DESIGN Case report. METHODS Twelve day 3 embryos, obtained by IVF with intracytoplasmic sperm injection, underwent single-cell DNA testing via polymerase chain reaction and restriction enzyme analysis to detect the presence of a paternal RB1 mutation. Embryos were diagnosed as being unaffected and were transferred to the uterus on day 5. MAIN OUTCOME MEASURES Achieving a healthy pregnancy and delivery, assessed by clinical presentation, fundus photography, and RB1 molecular analysis. RESULTS A singleton pregnancy was achieved, and a child without retinoblastoma was born. The absence of the paternal RB1 mutation was confirmed on a sample of peripheral blood from the newborn. CONCLUSIONS We are first to report a successful human liveborn, delivered after IVF with preimplantation genetic diagnosis for retinoblastoma. The successful result indicates that preimplantation genetic diagnosis exists for this genetic disease and may represent a viable alternative to prenatal diagnosis with the subsequent option of terminating an affected pregnancy.
Collapse
Affiliation(s)
- Kangpu Xu
- Institute for Reproductive Medicine, New York Presbyterian Hospital-Weill Medical College of Cornell University, New York, New York 10021, USA.
| | | | | | | | | | | |
Collapse
|
19
|
Abramson DH, Beaverson K, Sangani P, Vora RA, Lee TC, Hochberg HM, Kirszrot J, Ranjithan M. Screening for retinoblastoma: presenting signs as prognosticators of patient and ocular survival. Pediatrics 2003; 112:1248-55. [PMID: 14654593 DOI: 10.1542/peds.112.6.1248] [Citation(s) in RCA: 114] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE To correlate 3 common presenting signs of retinoblastoma with patient and ocular survival and to assess the efficacy of current pediatric screening practices for retinoblastoma. METHODS A retrospective study was conducted of 1831 retinoblastoma patients from our center (1914-June 2000). Patient survival (excluding deaths from other primary neoplasms) and ocular survival (presenting eyes) rates were calculated and analyzed using the Kaplan-Meier method. RESULTS Leukocoria correlated with excellent patient survival (>86%, 5 years) but poor ocular survival in unilateral (4%, 5 years) and bilateral patients (29%, 5 years). A total of 308 (19%) of 1654 patients presented with strabismus: patient survival was excellent (90%, 5 years), and ocular survival was poor (17%, 5 years) yet better than leukocoria. Patients who had a family history of retinoblastoma and were clinically screened for retinal tumors from birth were diagnosed younger (8 months of age) and earlier (Reese Ellsworth group 1 = 26 [58%] of 45) and had better ocular survival than nonscreened patients with a family history. More patients were initially detected by family/friends (1315 [80%] of 1632) than pediatricians (123 [8%] of 1632) or ophthalmologists (156 [10%] of 1632). CONCLUSION Most US children whose retinoblastoma is diagnosed initially present with leukocoria detected by a parent, despite routine pediatric screening for leukocoria via the red reflex test. Initial disease detection at the point of leukocoria or strabismus correlated with high patient survival rates and poor ocular survival rates for the presenting eye. Saving eyes and vision requires disease recognition before leukocoria, as demonstrated by the better ocular salvage rate among patients who had a positive family history and received clinical surveillance via early, routine dilated funduscopic examinations by an ophthalmologist.
Collapse
Affiliation(s)
- David H Abramson
- Robert M. Ellsworth Ophthalmic Oncology Center, Department of Ophthalmology, New York Presbyterian Hospital-Weill Medical College of Cornell University, New York, USA.
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Lee TC, Hayashi NI, Dunkel IJ, Beaverson K, Novetsky D, Abramson DH. New retinoblastoma tumor formation in children initially treated with systemic carboplatin. Ophthalmology 2003; 110:1989-94; discussion 1994-5. [PMID: 14522776 DOI: 10.1016/s0161-6420(03)00669-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
PURPOSE To determine the frequency and timing of new intraocular tumor formation in children with hereditary retinoblastoma initially treated with systemic carboplatin. DESIGN Retrospective, noncomparative case series. PARTICIPANTS This study included 34 children (57 eyes) with hereditary bilateral retinoblastoma initially treated with systemic carboplatin at the Robert M. Ellsworth Ophthalmic Oncology Center at NewYork-Presbyterian Hospital from 1994 through 2000. MAIN OUTCOME MEASURES New tumor formation after initial treatment with systemic carboplatin. RESULTS There were a total of 165 tumors in 57 eyes. There were 63 new tumors in 27 eyes (47%) after administration of systemic carboplatin, for a mean of 1.1 new tumors per eye. The mean patient age at time of new tumor presentation was 9 months, with 57% of new tumors developing within 4 months of carboplatin treatment. Kaplan-Meier analysis showed that children who were treated when younger than 6 months of age were more likely to have new tumors (60%) compared with those treated after 6 months of age (31%; P = 0.0182). CONCLUSIONS New intraocular tumors continue to develop after systemic carboplatin; most new tumors appeared within 4 months of treatment.
Collapse
Affiliation(s)
- Thomas C Lee
- Department of Ophthalmology, New York-Presbyterian Hospital-Weill Medical College of Cornell University, 70 East 66th Street, New York, NY 10021, USA
| | | | | | | | | | | |
Collapse
|
21
|
Moll AC, Imhof SM, Meeteren AY, Boers M. At what age could screening for familial retinoblastoma be stopped? A register based study 1945-98. Br J Ophthalmol 2000; 84:1170-2. [PMID: 11004105 PMCID: PMC1723250 DOI: 10.1136/bjo.84.10.1170] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To evaluate until what age children in families with retinoblastoma should be screened. METHODS A register based cohort (n= 685) study of Dutch retinoblastoma patients (1945-1998). The records of all familial hereditary retinoblastoma patients from 1945 were reviewed and the age at diagnosis and either they were screened from birth determined. RESULTS 75 patients had the familial hereditary form of retinoblastoma. The mean age at diagnosis in patients with fundus screening (n=50) from birth on was 4.9 months (median 1.9 months; range 1 day to 48 months). Thus, 4 years was the latest onset of familial retinoblastoma properly evaluated from birth. This mean age was significantly different (p<0.0001) from the mean age at diagnosis in patients without fundus screening (n=25) from birth (mean 17.2 months; median 10.0 months; range 1.5-63.0 months). CONCLUSIONS Ophthalmological screening of children and sibs at risk for familial hereditary retinoblastoma is recommended until the age of 4 years in order to detect retinoblastoma as early as possible.
Collapse
Affiliation(s)
- A C Moll
- Department of Ophthalmology, Vrije Universiteit, Amsterdam, Netherlands.
| | | | | | | |
Collapse
|
22
|
Friedman DL, Himelstein B, Shields CL, Shields JA, Needle M, Miller D, Bunin GR, Meadows AT. Chemoreduction and local ophthalmic therapy for intraocular retinoblastoma. J Clin Oncol 2000; 18:12-7. [PMID: 10623688 DOI: 10.1200/jco.2000.18.1.12] [Citation(s) in RCA: 183] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To study the effectiveness of combined systemic chemotherapy and local ophthalmic therapy for retinoblastoma with the goal of avoiding enucleation and external-beam radiation therapy (EBRT). PATIENTS AND METHODS This was a prospective, nonrandomized, single-arm clinical trial. Seventy-five eyes were followed in 47 children. Patients were treated with a six-cycle protocol of vincristine, etoposide, and carboplatin. Most (83%) also received ophthalmic treatment (cryotherapy, laser photocoagulation, thermotherapy, or plaque radiation therapy) during and/or after the chemotherapy. RESULTS With a median follow-up of 13 months, event-free survival was 74%, with an event defined as enucleation and/or EBRT. Six children required EBRT in seven eyes (9%); five required enucleation of one eye (7%); five required a combination of EBRT and enucleation in six eyes (8%). Reese-Ellsworth groups 1, 2, and 3 eyes had excellent results, with avoidance of EBRT or enucleation in all 39. Treatment of groups 4 and 5 was less successful, with 33% of six eyes and 53% of 30 eyes, respectively, requiring EBRT and/or enucleation. Toxicities from chemotherapy were mild and included cytopenias (89%), fever and neutropenia (28%), infection (9%), and gastrointestinal symptoms, dehydration, and vincristine neurotoxicity (40%). No patients developed a second malignancy, metastatic disease, renal disease, or ototoxicity. CONCLUSION In retinoblastoma patients with Reese-Ellsworth eye groups 1, 2, or 3, systemic chemotherapy used with local ophthalmic therapies can eliminate the need for enucleation or EBRT without significant systemic toxicity. More effective therapy is required for Reese-Ellsworth eye groups 4 and 5.
Collapse
Affiliation(s)
- D L Friedman
- Department of Pediatrics, Division of Oncology, The Children's Hospital of Philadelphia, PA, USA.
| | | | | | | | | | | | | | | |
Collapse
|
23
|
Affiliation(s)
- T H Metz
- Pediatric Ophthalmology and Ocular Oncology Services, Wills Eye Hospital, Philadelphia, PA 19107, USA
| | | | | |
Collapse
|