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Phan TAT, Derumigny A, Duong MC, Desjardins L, Cung TA, Nguyen CK. Conservative treatment using laser diode and systemic chemotherapy for early-stage bilateral retinoblastoma: A 14-year prospective cohort study. Cancer Rep (Hoboken) 2024; 7:e1919. [PMID: 37849419 PMCID: PMC10809195 DOI: 10.1002/cnr2.1919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/12/2023] [Accepted: 10/08/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Solid evidence of the safety and effectiveness of retinoblastoma (RB) conservative treatment using thermotherapy and systemic chemotherapy with long-term follow-up is scarce, especially in low-resource countries. AIMS This study examined the outcomes of this treatment and associated predictors in Vietnam to strengthen the current RB treatment protocol focusing on preserving eye and vision in low-resource settings. METHODS AND RESULTS A prospective cohort study was conducted at Ho Chi Minh City Eye Hospital in Vietnam from 2005 to 2019. All eligible patients with bilateral RB (one eye already removed and another eye classified as group A or B) and without previous treatment were recruited. All patients received thermotherapy and six cycles of systemic three-agent chemotherapy repeated every 4 weeks. A standardized questionnaire was used to collect information on study participants' age, symptoms, tumor characteristics, treatment, and outcomes. Among 50 eyes of all 50 patients with a median age of 9 (4-20) months, 34 eyes were in group B (68%). The median follow-up time was 60 (60-84) months. All 139 preserved tumors regressed mostly to type 4 (70.4%) and type 3 (23.7%) scars. Kaplan-Meier analysis found the overall globe-salvage rate at 5 years of 91.9% (95% CI: 80.1%-97.7%). Most eyes (41/50, 82%, 95% CI: 69.2%-90.2%) had a final visual acuity ≥0.1. The visual acuity is higher when tumors regressed to a type 4 scar (p = .007, AOR = 8.098, 95% CI: 1.79-36.53) which also shows less enucleation than a type 3 scar (p = .002, AOR = 0.06, 95% CI: 0.01-0.37%). Gender effect on visual acuity after treatment was significant and may be due to discrimination. No major complications were recorded. CONCLUSION Conservative treatment of early-stage RB is safe and effective. Long-term, thorough follow-ups of patients post-treatment are needed. The regression patterns of scars could be a useful indicator of treatment failure.
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Affiliation(s)
- Thi Anh Thu Phan
- Department of OphthalmologyUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Alexis Derumigny
- Department of Applied MathematicsDelft University of TechnologyDelftthe Netherlands
| | - Minh Cuong Duong
- Faculty of Medicine, School of Population HealthUNSWKensingtonNew South WalesAustralia
| | | | - Tuyet Anh Cung
- Department of OncologyUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Cong Kiet Nguyen
- Department of OphthalmologyUniversity of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
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Lukamba RM, Budiongo AN, Monga BB, Yao A, Bey P, Chenge GB, Desjardins L, Doz F, Mwembo AT, Kabesha TA, Luboya ON. Treatment adherence in retinoblastoma: A retro-prospective cohort study in Ivory Coast and the Democratic Republic of Congo. Cancer Rep (Hoboken) 2023; 7:e1949. [PMID: 38146612 PMCID: PMC10849925 DOI: 10.1002/cnr2.1949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/11/2023] [Accepted: 11/12/2023] [Indexed: 12/27/2023] Open
Abstract
BACKGROUND In high-income countries, retinoblastoma is curable in more than 95% of cases, whereas in low-income countries, mortality remains high, especially when the diagnosis is made late or the treatment is discontinued. AIMS To determine the factors associated with adherence to the treatment of retinoblastoma in the Ivory Coast and the Democratic Republic of Congo (DRC). METHODS AND RESULTS A retro-prospective cohort study was carried out. Data were collected from patient folders and follow-up records of parents. RESULTS A total of 175 children with retinoblastoma were registered from January 2013 to December 2015. Seventy-six children (43%) were 5 years old and above. Care costs were covered by families in 86.9% of cases. Chemotherapy refusal was recorded in 39 cases (22.3%), and enucleation refusal was recorded in 79 cases (45.1%). After 36 months of follow-up, we recorded 16.6% deaths, 27.4% treatment dropouts, and 18.3% loss to follow-up after treatment. The commonest cause for enucleation refusal was fear of infirmity, while chemotherapy refusal and absconding treatment were due to financial constraints. CONCLUSION Poor adherence to retinoblastoma management was due to financial constraints, and a lack of knowledge of the disease and its treatment. Family psychosocial support is needed to improve this condition.
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Affiliation(s)
- Robert Mbuli Lukamba
- Department of Pediatrics (Pediatric Oncology Unit)University of LubumbashiLubumbashiDemocratic Republic of the Congo (DRC)
| | - Aléine Nzazi Budiongo
- Department of Pediatrics (Pediatric Oncology Unit)University of KinshasaKinshasaDemocratic Republic of the Congo (DRC)
| | - Ben Bondo Monga
- Faculty of Medicine and School of Public HealthUniversity of LubumbashiLubumbashiDemocratic Republic of the Congo (DRC)
| | - Atteby Yao
- Pediatric Oncology UnitUniversity Teaching Hospital of TreichvilleAbidjanIvory Coast
| | - Pierre Bey
- Advisor to the President of Institut CurieUniversity of Lorraine and AMCCParisFrance
| | | | | | - François Doz
- SIREDO Oncology Center (Care, Innovation, Research in Child Oncology, Adolescent and Young Adult) Institut Curie and University Paris CitéParisFrance
| | - Albert Tambwe Mwembo
- Faculty of Medicine and School of Public HealthUniversity of LubumbashiLubumbashiDemocratic Republic of the Congo (DRC)
| | | | - Oscar Numbi Luboya
- Department of Pediatrics and School of Public HealthUniversity of LubumbashiLubumbashiDemocratic Republic of the Congo (DRC)
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Desjardins L, Labetoulle M, Weise F, Baudouin C. [JFO turns the page: The switch to all-digital technology]. J Fr Ophtalmol 2023; 46:1140-1141. [PMID: 38043955 DOI: 10.1016/j.jfo.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Affiliation(s)
- L Desjardins
- Société française d'ophtalmologie, 17, Villa Alésia, 75014 Paris, France.
| | - M Labetoulle
- Service d'ophtalmologie, hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - F Weise
- Éditions Elsevier Masson, 65, rue Camille-Desmoulins, 92442 Issy-les-Moulineaux cedex, France
| | - C Baudouin
- Service d'ophtalmologie, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
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van Heerden J, Balagadde-Kambugu J, Angom R, Lusobya RC, Chantada G, Desjardins L, Fabian ID, Israels T, Paintsil V, Hessissen L, Diouf MN, Elayadi M, Turner SD, Kouya F, Geel JA. Evaluating the baseline survival outcomes of the "six Global Initiative for Childhood Cancer index cancers" in Africa. Pediatr Hematol Oncol 2022; 40:203-223. [PMID: 36369884 DOI: 10.1080/08880018.2022.2140860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Limited survival data for the six Global Initiative for Childhood Cancer (GICC) priority cancers are available in Africa. Management of pediatric malignancies in Africa is challenging due to lack of resources, setting-specific comorbidities, high rates of late presentation and treatment abandonment. Reporting of outcome data is problematic due to the lack of registries. With the aim of evaluating the feasibility of baseline outcomes for the six index cancers, we present a descriptive analysis of respective survival rates in Africa. The survival rates were between 18% (lower middle-income countries) to 82.3% (upper middle-income countries) for acute lymphoblastic leukemia, between 26.9% (low-income countries) to 77.9% (upper middle-income countries) for nephroblastoma, between 23% (low-income countries) to 100% (upper middle-income countries), for retinoblastoma, 45% (low-income countries) to 95% (upper middle-income countries) for Hodgkin lymphoma and 28% (low-income countries) to 76% (upper middle-income countries) for Burkitt lymphoma. Solutions to improve survival rates and reported outcomes include establishing and funding sustainable registries, training and to actively include all countries in consortia from different African regions.HighlightsContinental differences in childhood cancer management such lack of resources, setting-specific comorbidities, high rates of late presentation and treatment abandonment, present challenges to the achievement of Global Initiative for Childhood Cancer goals.The available data registries do not adequately inform on the true incidences and outcomes of childhood cancers in Africa.The pathophysiology of some childhood cancers in Africa are associated with high-risk prognostic factors.Outcomes can be improved by greater regional collaboration to manage childhood cancer based on local resources and tumor characteristics.Some individual countries have reached the Global Initiative for Childhood Cancer goals for single cancers and it should be possible for more African countries to follow suit.
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Affiliation(s)
- Jaques van Heerden
- Pediatric Hematology and Oncology, Department of Pediatrics, Antwerp University Hospital, Antwerp, Belgium.,Pediatric hematology and Oncology, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa.,Department of Pediatric Oncology, Uganda Cancer Institute, Kampala, Uganda
| | | | - Racheal Angom
- Department of Pediatric Oncology, Uganda Cancer Institute, Kampala, Uganda
| | - Rebecca Claire Lusobya
- Department of Ophthalmology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Guillermo Chantada
- Department of Pediatric Oncology, Hospital Sant Joan de Deu, Barcelona, Spain
| | | | - Ido Didi Fabian
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel.,International Center for Eye Health London School of Hygiene and Tropical Medicine, London, UK
| | - Trijn Israels
- Department of Pediatrics, Queen Elizabeth Central Hospital, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Vivian Paintsil
- Department of Child Health, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Laila Hessissen
- Pediatric Hematology and Oncology Center, University Mohammed V Rabat, Rabat, Morocco
| | | | - Moatasem Elayadi
- Department of Pediatric Oncology, National Cancer Institute, Egypt & Children Cancer Hospital of Egypt (CCHE-57357), Cairo University, Giza, Egypt
| | | | - Francine Kouya
- Department of Pediatric Oncology, Cameroon Baptist Convention Hospitals in Mutengene, Mbingo and Banso, Mutengene, Cameroon
| | - Jennifer A Geel
- Division of Pediatric Hematology-Oncology, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Witwatersrand, South Africa
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Fabian ID, Abdallah E, Abdullahi SU, Abdulqader RA, Abdulrahaman AA, Abouelnaga S, Ademola-Popoola DS, Adio A, Afifi MA, Afshar AR, Aggarwal P, Aghaji AE, Ahmad A, Akib MNR, Akinsete A, Al Harby L, Al Mesfer S, Al Ani MH, Alarcón Portabella S, Al-Badri SAF, Alcasabas APA, Al-Dahmash SA, Alejos A, Alemany-Rubio E, Alfa Bio AI, Alfonso Carreras Y, Al-Haddad CE, Al-Hussaini HHY, Ali AM, Alia DB, Al-Jadiry MF, Al-Jumaily U, Alkatan HM, All-Eriksson C, Al-Mafrachi AARM, Almeida AA, Alsawidi KM, Al-Shaheen AASM, Al-Shammary EH, Amankwaa-Frempong D, Amiruddin PO, Armytasari I, Astbury NJ, Atalay HT, Ataseven E, Atchaneeyasakul LO, Atsiaya R, Autrata R, Balaguer J, Balayeva R, Barranco H, Bartoszek P, Bartuma K, Bascaran C, Bechrakis NE, Beck Popovic M, Begimkulova AS, Benmiloud S, Berete RC, Berry JL, Bhaduri A, Bhat S, Bhattacharyya A, Biewald EM, Binkley E, Blum S, Bobrova N, Boldt H, Bonanomi MTBC, Bouda GC, Bouguila H, Brennan RC, Brichard BG, Buaboonnam J, Budiongo A, Burton MJ, Calderón-Sotelo P, Calle Jara DA, Camuglia JE, Cano MR, Capra M, Caspi S, Cassoux N, Castela G, Castillo L, Català-Mora J, Cavieres I, Chandramohan A, Chantada GL, Chaudhry S, Chawla B, Chen W, Chiwanga FS, Chuluunbat T, Cieslik K, Clark A, Cockcroft RL, Comsa C, Correa Llano MG, Corson TW, Couitchere L, Cowan-Lyn KE, Csóka M, Dangboon W, Das A, Das P, Das S, Davanzo JM, Davidson A, De Francesco S, De Potter P, Quintero D K, Demirci H, Desjardins L, Díaz Coronado RY, Dimaras H, Dodgshun AJ, Donato Macedo CR, Dragomir MD, Du Y, Du Bruyn M, Du Plessis J, Dudeja G, Eerme K, Eka Sutyawan IW, El Kettani A, Elbahi AM, Elder JE, Elhaddad AM, Elhassan MMA, Elzembely MM, Ericksen C, Essuman VA, Evina TGA, Ezegwui IR, Fadoo Z, Fandiño AC, Faranoush M, Fasina O, Fernández DDPG, Fernández-Teijeiro A, Foster A, Frenkel S, Fu LD, Fuentes-Alabi SL, Garcia JL, García Aldana D, Garcia Pacheco HN, Geel JA, Ghassemi F, Girón AV, Goenz MA, Gold AS, Goldberg H, Gole GA, Gomel N, Gonzalez E, Gonzalez Perez G, González-Rodríguez L, Gorfine M, Graells J, Gregersen PA, Grigorovski NDAK, Guedenon KM, Gunasekera DS, Gündüz AK, Gupta H, Gupta S, Gupta V, Hadjistilianou T, Hamel P, Hamid SA, Hamzah N, Hansen ED, Harbour JW, Hartnett ME, Hasanreisoglu M, Muhammad H, Hassan S, Hassan S, Hautz W, Haydar H, Hederova S, Hessissen L, Hongeng S, Hordofa DF, Hubbard GB, Hummelen M, Husakova K, Hussein Al-Janabi AN, Ibanga A, Ida R, Ilic VR, Islamov Z, Jairaj V, Janjua T, Jeeva I, Ji X, Jo DH, Jones MM, Kabesha Amani TB, Kabore RL, Kaliki S, Kalinaki A, Kamsang P, Kantar M, Kapelushnik N, Kardava T, Kebudi R, Keomisy J, Kepak T, Ketteler P, Khan ZJ, Khaqan HA, Khetan V, Khodabande A, Khotenashvili Z, Kim JW, Kim JH, Kiratli H, Kivela TT, Klett A, Koç I, Kosh Komba Palet JE, Krivaitiene D, Kruger M, Kulvichit K, Kuntorini MW, Kyara A, Lam GC, Larson SA, Latinović S, Laurenti KD, Lavy Y, Lavric Groznik A, Leverant AA, Li C, Li K, Limbu B, Liu CH, Quah B, López JP, Lukamba RM, Luna-Fineman S, Lutfi D, Lysytsia L, Madgar S, Magrath GN, Mahajan A, Maitra P, Maka E, Makimbetov EK, Maktabi A, Maldonado C, Mallipatna A, Manudhane R, Manzhuova L, Martín-Begue N, Masud S, Matende IO, Mattosinho CCDS, Matua M, Mayet I, Mbumba FB, McKenzie JD, Mehrvar A, Mengesha AA, Menon V, Mercado GJV, Mets MB, Midena E, Miller A, Mishra DKC, Mndeme FG, Mohamedani AA, Mohammad MT, Moll AC, Montero MM, Moreira C, Mruthyunjaya P, Msina MS, Msukwa G, Mudaliar SS, Muma KIM, Munier FL, Murray TG, Musa KO, Mushtaq A, Musika AA, Mustak H, Mustapha T, Muyen OM, Myezo KH, Naidu G, Naidu N, Nair AG, Natarajan S, Naumenko L, Ndoye Roth PA, Nency YM, Neroev V, Ng Y, Nikitovic M, Nkanga ED, Nkumbe HE, Numbi MN, Nummi K, Nuruddin M, Nyaywa M, Nyirenda C, Obono-Obiang G, Oliver SCN, Oporto J, Ortega-Hernández M, Oscar AH, Ossandon D, Pagarra H, Paintsil V, Paiva L, Palanivelu MS, Papyan R, Parrozzani R, Pascual Morales CR, Paton KE, Pe'er J, Peralta Calvo J, Perić S, Pham CTM, Philbert R, Plager DA, Pochop P, Polania RA, Polyakov V, Ponce J, Qadir AO, Qayyum S, Qian J, Refaeli D, Rahman A, Rajkarnikar P, Ramanjulu R, Ramasubramanian A, Ramirez-Ortiz MA, Randhawa JK, Randrianarisoa HL, Raobela L, Rashid R, Reddy M, Renner LA, Reynders D, Ribadu D, Ritter-Sovinz P, Rogowska A, Rojanaporn D, Romero L, Roy SR, Saab RH, Saakyan S, Sabhan AH, Sagoo MS, Said AMA, Saiju R, Salas B, San Román Pacheco S, Sánchez GL, Sanchez Orozco AJ, Sayalith P, Scanlan TA, Schlüter S, Schwab C, Sedaghat A, Seth R, Sgroi M, Shah AS, Shakoor SA, Sharma MK, Sherief ST, Shields CL, Sia D, Siddiqui SN, Sidi cheikh S, Silva S, Singh AD, Singh U, Singha P, Sitorus RS, Skalet AH, Soebagjo HD, Sorochynska T, Ssali G, Stacey AW, Staffieri SE, Stahl ED, Steinberg DM, Stones DK, Strahlendorf C, Suarez MEC, Sultana S, Sun X, Superstein R, Supriyadi E, Surukrattanaskul S, Suzuki S, Svojgr K, Sylla F, Tamamyan G, Tan D, Tandili A, Tang J, Tarrillo Leiva FF, Tashvighi M, Tateshi B, Teh KH, Tehuteru ES, Teixeira LF, Tekavcic Pompe M, Thawaba ADM, Theophile T, Toledano H, Trang DL, Traoré F, Tripathy D, Tuncer S, Tyau-Tyau H, Umar AB, Unal E, Uner OE, Urbak SF, Ushakova TL, Usmanov RH, Valeina S, Valente P, van Hoefen Wijsard M, Vasquez Anchaya JK, Vaughan LO, Veleva-Krasteva NV, Verma N, Victor AA, Viksnins M, Villacís Chafla EG, Villegas VM, Vishnevskia-Dai V, Waddell K, Wali AH, Wang YZ, Wangtiraumnuay N, Wetter J, Widiarti W, Wilson MW, Wime ADC, Wiwatwongwana A, Wiwatwongwana D, Wolley Dod C, Wong ES, Wongwai P, Wu SQ, Xiang D, Xiao Y, Xu B, Xue K, Yaghy A, Yam JC, Yang H, Yanga JM, Yaqub MA, Yarovaya VA, Yarovoy AA, Ye H, Yee RI, Yousef YA, Yuliawati P, Zapata López AM, Zein E, Zhang Y, Zhilyaeva K, Zia N, Ziko OAO, Zondervan M, Bowman R. The Global Retinoblastoma Outcome Study: a prospective, cluster-based analysis of 4064 patients from 149 countries. The Lancet Global Health 2022; 10:e1128-e1140. [PMID: 35839812 PMCID: PMC9397647 DOI: 10.1016/s2214-109x(22)00250-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/06/2022] [Accepted: 05/23/2022] [Indexed: 02/01/2023] Open
Abstract
Background Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. Methods We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. Findings The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). Interpretation This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes. Funding Queen Elizabeth Diamond Jubilee Trust.
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Liu J, Ottaviani D, Sefta M, Desbrousses C, Chapeaublanc E, Aschero R, Sirab N, Lubieniecki F, Lamas G, Tonon L, Dehainault C, Hua C, Fréneaux P, Reichman S, Karboul N, Biton A, Mirabal-Ortega L, Larcher M, Brulard C, Arrufat S, Nicolas A, Elarouci N, Popova T, Némati F, Decaudin D, Gentien D, Baulande S, Mariani O, Dufour F, Guibert S, Vallot C, Rouic LLL, Matet A, Desjardins L, Pascual-Pasto G, Suñol M, Catala-Mora J, Llano GC, Couturier J, Barillot E, Schaiquevich P, Gauthier-Villars M, Stoppa-Lyonnet D, Golmard L, Houdayer C, Brisse H, Bernard-Pierrot I, Letouzé E, Viari A, Saule S, Sastre-Garau X, Doz F, Carcaboso AM, Cassoux N, Pouponnot C, Goureau O, Chantada G, de Reyniès A, Aerts I, Radvanyi F. A high-risk retinoblastoma subtype with stemness features, dedifferentiated cone states and neuronal/ganglion cell gene expression. Nat Commun 2021; 12:5578. [PMID: 34552068 PMCID: PMC8458383 DOI: 10.1038/s41467-021-25792-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 08/26/2021] [Indexed: 02/06/2023] Open
Abstract
Retinoblastoma is the most frequent intraocular malignancy in children, originating from a maturing cone precursor in the developing retina. Little is known on the molecular basis underlying the biological and clinical behavior of this cancer. Here, using multi-omics data, we demonstrate the existence of two retinoblastoma subtypes. Subtype 1, of earlier onset, includes most of the heritable forms. It harbors few genetic alterations other than the initiating RB1 inactivation and corresponds to differentiated tumors expressing mature cone markers. By contrast, subtype 2 tumors harbor frequent recurrent genetic alterations including MYCN-amplification. They express markers of less differentiated cone together with neuronal/ganglion cell markers with marked inter- and intra-tumor heterogeneity. The cone dedifferentiation in subtype 2 is associated with stemness features including low immune and interferon response, E2F and MYC/MYCN activation and a higher propensity for metastasis. The recognition of these two subtypes, one maintaining a cone-differentiated state, and the other, more aggressive, associated with cone dedifferentiation and expression of neuronal markers, opens up important biological and clinical perspectives for retinoblastomas.
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Affiliation(s)
- Jing Liu
- Institut Curie, CNRS, UMR144, Equipe Labellisée Ligue contre le Cancer, PSL Research University, 75005, Paris, France
- Sorbonne Universités, UPMC Université Paris 06, CNRS, UMR144, 75005, Paris, France
- Programme Cartes d'Identité des Tumeurs, Ligue Nationale Contre le Cancer, 75013, Paris, France
| | - Daniela Ottaviani
- Institut Curie, CNRS, UMR144, Equipe Labellisée Ligue contre le Cancer, PSL Research University, 75005, Paris, France
- Sorbonne Universités, UPMC Université Paris 06, CNRS, UMR144, 75005, Paris, France
- Precision Medicine, Hospital J.P. Garrahan, Buenos Aires, Argentina
| | - Meriem Sefta
- Institut Curie, CNRS, UMR144, Equipe Labellisée Ligue contre le Cancer, PSL Research University, 75005, Paris, France
- Sorbonne Universités, UPMC Université Paris 06, CNRS, UMR144, 75005, Paris, France
| | - Céline Desbrousses
- Institut Curie, CNRS, UMR144, Equipe Labellisée Ligue contre le Cancer, PSL Research University, 75005, Paris, France
- Sorbonne Universités, UPMC Université Paris 06, CNRS, UMR144, 75005, Paris, France
| | - Elodie Chapeaublanc
- Institut Curie, CNRS, UMR144, Equipe Labellisée Ligue contre le Cancer, PSL Research University, 75005, Paris, France
- Sorbonne Universités, UPMC Université Paris 06, CNRS, UMR144, 75005, Paris, France
| | - Rosario Aschero
- Pathology Service, Hospital J.P. Garrahan, Buenos Aires, Argentina
| | - Nanor Sirab
- Institut Curie, CNRS, UMR144, Equipe Labellisée Ligue contre le Cancer, PSL Research University, 75005, Paris, France
- Sorbonne Universités, UPMC Université Paris 06, CNRS, UMR144, 75005, Paris, France
| | | | - Gabriela Lamas
- Pathology Service, Hospital J.P. Garrahan, Buenos Aires, Argentina
| | - Laurie Tonon
- Synergie Lyon Cancer, Plateforme de Bioinformatique "Gilles Thomas", Centre Léon Bérard, 69008, Lyon, France
| | - Catherine Dehainault
- Département de Biologie des Tumeurs, Institut Curie, 75005, Paris, France
- Service de Génétique, Institut Curie, 75005, Paris, France
| | - Clément Hua
- Institut Curie, CNRS, UMR144, Equipe Labellisée Ligue contre le Cancer, PSL Research University, 75005, Paris, France
- Sorbonne Universités, UPMC Université Paris 06, CNRS, UMR144, 75005, Paris, France
| | - Paul Fréneaux
- Département de Biologie des Tumeurs, Institut Curie, 75005, Paris, France
| | - Sacha Reichman
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 75012, Paris, France
| | - Narjesse Karboul
- Institut Curie, CNRS, UMR144, Equipe Labellisée Ligue contre le Cancer, PSL Research University, 75005, Paris, France
- Sorbonne Universités, UPMC Université Paris 06, CNRS, UMR144, 75005, Paris, France
| | - Anne Biton
- Institut Curie, CNRS, UMR144, Equipe Labellisée Ligue contre le Cancer, PSL Research University, 75005, Paris, France
- Sorbonne Universités, UPMC Université Paris 06, CNRS, UMR144, 75005, Paris, France
- Institut Curie, PSL Research University, INSERM, U900, 75005, Paris, France
- Ecole des Mines ParisTech, 77305, Fontainebleau, France
- Institut Pasteur - Hub Bioinformatique et Biostatistique - C3BI, USR 3756 IP CNRS, 75015, Paris, France
| | - Liliana Mirabal-Ortega
- Institut Curie, CNRS, UMR3347, PSL Research University, 91405, Orsay, France
- Institut Curie, PSL Research University, INSERM, U1021, 91405, Orsay, France
- Université Paris-Saclay, 91405, Orsay, France
| | - Magalie Larcher
- Institut Curie, CNRS, UMR3347, PSL Research University, 91405, Orsay, France
- Institut Curie, PSL Research University, INSERM, U1021, 91405, Orsay, France
- Université Paris-Saclay, 91405, Orsay, France
| | - Céline Brulard
- Institut Curie, CNRS, UMR144, Equipe Labellisée Ligue contre le Cancer, PSL Research University, 75005, Paris, France
- Sorbonne Universités, UPMC Université Paris 06, CNRS, UMR144, 75005, Paris, France
- INSERM U930, CHU Bretonneau, 37000, Tours, France
| | - Sandrine Arrufat
- Département de Biologie des Tumeurs, Institut Curie, 75005, Paris, France
| | - André Nicolas
- Département de Biologie des Tumeurs, Institut Curie, 75005, Paris, France
| | - Nabila Elarouci
- Programme Cartes d'Identité des Tumeurs, Ligue Nationale Contre le Cancer, 75013, Paris, France
| | - Tatiana Popova
- Institut Curie, PSL Research University, INSERM U830, 75005, Paris, France
| | - Fariba Némati
- Département de Recherche Translationnelle, Institut Curie, 75005, Paris, France
| | - Didier Decaudin
- Département de Recherche Translationnelle, Institut Curie, 75005, Paris, France
| | - David Gentien
- Département de Recherche Translationnelle, Institut Curie, 75005, Paris, France
| | - Sylvain Baulande
- Institut Curie, PSL Research University, NGS Platform, 75005, Paris, France
| | - Odette Mariani
- Département de Biologie des Tumeurs, Institut Curie, 75005, Paris, France
| | - Florent Dufour
- Institut Curie, CNRS, UMR144, Equipe Labellisée Ligue contre le Cancer, PSL Research University, 75005, Paris, France
- Sorbonne Universités, UPMC Université Paris 06, CNRS, UMR144, 75005, Paris, France
| | | | - Céline Vallot
- GeCo Genomics Consulting, Integragen, 91000, Evry, France
| | | | - Alexandre Matet
- Département de Chirurgie, Service d'Ophtalmologie, Institut Curie, 75005, Paris, France
- Université de Paris, Paris, France
| | - Laurence Desjardins
- Département de Chirurgie, Service d'Ophtalmologie, Institut Curie, 75005, Paris, France
| | - Guillem Pascual-Pasto
- Institut de Recerca Sant Joan de Déu, 08950, Barcelona, Spain
- Pediatric Hematology and Oncology, Hospital Sant Joan de Déu, 08950, Barcelona, Spain
| | - Mariona Suñol
- Institut de Recerca Sant Joan de Déu, 08950, Barcelona, Spain
- Department of Pathology, Hospital Sant Joan de Déu, 08950, Barcelona, Spain
| | - Jaume Catala-Mora
- Institut de Recerca Sant Joan de Déu, 08950, Barcelona, Spain
- Department of Ophthalmology, Hospital Sant Joan de Déu, 08950, Barcelona, Spain
| | - Genoveva Correa Llano
- Institut de Recerca Sant Joan de Déu, 08950, Barcelona, Spain
- Pediatric Hematology and Oncology, Hospital Sant Joan de Déu, 08950, Barcelona, Spain
| | - Jérôme Couturier
- Département de Biologie des Tumeurs, Institut Curie, 75005, Paris, France
| | - Emmanuel Barillot
- Institut Curie, PSL Research University, INSERM, U900, 75005, Paris, France
- Ecole des Mines ParisTech, 77305, Fontainebleau, France
| | - Paula Schaiquevich
- Pathology Service, Hospital J.P. Garrahan, Buenos Aires, Argentina
- National Scientific and Technical Research Council, CONICET, Buenos Aires, Argentina
| | - Marion Gauthier-Villars
- Département de Biologie des Tumeurs, Institut Curie, 75005, Paris, France
- Service de Génétique, Institut Curie, 75005, Paris, France
- Institut Curie, PSL Research University, INSERM U830, 75005, Paris, France
| | - Dominique Stoppa-Lyonnet
- Département de Biologie des Tumeurs, Institut Curie, 75005, Paris, France
- Service de Génétique, Institut Curie, 75005, Paris, France
- Université de Paris, Paris, France
| | - Lisa Golmard
- Département de Biologie des Tumeurs, Institut Curie, 75005, Paris, France
- Service de Génétique, Institut Curie, 75005, Paris, France
- Institut Curie, PSL Research University, INSERM U830, 75005, Paris, France
| | - Claude Houdayer
- Département de Biologie des Tumeurs, Institut Curie, 75005, Paris, France
- Service de Génétique, Institut Curie, 75005, Paris, France
- Institut Curie, PSL Research University, INSERM U830, 75005, Paris, France
- Department of Genetics, Rouen University Hospital, 76000, Rouen, France
| | - Hervé Brisse
- Département d'Imagerie Médicale, Institut Curie, 75005, Paris, France
| | - Isabelle Bernard-Pierrot
- Institut Curie, CNRS, UMR144, Equipe Labellisée Ligue contre le Cancer, PSL Research University, 75005, Paris, France
- Sorbonne Universités, UPMC Université Paris 06, CNRS, UMR144, 75005, Paris, France
| | - Eric Letouzé
- Centre de Recherche des Cordeliers, Sorbonne Universités, INSERM, 75006, Paris, France
- Functional Genomics of Solid Tumors, équipe labellisée Ligue Contre le Cancer, Université de Paris, Université Paris 13, Paris, France
| | - Alain Viari
- Synergie Lyon Cancer, Plateforme de Bioinformatique "Gilles Thomas", Centre Léon Bérard, 69008, Lyon, France
| | - Simon Saule
- Institut Curie, CNRS, UMR3347, PSL Research University, 91405, Orsay, France
- Institut Curie, PSL Research University, INSERM, U1021, 91405, Orsay, France
- Université Paris-Saclay, 91405, Orsay, France
| | - Xavier Sastre-Garau
- Département de Biologie des Tumeurs, Institut Curie, 75005, Paris, France
- Department of Pathology, Centre Hospitalier Intercommunal de Créteil, 94000, Créteil, France
| | - François Doz
- Université de Paris, Paris, France
- SIREDO Center (Care, Innovation and Research in Pediatric Adolescent and Young Adult Oncology), Institut Curie, 75005, Paris, France
| | - Angel M Carcaboso
- Institut de Recerca Sant Joan de Déu, 08950, Barcelona, Spain
- Pediatric Hematology and Oncology, Hospital Sant Joan de Déu, 08950, Barcelona, Spain
| | - Nathalie Cassoux
- Département de Chirurgie, Service d'Ophtalmologie, Institut Curie, 75005, Paris, France
- Université de Paris, Paris, France
| | - Celio Pouponnot
- Institut Curie, CNRS, UMR3347, PSL Research University, 91405, Orsay, France
- Institut Curie, PSL Research University, INSERM, U1021, 91405, Orsay, France
- Université Paris-Saclay, 91405, Orsay, France
| | - Olivier Goureau
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 75012, Paris, France
| | - Guillermo Chantada
- Precision Medicine, Hospital J.P. Garrahan, Buenos Aires, Argentina
- Institut de Recerca Sant Joan de Déu, 08950, Barcelona, Spain
- Pediatric Hematology and Oncology, Hospital Sant Joan de Déu, 08950, Barcelona, Spain
- National Scientific and Technical Research Council, CONICET, Buenos Aires, Argentina
| | - Aurélien de Reyniès
- Programme Cartes d'Identité des Tumeurs, Ligue Nationale Contre le Cancer, 75013, Paris, France
| | - Isabelle Aerts
- Institut Curie, CNRS, UMR144, Equipe Labellisée Ligue contre le Cancer, PSL Research University, 75005, Paris, France
- Sorbonne Universités, UPMC Université Paris 06, CNRS, UMR144, 75005, Paris, France
- SIREDO Center (Care, Innovation and Research in Pediatric Adolescent and Young Adult Oncology), Institut Curie, 75005, Paris, France
| | - François Radvanyi
- Institut Curie, CNRS, UMR144, Equipe Labellisée Ligue contre le Cancer, PSL Research University, 75005, Paris, France.
- Sorbonne Universités, UPMC Université Paris 06, CNRS, UMR144, 75005, Paris, France.
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7
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Lemaître S, Green F, Dendale R, Vincent-Salomon A, Desjardins L, Cassoux N, Couturaud B, Lévy-Gabriel C. Total orbital exenteration with temporalis muscle transfer and secondary healing. Can J Ophthalmol 2021; 57:8-15. [PMID: 33715985 DOI: 10.1016/j.jcjo.2021.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 01/28/2021] [Accepted: 02/07/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate the outcomes of orbital exenteration with temporalis muscle flap repair of the socket and secondary healing of the anterior surface of the flap in ocular, conjunctival, and eyelid malignancies. DESIGN Retrospective single-centre study. PARTICIPANTS Consecutive patients who underwent total exenteration for malignancy with temporal muscle flap repair of the socket between December 2009 and January 2016. METHODS We report the outcomes of this surgical technique in terms of healing without fistula formation and time to epithelialization. RESULTS Twenty-nine patients underwent surgery using this technique. Diagnoses consisted of 18 conjunctival melanomas, 2 choroidal melanomas, 6 squamous cell carcinomas, 2 sebaceous cell carcinomas, and 1 basal cell carcinoma. Mean age at surgery was 70.7 years and mean follow-up was 27.4 months. On histological analysis, tumour excision was complete in 25 patients, of whom 3 had an orbital recurrence after exenteration (3 conjunctival melanomas). Four patients had incomplete tumour excision, of whom 3 underwent postoperative orbital radiotherapy with no subsequent orbital recurrences. Complete epithelialization of the socket occurred in mean 7.9 weeks (range 2-16 weeks). Flap necrosis occurred in 1 patient after postoperative radiotherapy (with sino-nasal fistula formation); 2 other patients developed sino-orbital fistulas. CONCLUSION After orbital exenteration, spontaneous epithelialization of the socket may take up to several months. Use of a temporalis muscle flap can reduce the duration of socket healing postoperatively, even if left to heal by secondary intention. This may facilitate early postoperative radiotherapy when indicated. Aesthetic results are acceptable and local surgical complications are rare.
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Affiliation(s)
- Stéphanie Lemaître
- Ocular Oncology Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; Institut Curie, Service d'oncologie oculaire, Paris, France.
| | - Frederick Green
- Department of Ear, Nose and Throat, Royal London Hospital, London, United Kingdom
| | - Rémi Dendale
- Institut Curie, Centre de protonthérapie, Campus universitaire d'Orsay, Orsay, France
| | | | | | - Nathalie Cassoux
- Institut Curie, Service d'oncologie oculaire, Paris, France; Université de Paris, Paris, France
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8
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Russo I, Levy-Gabriel C, Dupont A, Lumbroso-Le Rouic L, Cassoux N, Desjardins L, Bertozzi AI, Coze C, Doz F, Savignoni A, Aerts I. Prospective phase II study of children affected by bilateral intraocular retinoblastoma with macular involvement of both eyes or in the only preserved eye. Macular tumor control, eye preservation rate, and visual outcome. Pediatr Blood Cancer 2021; 68:e28721. [PMID: 33098751 DOI: 10.1002/pbc.28721] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 08/19/2020] [Accepted: 09/04/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Conservative treatments of intraocular retinoblastoma often consist of chemotherapy and focal treatments. The protocols vary and currently may combine two or three drugs, with different number of cycles, associated to the ocular treatments. In case of macular/paramacular involvement, tumor location and retinal scars induced by focal treatments often have a major negative impact on final visual outcome. METHODS This study aimed to include children affected by bilateral intraocular macular/paramacular retinoblastoma in a prospective phase II study. The protocol consisted of six cycles of a three-drug combination (vincristine, etoposide, carboplatin), and the addition of macula-sparing transpupillary thermotherapy (TTT) to the third cycle. The primary endpoint was the local control rate without external beam radiotherapy (EBR) and/or enucleation. RESULTS Nineteen patients (26 eyes) were included from July 2004 to November 2009. Thirteen eyes belonged to group V of the Reese-Ellsworth classification and 10 to group D of the International Intraocular Retinoblastoma Classification. Macular/paramacular tumors were treated with chemotherapy alone in nine eyes, and with chemotherapy associated with macula-sparing TTT in 17 eyes. Four eyes experienced macular relapse. At a median follow up of 77 months, 23 eyes (88.5%) were saved without EBR, two were enucleated and one received EBR. The median visual acuity of the 24 saved eyes was 20/50. No severe adverse effect was observed. CONCLUSION Six cycles of a three-drug combination associated with macula-sparing TTT achieved good tumor control, improved eye preservation rates without EBR, and decreased macular damage, often providing satisfactory visual results with long-term follow up.
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Affiliation(s)
- Ida Russo
- Oncology Center SIREDO, Institut Curie, PSL Research University, Paris, France.,Department of Onco-Hematology, Bambino Gesù Pediatric Hospital IRCCS, Rome, Italy
| | | | - Axelle Dupont
- Department of Biostatistics, Institut Curie, Paris, France
| | | | - Nathalie Cassoux
- Department of Ophthalmology, Institut Curie, Paris, France.,University of Paris, Paris, France
| | | | | | - Carole Coze
- Department of Pediatric Hematology-Oncology, Université Aix-Marseille/APHM, Hôpital d'Enfants de La Timone, Marseille, France
| | - François Doz
- Oncology Center SIREDO, Institut Curie, PSL Research University, Paris, France.,University of Paris, Paris, France
| | | | - Isabelle Aerts
- Oncology Center SIREDO, Institut Curie, PSL Research University, Paris, France
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9
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Fabian ID, Stacey AW, Foster A, Kivelä TT, Munier FL, Keren-Froim N, Gomel N, Cassoux N, Sagoo MS, Reddy MA, Harby LA, Zondervan M, Bascaran C, Abdallah E, Abdullahi SU, Boubacar SA, Ademola-Popoola DS, Adio A, Aghaji AE, Portabella SA, Alfa Bio AI, Ali AM, Alia DB, All-Eriksson C, Almeida AA, Alsawidi KM, Antonino R, Astbury NJ, Atsiaya R, Balaguer J, Balwierz W, Barranco H, Popovic MB, Benmiloud S, Guebessi NB, Berete RC, Biddulph SJ, Biewald EM, Blum S, Bobrova N, Boehme M, Bornfeld N, Bouda GC, Bouguila H, Boumedane A, Brichard BG, L MC, Castela G, Català-Mora J, Chantada GL, Chernodrinska VS, Chiwanga FS, Cieslik K, Comsa C, Correa Llano MG, Csóka M, Da Gama IV, Davidson A, Potter PD, Desjardins L, Dragomir MD, Bruyn MD, Kettani AE, Elbahi AM, Elgalaly D, Elhaddad AM, Ali Elhassan MM, Elzembely MM, Essuman VA, Evina TGA, Fasina O, Fernández-Teijeiro A, Gandiwa M, Aldana DG, Geel JA, Gizachew Z, Gregersen PA, Guedenon KM, Hadjistilianou T, Hassan S, Hederova S, Hessissen L, Hordofa DF, Hummlen M, Husakova K, Ida R, Ilic VR, Jenkinson H, Amani Kabesha TB, Kabore RL, Kalinaki A, Kapelushnik N, Kardava T, Kemilev PK, Kepak T, Khotenashvili Z, Klett A, Kosh Komba Palet JE, Krivaitiene D, Kruger M, Kyara A, Lachmann ES, Latinović S, Lecuona K, Lukamba RM, Lumbroso L, Lysytsia L, Maka E, Makan M, Manda C, Begue NM, Matende IO, Matua M, Mayet I, Mbumba FB, Mengesha AA, Midena E, Mndeme FG, Mohamedani AA, Moll AC, Moreira C, Msina MS, Msukwa G, Muma KI, Murgoi G, Musa KO, Mustak H, Muyen OM, Naidu G, Naumenko L, Ndoye Roth PA, Neroev V, Nikitovic M, Nkanga ED, Nkumbe H, Nyaywa M, Obono-Obiang G, Oguego NC, Olechowski A, Oscar AH, Osei-Bonsu P, Painter SL, Paintsil V, Paiva L, Papyan R, Parrozzani R, Parulekar M, Pawinska-Wasikowska K, Perić S, Philbert R, Pochop P, Polyakov VG, Pompe MT, Pons JJ, Raobela L, Renner LA, Reynders D, Ribadu D, Riheia MM, Ritter-Sovinz P, Saakyan S, Said AM, Román Pacheco SS, Scanlan TA, Schoeman J, Seregard S, Sherief ST, Cheikh SS, Silva S, Sorochynska T, Ssali G, Stathopoulos C, Kranjc BS, Stones DK, Svojgr K, Sylla F, Tamamyan G, Tandili A, Tateshi B, Theophile T, Traoré F, Tyau-Tyau H, Umar AB, Urbak SF, Ushakova TL, Valeina S, Hoefen Wijsard MV, Veleva-Krasteva NV, Viksnins M, Wackernagel W, Waddell K, Wade PD, Wali Nigeria AH, Wime AD, Dod CW, Yanga JM, Yarovaya VA, Yarovoy AA, Zein E, Sharabi S, Zhilyaeva K, Ziko OA, Bowman R. Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries. Br J Ophthalmol 2020; 105:1435-1443. [PMID: 32933936 DOI: 10.1136/bjophthalmol-2020-316613] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/28/2020] [Accepted: 08/17/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND The travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe. METHODS A cross-sectional analysis including 518 treatment-naïve patients with retinoblastoma residing in 40 European countries and 1024 treatment-naïve patients with retinoblastoma residing in 43 African countries. RESULTS Capture rate was 42.2% of expected patients from Africa and 108.8% from Europe. African patients were older (95% CI -12.4 to -5.4, p<0.001), had fewer cases of familial retinoblastoma (95% CI 2.0 to 5.3, p<0.001) and presented with more advanced disease (95% CI 6.0 to 9.8, p<0.001); 43.4% and 15.4% of Africans had extraocular retinoblastoma and distant metastasis at the time of diagnosis, respectively, compared to 2.9% and 1.0% of the Europeans. To reach a retinoblastoma centre, European patients travelled 421.8 km compared to Africans who travelled 185.7 km (p<0.001). On regression analysis, lower-national income level, African residence and older age (p<0.001), but not travel distance (p=0.19), were risk factors for advanced disease. CONCLUSIONS Fewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral.
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Affiliation(s)
- Ido Didi Fabian
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK .,The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel
| | - Andrew W Stacey
- Department of Ophthalmology, University of Washington, Seattle, WA, US
| | - Allen Foster
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Tero T Kivelä
- Ocular Oncology Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Francis L Munier
- Jules-Gonin Eye Hospital, Fondation Asile de Aveugles, University of Lausanne, Lausanne, Switzerland
| | | | - Nir Gomel
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Nathalie Cassoux
- Institut curie, université de Paris medicine Paris V Descartes, Paris, France
| | - Mandeep S Sagoo
- NIHR Biomedical Research Center for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology and London Retinoblastoma Service, Royal London Hospital, London, UK
| | - M Ashwin Reddy
- The Royal London Hospital, Barts Health NHS Trust, and Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Lamis Al Harby
- The Royal London Hospital, Barts Health NHS Trust, and Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Marcia Zondervan
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Covadonga Bascaran
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Elhassan Abdallah
- Ophthalmology Department of Rabat, Mohammed V university, Rabat, Morocco
| | | | | | - Dupe S Ademola-Popoola
- University of Ilorin and University of IlorinTeaching Hospital, Ilorin, Kwara State, Nigeria
| | - Adedayo Adio
- Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | - Ada E Aghaji
- Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria
| | | | | | - Amany M Ali
- Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Donjeta B Alia
- University Hospital Center 'Mother Theresa', Tirana, Albania
| | | | | | | | | | - Nicholas J Astbury
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Rose Atsiaya
- Light House For Christ Eye Center, Mombasa, Kenya
| | - Julia Balaguer
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Walentyna Balwierz
- Institute of Pediatrics, Jagiellonian University Medical College, Childrens University Hospital of Krakow, Krakow, Poland
| | - Honorio Barranco
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Maja Beck Popovic
- Unit of Pediatric Hematology-Oncology, University Hospital CHUV, Lausanne, Switzerland
| | - Sarra Benmiloud
- Department of Pediatric Oncology, University Hassan II Fès, Fez, Morocco
| | | | - Rokia C Berete
- Ophthalmologic Department of the Teaching Hospital of Treichville, Abidjan, Côte d'ivoire
| | | | - Eva M Biewald
- University Hospital Essen, Department of Ophthalmology, University Duisburg-Essen, Essen, Germany
| | - Sharon Blum
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel
| | - Nadia Bobrova
- The Filatov Institute of Eye diseases and Tissue Therapy, Odessa, Ukraine
| | - Marianna Boehme
- University Hospital Essen, Department of Ophthalmology, University Duisburg-Essen, Essen, Germany
| | - Norbert Bornfeld
- University Hospital Essen, Department of Ophthalmology, University Duisburg-Essen, Essen, Germany
| | - Gabrielle C Bouda
- Center Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Hédi Bouguila
- Institut Hédi-Raïs d'Ophtalmologie de Tunis, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - Amaria Boumedane
- Etablissement Hospitalière Spécialise Emir Abdelkader CEA Service d'Oncologie Pédiatrique, Oran, Algeria
| | | | | | - Guilherme Castela
- Centro Hospital Universitário de Coimbra, University of Coimbra, Coimbra, Portugal
| | | | | | - Violeta S Chernodrinska
- Eye Clinic, University Hospital 'Alexandrovska', Department of Ophthalmology, Medical University, Sofia, Bulgaria
| | | | - Krzysztof Cieslik
- Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland
| | - Codruta Comsa
- Oncology Institute 'Prof. Dr. Al. Trestioreanu' Bucharest, Romania
| | | | - Monika Csóka
- Semmelweis University Budapest, Budapest, Hungary
| | | | - Alan Davidson
- Red Cross Children's War Memorial Hospital and the University of Cape Town, Cape Town, South Africa
| | | | | | | | | | - Asmaa El Kettani
- Center Hospitalier et Universitaire Ibn Rochd, Casablanca, Morocco
| | - Amal M Elbahi
- Tripoli Eye Hospital, Tripoli University, Tripoli, Libya
| | - Dina Elgalaly
- Children's Cancer Hospital Egypt 57357, Cairo, Egypt
| | | | - Moawia M Ali Elhassan
- Oncology Department, National Cancer Institute, University of Gezira, Wadi Madani, Sudan
| | - Mahmoud M Elzembely
- Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Vera A Essuman
- Ophthalmology Unit, Department of Surgery, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | | | - Oluyemi Fasina
- Department of Ophthalmology, University College Hospital/University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - Moira Gandiwa
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | - Jennifer A Geel
- University of the Witwatersrand, Johannesburg, South Africa.,Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Zelalem Gizachew
- Addis Ababa University, School of Medicine, Department of Ophthalmology, Addis Ababa, Ethiopia
| | - Pernille A Gregersen
- Department of Clinical Genetics, and Center for Rare Disorders, Aarhus University Hopspital, Aarhus, Denmark
| | - Koffi M Guedenon
- Département de Pédiatrie, CHU Sylvanus Olympio, Université de Lomé, Lomé, Togo
| | | | - Sadiq Hassan
- Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria
| | | | - Laila Hessissen
- Pediatric Hematology and Oncology Department of Rabat - Mohammed V University, Rabat, Morocco
| | - Diriba F Hordofa
- Department of Pediatrics and Child Health, Jimma University Medical Center, Jimma, Ethiopia
| | - Marlies Hummlen
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | | | - Russo Ida
- Bambino Gesù IRCCS Children's Hospital, Rome, Italy
| | - Vesna R Ilic
- Institute for Oncology and Radiology, Belgrade, Serbia
| | - Helen Jenkinson
- Birmingham Children's Hospital Eye Department, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | | | - Rolande L Kabore
- Center Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Abubakar Kalinaki
- Makerere University College of Health Sciences, Department of Ophthalmology, Kamplala, Uganda
| | - Noa Kapelushnik
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel
| | - Tamar Kardava
- Ophthalmology Department, Central Children's Hospital of Georgia, Tbilisi, Georgia
| | - Pavlin Kroumov Kemilev
- Eye Clinic, University Hospital 'Alexandrovska', Department of Ophthalmology, Medical University, Sofia, Bulgaria
| | - Tomas Kepak
- University Hospital Brno, Masaryk University and ICRC/St. Anna University Hospital, Brno, Czech Republic
| | - Zaza Khotenashvili
- Ophthalmology Department, Central Children's Hospital of Georgia, Tbilisi, Georgia
| | - Artur Klett
- East Tallinn Central Hospital, Tallinn, Estonia
| | | | - Dalia Krivaitiene
- Chidren's Ophthalmology Department, Chidren's Hospital of Vilnius, University Hospital Santaros Clinic, Vilnius, Lithuania
| | - Mariana Kruger
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Alice Kyara
- Muhimbili National Hospital, Dar es Salaam, Tanzania
| | | | - Slobodanka Latinović
- Clinical Center Of Vojvodina - University Eye Clinic, Eye Research Foundation Vidar - Latinović, Novi Sad, Serbia
| | - Karin Lecuona
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Robert M Lukamba
- University Clinics of Lubumbashi, University of Lubumbashi, Lubumbashi, DRC
| | | | - Lesia Lysytsia
- The Okhmatdyt National Children's Hospital, Kiev, Ukraine
| | - Erika Maka
- Semmelweis University Budapest, Budapest, Hungary
| | - Mayuri Makan
- Sekuru Kaguvi Eye Unit, Parirenyatwa Group of Hospitals, Harare, Zimbabwe
| | - Chatonda Manda
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Nieves Martín Begue
- Department of Pediatric Ophthalmology, Hospital Vall d'Hebron, Barcelona, Spain
| | | | | | - Ismail Mayet
- University of the Witwatersrand, Johannesburg, South Africa
| | - Freddy B Mbumba
- Botswana Government - Scottish Livingstone Hospital, Molepolole, Botswana
| | | | - Edoardo Midena
- Department of Ophthalmology, University of Padova, Padova, Italy
| | | | - Ahmed A Mohamedani
- Pathology Department, Faculty of Medicine, University of Gezira, Wadi Madani, Sudan
| | - Annette C Moll
- Department of Ophthalmology, Amsterdam UMC, Amsterdam, Netherlands
| | - Claude Moreira
- Service d'oncologie pédiatrique de l'hôpital Aristide le Dantec, Dakar, Senegal
| | | | - Gerald Msukwa
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | - Gabriela Murgoi
- Oncology Institute 'Prof. Dr. Al. Trestioreanu' Bucharest, Romania
| | - Kareem O Musa
- Department of Ophthalmology, Lagos University Teaching Hospital/College of Medicine of the University of Lagos, Lagos, Nigeria
| | - Hamzah Mustak
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | | | - Gita Naidu
- University of the Witwatersrand, Johannesburg, South Africa
| | - Larisa Naumenko
- N.N. Alexandrov National Cancer Center of Belarus, Minsk, Belarus
| | | | - Vladimir Neroev
- Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia
| | | | - Elizabeth D Nkanga
- Calabar Children's Eye Center, Department of Ophthalmology University of Calabar Teaching Hospital Calabar Cross River State, Nigeria
| | - Henry Nkumbe
- Magrabi ICO Cameroon Eye Institute, Yaounde, Cameroon
| | | | | | - Ngozi C Oguego
- Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Andrzej Olechowski
- Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland
| | - Alexander Hugo Oscar
- Eye Clinic, University Hospital 'Alexandrovska', Department of Ophthalmology, Medical University, Sofia, Bulgaria
| | | | - Sally L Painter
- Birmingham Children's Hospital Eye Department, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | | | - Luisa Paiva
- National Ophthalmological Institute of Angola, Luanda, Angola
| | - Ruzanna Papyan
- Yerevan State Medical University, Department of Oncology and Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after R.H. Yeolyan, Yerevan, Armenia
| | | | - Manoj Parulekar
- Birmingham Children's Hospital Eye Department, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Katarzyna Pawinska-Wasikowska
- Institute of Pediatrics, Jagiellonian University Medical College, Childrens University Hospital of Krakow, Krakow, Poland
| | - Sanja Perić
- University Hospital Center Zagreb, Zagreb, Croatia
| | - Remezo Philbert
- Center Hospitaliere Universitaire de Kamenge, Bujumbura, Burundi
| | - Pavel Pochop
- Department of Ophthalmology for Children and Adults, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | - Vladimir G Polyakov
- Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology of N.N. Blokhin National Medical Research Center of Oncology of Russian Federation, Moscow, Russian Federation.,Medical Academy of Postgraduate Education, Moscow, Russia
| | - Manca T Pompe
- Univ. Medical Center Ljubljana, Univ.Eye Hospital Ljubljana, Ljubljana, Slovenia
| | | | - Léa Raobela
- Center Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar
| | - Lorna A Renner
- University of Ghana School of Medicine and Dentistry, Korle Bu Teaching Hospital, Accra, Ghana
| | | | | | | | - Petra Ritter-Sovinz
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology/Oncology, Medical University of Graz, Graz, Austria
| | - Svetlana Saakyan
- Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia
| | - Azza Ma Said
- Ophthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | | | | | | | - Sadik T Sherief
- Addis Ababa University, School of Medicine, Department of Ophthalmology, Addis Ababa, Ethiopia
| | - Sidi Sidi Cheikh
- Ophthalmology department, Nouakchott Medical University, Nouakchott, Mauritania
| | - Sónia Silva
- Centro Hospital Universitário de Coimbra, University of Coimbra, Coimbra, Portugal
| | | | - Grace Ssali
- Mulago National Referral and Teaching Hospital, Kamplala, Uganda
| | - Christina Stathopoulos
- Jules-Gonin Eye Hospital, Fondation Asile de Aveugles, University of Lausanne, Lausanne, Switzerland
| | - Branka Stirn Kranjc
- Univ. Medical Center Ljubljana, Univ.Eye Hospital Ljubljana, Ljubljana, Slovenia
| | - David K Stones
- Department of Paediatrics and Child Health, University of the Free Sate, Bloemfontein, South Africa
| | - Karel Svojgr
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | | | - Gevorg Tamamyan
- Yerevan State Medical University, Department of Oncology and Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after R.H. Yeolyan, Yerevan, Armenia
| | - Alketa Tandili
- University Hospital Center 'Mother Theresa', Tirana, Albania
| | | | | | - Fousseyni Traoré
- Pediatric Oncology Service, Gabriel Toure Hospital, Bamako, Mali
| | | | - Ali B Umar
- Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Steen F Urbak
- Department of ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Tatiana L Ushakova
- Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology of N.N. Blokhin National Medical Research Center of Oncology of Russian Federation, Moscow, Russian Federation.,Medical Academy of Postgraduate Education, Moscow, Russia
| | | | | | - Nevyana V Veleva-Krasteva
- Eye Clinic, University Hospital 'Alexandrovska', Department of Ophthalmology, Medical University, Sofia, Bulgaria
| | | | | | | | | | | | - Amelia Dc Wime
- National Ophthalmological Institute of Angola, Luanda, Angola
| | | | - Jenny M Yanga
- Service d'Ophtalmologie, Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, DRC
| | - Vera A Yarovaya
- S.Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
| | - Andrey A Yarovoy
- S.Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
| | - Ekhtelbenina Zein
- Assistante Hospitalo - Universitaire, Faculte de Medecine de Nouakchott Medecin Oncopediatre, Center National d'Oncologie, Nouakchott, Mauritania
| | - Shirley Sharabi
- Radiology Department, Sheba Medical Center, Ramat-Gan, Israel
| | | | - Othman Ao Ziko
- Ophthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Richard Bowman
- Ophthalmology Department, Great Ormond Street Children's Hospital, London, UK
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10
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Fabian ID, Abdallah E, Abdullahi SU, Abdulqader RA, Adamou Boubacar S, Ademola-Popoola DS, Adio A, Afshar AR, Aggarwal P, Aghaji AE, Ahmad A, Akib MNR, Al Harby L, Al Ani MH, Alakbarova A, Portabella SA, Al-Badri SAF, Alcasabas APA, Al-Dahmash SA, Alejos A, Alemany-Rubio E, Alfa Bio AI, Alfonso Carreras Y, Al-Haddad C, Al-Hussaini HHY, Ali AM, Alia DB, Al-Jadiry MF, Al-Jumaily U, Alkatan HM, All-Eriksson C, Al-Mafrachi AARM, Almeida AA, Alsawidi KM, Al-Shaheen AASM, Al-Shammary EH, Amiruddin PO, Antonino R, Astbury NJ, Atalay HT, Atchaneeyasakul LO, Atsiaya R, Attaseth T, Aung TH, Ayala S, Baizakova B, Balaguer J, Balayeva R, Balwierz W, Barranco H, Bascaran C, Beck Popovic M, Benavides R, Benmiloud S, Bennani Guebessi N, Berete RC, Berry JL, Bhaduri A, Bhat S, Biddulph SJ, Biewald EM, Bobrova N, Boehme M, Boldt HC, Bonanomi MTBC, Bornfeld N, Bouda GC, Bouguila H, Boumedane A, Brennan RC, Brichard BG, Buaboonnam J, Calderón-Sotelo P, Calle Jara DA, Camuglia JE, Cano MR, Capra M, Cassoux N, Castela G, Castillo L, Català-Mora J, Chantada GL, Chaudhry S, Chaugule SS, Chauhan A, Chawla B, Chernodrinska VS, Chiwanga FS, Chuluunbat T, Cieslik K, Cockcroft RL, Comsa C, Correa ZM, Correa Llano MG, Corson TW, Cowan-Lyn KE, Csóka M, Cui X, Da Gama IV, Dangboon W, Das A, Das S, Davanzo JM, Davidson A, De Potter P, Delgado KQ, Demirci H, Desjardins L, Diaz Coronado RY, Dimaras H, Dodgshun AJ, Donaldson C, Donato Macedo CR, Dragomir MD, Du Y, Du Bruyn M, Edison KS, Eka Sutyawan IW, El Kettani A, Elbahi AM, Elder JE, Elgalaly D, Elhaddad AM, Elhassan MMA, Elzembely MM, Essuman VA, Evina TGA, Fadoo Z, Fandiño AC, Faranoush M, Fasina O, Fernández DDPG, Fernández-Teijeiro A, Foster A, Frenkel S, Fu LD, Fuentes-Alabi SL, Gallie BL, Gandiwa M, Garcia JL, García Aldana D, Gassant PY, Geel JA, Ghassemi F, Girón AV, Gizachew Z, Goenz MA, Gold AS, Goldberg-Lavid M, Gole GA, Gomel N, Gonzalez E, Gonzalez Perez G, González-Rodríguez L, Garcia Pacheco HN, Graells J, Green L, Gregersen PA, Grigorovski NDAK, Guedenon KM, Gunasekera DS, Gündüz AK, Gupta H, Gupta S, Hadjistilianou T, Hamel P, Hamid SA, Hamzah N, Hansen ED, Harbour JW, Hartnett ME, Hasanreisoglu M, Hassan S, Hassan S, Hederova S, Hernandez J, Hernandez LMC, Hessissen L, Hordofa DF, Huang LC, Hubbard GB, Hummlen M, Husakova K, Hussein Al-Janabi AN, Ida R, Ilic VR, Jairaj V, Jeeva I, Jenkinson H, Ji X, Jo DH, Johnson KP, Johnson WJ, Jones MM, Kabesha TBA, Kabore RL, Kaliki S, Kalinaki A, Kantar M, Kao LY, Kardava T, Kebudi R, Kepak T, Keren-Froim N, Khan ZJ, Khaqan HA, Khauv P, Kheir WJ, Khetan V, Khodabande A, Khotenashvili Z, Kim JW, Kim JH, Kiratli H, Kivelä TT, Klett A, Komba Palet JEK, Krivaitiene D, Kruger M, Kulvichit K, Kuntorini MW, Kyara A, Lachmann ES, Lam CPS, Lam GC, Larson SA, Latinovic S, Laurenti KD, Le BHA, Lecuona K, Leverant AA, Li C, Limbu B, Long QB, López JP, Lukamba RM, Lumbroso L, Luna-Fineman S, Lutfi D, Lysytsia L, Magrath GN, Mahajan A, Majeed AR, Maka E, Makan M, Makimbetov EK, Manda C, Martín Begue N, Mason L, Mason JO, Matende IO, Materin M, Mattosinho CCDS, Matua M, Mayet I, Mbumba FB, McKenzie JD, Medina-Sanson A, Mehrvar A, Mengesha AA, Menon V, Mercado GJVD, Mets MB, Midena E, Mishra DKC, Mndeme FG, Mohamedani AA, Mohammad MT, Moll AC, Montero MM, Morales RA, Moreira C, Mruthyunjaya P, Msina MS, Msukwa G, Mudaliar SS, Muma KI, Munier FL, Murgoi G, Murray TG, Musa KO, Mushtaq A, Mustak H, Muyen OM, Naidu G, Nair AG, Naumenko L, Ndoye Roth PA, Nency YM, Neroev V, Ngo H, Nieves RM, Nikitovic M, Nkanga ED, Nkumbe H, Nuruddin M, Nyaywa M, Obono-Obiang G, Oguego NC, Olechowski A, Oliver SCN, Osei-Bonsu P, Ossandon D, Paez-Escamilla MA, Pagarra H, Painter SL, Paintsil V, Paiva L, Pal BP, Palanivelu MS, Papyan R, Parrozzani R, Parulekar M, Pascual Morales CR, Paton KE, Pawinska-Wasikowska K, Pe'er J, Peña A, Peric S, Pham CTM, Philbert R, Plager DA, Pochop P, Polania RA, Polyakov VG, Pompe MT, Pons JJ, Prat D, Prom V, Purwanto I, Qadir AO, Qayyum S, Qian J, Rahman A, Rahman S, Rahmat J, Rajkarnikar P, Ramanjulu R, Ramasubramanian A, Ramirez-Ortiz MA, Raobela L, Rashid R, Reddy MA, Reich E, Renner LA, Reynders D, Ribadu D, Riheia MM, Ritter-Sovinz P, Rojanaporn D, Romero L, Roy SR, Saab RH, Saakyan S, Sabhan AH, Sagoo MS, Said AMA, Saiju R, Salas B, San Román Pacheco S, Sánchez GL, Sayalith P, Scanlan TA, Schefler AC, Schoeman J, Sedaghat A, Seregard S, Seth R, Shah AS, Shakoor SA, Sharma MK, Sherief ST, Shetye NG, Shields CL, Siddiqui SN, Sidi Cheikh S, Silva S, Singh AD, Singh N, Singh U, Singha P, Sitorus RS, Skalet AH, Soebagjo HD, Sorochynska T, Ssali G, Stacey AW, Staffieri SE, Stahl ED, Stathopoulos C, Stirn Kranjc B, Stones DK, Strahlendorf C, Suarez MEC, Sultana S, Sun X, Sundy M, Superstein R, Supriyadi E, Surukrattanaskul S, Suzuki S, Svojgr K, Sylla F, Tamamyan G, Tan D, Tandili A, Tarrillo Leiva FF, Tashvighi M, Tateshi B, Tehuteru ES, Teixeira LF, Teh KH, Theophile T, Toledano H, Trang DL, Traoré F, Trichaiyaporn S, Tuncer S, Tyau-Tyau H, Umar AB, Unal E, Uner OE, Urbak SF, Ushakova TL, Usmanov RH, Valeina S, van Hoefen Wijsard M, Varadisai A, Vasquez L, Vaughan LO, Veleva-Krasteva NV, Verma N, Victor AA, Viksnins M, Villacís Chafla EG, Vishnevskia-Dai V, Vora T, Wachtel AE, Wackernagel W, Waddell K, Wade PD, Wali AH, Wang YZ, Weiss A, Wilson MW, Wime ADC, Wiwatwongwana A, Wiwatwongwana D, Wolley Dod C, Wongwai P, Xiang D, Xiao Y, Yam JC, Yang H, Yanga JM, Yaqub MA, Yarovaya VA, Yarovoy AA, Ye H, Yousef YA, Yuliawati P, Zapata López AM, Zein E, Zhang C, Zhang Y, Zhao J, Zheng X, Zhilyaeva K, Zia N, Ziko OAO, Zondervan M, Bowman R. Global Retinoblastoma Presentation and Analysis by National Income Level. JAMA Oncol 2020; 6:685-695. [PMID: 32105305 PMCID: PMC7047856 DOI: 10.1001/jamaoncol.2019.6716] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Importance Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs.
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Affiliation(s)
| | - Ido Didi Fabian
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel
| | - Elhassan Abdallah
- Ophthalmology Department of Rabat, Mohammed V University, Rabat, Morocco
| | | | | | | | | | - Adedayo Adio
- Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | | | | | - Ada E Aghaji
- Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Alia Ahmad
- The Children's Hospital and the Institute of Child Health, Lahore, Pakistan
| | | | - Lamis Al Harby
- The Royal London Hospital, Barts Health NHS Trust, and Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | | | - Aygun Alakbarova
- Zarifa Aliyeva National Center of Ophthalmology, Baku, Azerbaijan
| | | | - Safaa A F Al-Badri
- Pediatric Oncology Unit, Children Welfare Teaching Hospital, College of Medicine, University of Baghdad, Baghdad, Iraq
| | | | | | - Amanda Alejos
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
| | | | | | | | - Christiane Al-Haddad
- Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon
| | | | - Amany M Ali
- Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Donjeta B Alia
- University Hospital Center Mother Theresa, Tirana, Albania
| | - Mazin F Al-Jadiry
- Pediatric Oncology Unit, Children Welfare Teaching Hospital, College of Medicine, University of Baghdad, Baghdad, Iraq
| | | | - Hind M Alkatan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | | | | | - Nicholas J Astbury
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Hatice T Atalay
- Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey
| | | | - Rose Atsiaya
- Lighthouse For Christ Eye Centre, Mombasa, Kenya
| | - Taweevat Attaseth
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Than H Aung
- Yangon Eye Hospital, University of Medicine 1, Yangon, Myanmar
| | | | - Baglan Baizakova
- Scientific Center of Pediatrics and Pediatric Surgery, Almaty, Kazakhstan
| | - Julia Balaguer
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Walentyna Balwierz
- Institute of Pediatrics, Jagiellonian University Medical College, Children's University Hospital of Krakow, Krakow, Poland
| | - Honorio Barranco
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Covadonga Bascaran
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Maja Beck Popovic
- Pediatric Hematology-Oncology Unit, Lausanne University Hospital, Lausanne, Switzerland
| | - Raquel Benavides
- Hospital Nacional de Niños Dr Carlos Sáenz Herrera, San Jose, Costa Rica
| | - Sarra Benmiloud
- Department of Pediatric Oncology, University Hassan II Fès, Fez, Morocco
| | | | - Rokia C Berete
- Ophthalmologic Department of the Teaching Hospital of Treichville, Abidjan, Côte d'Ivoire
| | - Jesse L Berry
- Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles
| | | | - Sunil Bhat
- Department of Pediatric Hematology and Oncology, Narayana Health City, Bangalore, India
| | | | - Eva M Biewald
- Department of Ophthalmology, Essen University Hospital, University Duisburg-Essen, Essen, Germany
| | - Nadia Bobrova
- The Filatov Institute of Eye Diseases and Tissue Therapy, Odessa, Ukraine
| | - Marianna Boehme
- Department of Ophthalmology, Essen University Hospital, University Duisburg-Essen, Essen, Germany
| | - H C Boldt
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City
| | | | - Norbert Bornfeld
- Department of Ophthalmology, Essen University Hospital, University Duisburg-Essen, Essen, Germany
| | - Gabrielle C Bouda
- Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Hédi Bouguila
- Institut Hédi Raïs d'Ophtalmologie, Faculté de Médecine, Université Tunis El Manar, Tunis, Tunisia
| | - Amaria Boumedane
- Etablissement Hospitalière Spécialise Emir Abdelkader CEA Service d'Oncologie Pédiatrique, Oran, Algeria
| | - Rachel C Brennan
- Solid Tumor Division, Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | | | | | | | | | - Jayne E Camuglia
- Department of Ophthalmology, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Miriam R Cano
- Salud Ocular, Ministerio de Salud Publica, Asuncion, Paraguay
| | | | - Nathalie Cassoux
- Institut Curie, Université de Paris Medicine Paris V Descartes, Paris, France
| | - Guilherme Castela
- Centro Hospital Universitário de Coimbra, University of Coimbra, Coimbra, Portugal
| | | | | | - Guillermo L Chantada
- Hospital Sant Joan de Déu, Barcelona, Spain
- Hospital Garrahan, Buenos Aires, Argentina
- NationalScientific and Technical Research Council, CONICET, Buenos Aires, Argentina
| | - Shabana Chaudhry
- Paediatric Ophthalmology Department, Mayo Hospital and College of Allied Visual Sciences, King Edward Medical University, Lahore, Pakistan
| | - Sonal S Chaugule
- Department of Ophthalmic Plastic Surgery, Orbit and Ocular Oncology, PBMA's H. V. Desai Eye Hospital, Pune, Maharashtra, India
| | | | - Bhavna Chawla
- Ocular Oncology Service, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Violeta S Chernodrinska
- Eye Clinic, Department of Ophthalmology, University Hospital Alexandrovska, Medical University, Sofia, Sofia, Bulgaria
| | | | | | - Krzysztof Cieslik
- Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland
| | | | - Codruta Comsa
- Institute of Oncology, Prof. Dr Al. Trestioreanu, Bucharest, Romania
| | - Zelia M Correa
- Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, Maryland, and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | | | | | | | | | - Xuehao Cui
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Wantanee Dangboon
- Department of Ophthalmology, Songklanagarind Hospital, Prince of Songkla University, Songkla, Thailand
| | - Anirban Das
- Department of Pediatric Hematology-Oncology, Tata Medical Center, Kolkata, India
| | - Sima Das
- Ocular Oncology Services, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | | | - Alan Davidson
- Red Cross War Memorial Children's Hospital and the University of Cape Town, Cape Town, South Africa
| | | | | | - Hakan Demirci
- Department of Ophthalmology, Kellogg Eye Center, University of Michigan, Ann Arbor
| | | | | | - Helen Dimaras
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Andrew J Dodgshun
- Department of Paediatrics, University of Otago, Christchurch, Children's Haematology and Oncology Center, Christchurch Hospital, Christchurch, New Zealand
| | - Craig Donaldson
- The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | | | - Monica D Dragomir
- Institute of Oncology, Prof. Dr Al. Trestioreanu, Bucharest, Romania
| | - Yi Du
- Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | | | - Kemala S Edison
- Ophthalmology Department, Dr M. Djamil General Hospital, Faculty of Medicine, Andalas University, West Sumatra, Indonesia
| | - I Wayan Eka Sutyawan
- Department of Ophthalmology, Faculty of Medicine, Udayana University, Sanglah Eye Hospital, Bali, Indonesia
| | - Asmaa El Kettani
- Center Hospitalier et Universitaire Ibn Rochd, Casablanca, Morocco
| | - Amal M Elbahi
- Tripoli Eye Hospital, University of Tripoli, Tripoli, Libya
| | - James E Elder
- Department of Ophthalmology, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
| | - Dina Elgalaly
- Children's Cancer Hospital Egypt 57357, Cairo, Egypt
| | | | - Moawia M Ali Elhassan
- Department of Oncology, National Cancer Institute, University of Gezira, Wadi Madani, Sudan
| | - Mahmoud M Elzembely
- Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Vera A Essuman
- Ophthalmology Unit, Department of Surgery, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | | | | | | | - Mohammad Faranoush
- Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Rasool Akram Hospital, Tehran, Iran
| | - Oluyemi Fasina
- Department of Ophthalmology, University College Hospital, University of Ibadan, Ibadan, Nigeria
| | | | | | - Allen Foster
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Shahar Frenkel
- Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Soad L Fuentes-Alabi
- Pediatric Oncology Department, Benjamin Bloom National Children's Hospital, San Salvador, El Salvador
| | | | - Moira Gandiwa
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | | | | | - Jennifer A Geel
- Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Fariba Ghassemi
- Retina and Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ana V Girón
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
| | - Zelalem Gizachew
- Department of Ophthalmology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Marco A Goenz
- Pediatric Oncology Department, Benjamin Bloom National Children's Hospital, San Salvador, El Salvador
| | - Aaron S Gold
- Murray Ocular Oncology and Retina, Miami, Florida
| | | | - Glen A Gole
- Department of Ophthalmology, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Nir Gomel
- Department of Ophthalmology, Sourasky Medical Center Tel Aviv, School of Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Efren Gonzalez
- Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | - Henry N Garcia Pacheco
- Pediatric Oncology Unit, Instituto Regional de Enfermedades Neoplásicas del Sur, Arequipa, Perú
| | - Jaime Graells
- Unidad de Oncologia Ocular Hospital Oncologico Luis Razzetti, Caracas, Venezuela
| | - Liz Green
- IAM NOOR Eye Care Programme, Afghanistan
| | - Pernille A Gregersen
- Department of Clinical Genetics and Center for Rare Disorders, Aarhus University Hospital, Aarhus, Denmark
| | | | - Koffi M Guedenon
- Département de Pédiatrie, CHU Sylvanus Olympio, Université de Lomé, Lomé, Togo
| | | | - Ahmet K Gündüz
- Department of Ophthalmology, Ankara University School of Medicine, Ankara, Turkey
| | - Himika Gupta
- Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Sanjiv Gupta
- King George's Medical University, Lucknow, India
| | | | - Patrick Hamel
- Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montréal, Quebec, Canada
| | | | | | - Eric D Hansen
- John A. Moran Eye Center, University of Utah, Salt Lake City
| | - J William Harbour
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | | | - Murat Hasanreisoglu
- Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey
| | - Sadiq Hassan
- Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria
| | - Shadab Hassan
- Department of Pediatric Ophthalmology and Strabismus, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| | | | - Jose Hernandez
- Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú
| | | | - Laila Hessissen
- Pediatric Hematology and Oncology Center, Mohammed V University, Rabat, Morocco
| | - Diriba F Hordofa
- Department of Pediatrics and Child Health, Jimma University Medical Center, Jimma, Ethiopia
| | - Laura C Huang
- Byers Eye Institute, Stanford University, Stanford, California
| | | | - Marlies Hummlen
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | | | | | - Russo Ida
- Bambino Gesù IRCCS Children's Hospital, Rome, Italy
| | - Vesna R Ilic
- Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | | | | | - Helen Jenkinson
- Eye Department, Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | - Xunda Ji
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dong Hyun Jo
- Fight Against Angiogenesis-Related Blindness Laboratory, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | | | - William J Johnson
- Storm Eye Institute, Medical University of South Carolina, Charleston
| | - Michael M Jones
- The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | | | - Rolande L Kabore
- Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Swathi Kaliki
- Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India
| | - Abubakar Kalinaki
- Department of Ophthalmology, Makerere University College of Health Sciences Kamplala, Uganda
| | - Mehmet Kantar
- Division of Pediatric Oncology, School of Medicine, Ege University, Izmir, Turkey
| | | | - Tamar Kardava
- Ophthalmology Department, Central Children's Hospital of Georgia, Tbilisi, Georgia
| | - Rejin Kebudi
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Cerrahpaşa Faculty of Medicine and Oncology Institute, Istanbul University, Istanbul, Turkey
| | - Tomas Kepak
- St. Anne's University Hospital Brno, Masaryk University, and International Clinical Research Center/St Anna University Hospital, Brno, Czech Republic
| | | | | | - Hussain A Khaqan
- Department of Ophthalmology, Postgraduate Medical Institute, Ameer-Ud-Din Medical College, Lahore General Hospital, Lahore, Pakistan
| | - Phara Khauv
- Angkor Hospital for Children, Krong Siem Reap, Cambodia
| | - Wajiha J Kheir
- Duke Eye Center, Duke University Hospital, Durham, North Carolina
| | | | - Alireza Khodabande
- Retina and Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zaza Khotenashvili
- Ophthalmology Department, Central Children's Hospital of Georgia, Tbilisi, Georgia
| | - Jonathan W Kim
- Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles
| | - Jeong Hun Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hayyam Kiratli
- Ocular Oncology Service, Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Tero T Kivelä
- Ocular Oncology Service, Department of Ophthalmology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Artur Klett
- East Tallinn Central Hospital, Tallinn, Estonia
| | | | - Dalia Krivaitiene
- Children's Ophthalmology Department, Children's Hospital of Vilnius, University Hospital Santaros Clinic, Vilnius, Lithuania
| | - Mariana Kruger
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Kittisak Kulvichit
- Vitreo-Retina Research Unit, Department of Ophthalmology, Chulalongkorn University, Bangkok, Thailand
| | | | - Alice Kyara
- Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Eva S Lachmann
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carol P S Lam
- Hong Kong Eye Hospital, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Geoffrey C Lam
- Perth Children's Hospital, University of Western Australia, Perth, Western Australia, Australia
| | - Scott A Larson
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City
| | - Slobodanka Latinovic
- Clinical Center of Vojvodina, University Eye Clinic, Eye Research Foundation Vidar-Latinović, Novi Sad, Serbia
| | - Kelly D Laurenti
- Division of Ophthalmology, Feinberg School of Medicine, Northwestern University, and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Bao Han A Le
- John A. Burns School of Medicine, University of Hawaii, Honolulu, and University of Southern California Roski Eye Institute, Los Angeles
| | - Karin Lecuona
- Division of Ophthalmology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - Cairui Li
- Affiliated Hospital of Dali University, Dali City, China
| | - Ben Limbu
- Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | | | - Juan P López
- Ophthalmology Department, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Robert M Lukamba
- University Clinics of Lubumbashi, University of Lubumbashi, Lubumbashi, Democratic Rrepublic of Congo
| | | | - Sandra Luna-Fineman
- Pediatric Hematology/Oncology/Stem Cell Transplantation, Center for Global Health, Children's Hospital Colorado, University of Colorado, Aurora
| | - Delfitri Lutfi
- Department of Ophthalmology, Dr Soetomo General Hospital, Airlangga University, Surabaya, Indonesia
| | | | - George N Magrath
- Storm Eye Institute, Medical University of South Carolina, Charleston
| | - Amita Mahajan
- Pediatric Hematology-Oncology Unit, Apollo Center for Advanced Pediatrics, Indraprastha Apollo Hospital, New Delhi, India
| | | | - Erika Maka
- Semmelweis University, Budapest, Hungary
| | - Mayuri Makan
- Sekuru Kaguvi Eye Unit, Parirenyatwa Group of Hospitals, Harare, Zimbabwe
| | | | - Chatonda Manda
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Nieves Martín Begue
- Department of Pediatric Ophthalmology, Hospital Vall d'Hebron, Barcelona, Spain
| | | | | | | | - Miguel Materin
- Duke Eye Center, Duke University Hospital, Durham, North Carolina
| | | | - Marchelo Matua
- Ruharo Eye Centre, Ruharo Mission Hospital, Mbarara, Uganda
| | - Ismail Mayet
- University of the Witwatersrand, Johannesburg, South Africa
| | | | - John D McKenzie
- Department of Ophthalmology, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Ocular Oncology, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Aurora Medina-Sanson
- Department of Oncology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Azim Mehrvar
- MAHAK Hematology Oncology Research Center, Mahak Hospital, Tehran, Iran
| | | | | | | | - Marilyn B Mets
- Division of Ophthalmology, Feinberg School of Medicine, Northwestern University, and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Edoardo Midena
- Department of Ophthalmology, University of Padova, Padova, Italy
| | | | | | - Ahmed A Mohamedani
- Department of Pathology, Faculty of Medicine, University of Gezira, Wad Medani, Sudan
| | | | - Annette C Moll
- Department of Ophthalmology, Amsterdam UMC, Amsterdam, the Netherlands
| | | | - Rosa A Morales
- Hospital Infantil Manuel de Jesús Rivera, Managua, Nicaragua
| | - Claude Moreira
- Service d'Oncologie Pédiatrique de l'Hôpital Aristide le Dantec, Dakar, Senegal
| | | | | | - Gerald Msukwa
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | | | - Francis L Munier
- Jules-Gonin Eye Hospital, Fondation Asile de Aveugles, University of Lausanne, Lausanne, Switzerland
| | - Gabriela Murgoi
- Institute of Oncology, Prof. Dr Al. Trestioreanu, Bucharest, Romania
| | | | - Kareem O Musa
- Department of Ophthalmology, Lagos University Teaching Hospital, College of Medicine of the University of Lagos, Lagos, Nigeria
| | - Asma Mushtaq
- The Children's Hospital and the Institute of Child Health, Lahore, Pakistan
| | - Hamzah Mustak
- Division of Ophthalmology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - Gita Naidu
- University of the Witwatersrand, Johannesburg, South Africa
| | - Akshay Gopinathan Nair
- Aditya Jyot Eye Hospital, Mumbai, India
- Lokmanya Tilak Municipal General Hospital and Medical College, Mumbai, India
| | - Larisa Naumenko
- N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus
| | | | - Yetty M Nency
- Child Health Department, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Vladimir Neroev
- Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia
| | - Hang Ngo
- Ho Chi Minh Eye Hospital, Ho Chi Minh, Vietnam
| | - Rosa M Nieves
- Hospital Infantil Dr Robert Reid Cabral, Santo Domingo, Dominican Republic
| | - Marina Nikitovic
- Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Elizabeth D Nkanga
- Department of Ophthalmology, Calabar Children's Eye Center, University of Calabar Teaching Hospital, Calabar Nigeria
| | - Henry Nkumbe
- Magrabi ICO Cameroon Eye Institute, Yaounde, Cameroon
| | - Murtuza Nuruddin
- Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh
| | | | | | - Ngozi C Oguego
- Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Andrzej Olechowski
- Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland
| | - Scott C N Oliver
- Sue Anschutz-Rodgers Eye Center, University of Colorado School of Medicine, Aurora
| | | | - Diego Ossandon
- Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile
| | | | | | - Sally L Painter
- Eye Department, Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | | | - Luisa Paiva
- National Ophthalmological Institute of Angola, Luanda, Angola
| | - Bikramjit P Pal
- H M Diwan Eye Foundation, and Tata Medical Center, Kolkata, India
| | | | - Ruzanna Papyan
- Department of Oncology, Yerevan State Medical University, and Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after R. H. Yeolyan, Yerevan, Armenia
| | | | - Manoj Parulekar
- Eye Department, Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | | | | | - Katarzyna Pawinska-Wasikowska
- Institute of Pediatrics, Jagiellonian University Medical College, Children's University Hospital of Krakow, Krakow, Poland
| | - Jacob Pe'er
- Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Sanja Peric
- University Hospital Center Zagreb, Zagreb, Croatia
| | - Chau T M Pham
- Vietnam National Institute of Ophthalmology, Ha Noi, Vietnam
| | - Remezo Philbert
- Centre Hospitalier Universitaire de Kamenge, Bujumbura, Burundi
| | | | - Pavel Pochop
- Department of Ophthalmology for Children and Adults, Second Faculty of Medicine, Charles University, and Motol University Hospital, Prague, Czech Republic
| | | | - Vladimir G Polyakov
- Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology, N.N. Blokhin Russian Cancer Research Center, Moscow, Russia
- Russian Medical Academy of Postgraduate Education, Moscow, Russia
| | - Manca T Pompe
- University Eye Hospital Ljubljana, University Medical Center Ljubljana, Ljubljana, Slovenia
| | | | - Daphna Prat
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel
| | | | - Ignatius Purwanto
- Sardjito Hospital, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Seema Qayyum
- The Children's Hospital and the Institute of Child Health, Lahore, Pakistan
| | - Jiang Qian
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
| | - Ardizal Rahman
- Ophthalmology Department, Dr M. Djamil General Hospital, Faculty of Medicine, Andalas University, West Sumatra, Indonesia
| | | | | | | | | | | | - Marco A Ramirez-Ortiz
- Department of Ophthalmology, Hospital Infantil de Mexico Federico Gómez, Mexico City, Mexico
| | - Léa Raobela
- Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar
| | - Riffat Rashid
- Department of Oculoplasty and Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh
| | - M Ashwin Reddy
- The Royal London Hospital, Barts Health NHS Trust, and Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Ehud Reich
- Department of Ophthalmology, Davidoff Center for Oncology, Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, Israel
| | - Lorna A Renner
- School of Medicine and Dentistry, Korle-Bu Teaching Hospital, University of Ghana, Accra, Ghana
| | | | | | | | - Petra Ritter-Sovinz
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Duangnate Rojanaporn
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Livia Romero
- Unidad de Oncologia Ocular Hospital Oncologico Luis Razzetti, Caracas, Venezuela
| | - Soma R Roy
- Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh
| | - Raya H Saab
- Children's Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Svetlana Saakyan
- Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia
| | - Ahmed H Sabhan
- Pediatric Oncology Unit, Children Welfare Teaching Hospital, College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Mandeep S Sagoo
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, and UCL Institute of Ophthalmology and London Retinoblastoma Service, Royal London Hospital, London, United Kingdom
| | - Azza M A Said
- Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Rohit Saiju
- Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | - Beatriz Salas
- Hospital Dr Manuel Ascencio Villarroel, Cochabamba, Bolivia
| | | | | | | | | | | | | | - Ahad Sedaghat
- Department of Ophthalmology, Rasool Akram Hospital, Tehran, Iran
| | | | - Rachna Seth
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Ankoor S Shah
- Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | - Sadik T Sherief
- Department of Ophthalmology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Carol L Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Sorath Noorani Siddiqui
- Department of Pediatric Ophthalmology and Strabismus, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| | - Sidi Sidi Cheikh
- Ophthalmology Department, Nouakchott Medical University, Nouakchott, Mauritania
| | - Sónia Silva
- Centro Hospital Universitário de Coimbra, University of Coimbra, Coimbra, Portugal
| | - Arun D Singh
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | | | - Usha Singh
- Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Penny Singha
- Department of Ophthalmology, Songklanagarind Hospital, Prince of Songkla University, Songkla, Thailand
| | - Rita S Sitorus
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, and Dr Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Alison H Skalet
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - Hendrian D Soebagjo
- Department of Ophthalmology, Dr Soetomo General Hospital, Airlangga University, Surabaya, Indonesia
| | | | - Grace Ssali
- Mulago National Referral Hospital, Kampala, Uganda
| | - Andrew W Stacey
- Department of Ophthalmology, University of Washington, Seattle
| | - Sandra E Staffieri
- Department of Ophthalmology, Royal Children's Hospital, Parkville, Victoria, Australia
- Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia
| | - Erin D Stahl
- Children's Mercy Hospital, Kansas City, Missouri
| | - Christina Stathopoulos
- Jules-Gonin Eye Hospital, Fondation Asile de Aveugles, University of Lausanne, Lausanne, Switzerland
| | - Branka Stirn Kranjc
- University Eye Hospital Ljubljana, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - David K Stones
- Department of Paediatrics and Child Health, University of the Free State, Bloemfontein, South Africa
| | | | | | - Sadia Sultana
- Department of Oculoplasty and Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh
| | - Xiantao Sun
- Henan Children's Hospital, Affiliated Children's Hospital of Zhengzhou University, Zhengzhou, China
| | - Meryl Sundy
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - Rosanne Superstein
- Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montréal, Quebec, Canada
| | - Eddy Supriyadi
- Sardjito Hospital, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Shigenobu Suzuki
- Department of Ophthalmic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Karel Svojgr
- Department of Pediatric Hematology and Oncology, Second Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic
| | | | - Gevorg Tamamyan
- Department of Oncology, Yerevan State Medical University, and Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after R. H. Yeolyan, Yerevan, Armenia
| | - Deborah Tan
- Singapore National Eye Center, Singapore, Singapore
| | - Alketa Tandili
- University Hospital Center Mother Theresa, Tirana, Albania
| | | | - Maryam Tashvighi
- MAHAK Hematology Oncology Research Center, Mahak Hospital, Tehran, Iran
| | | | - Edi S Tehuteru
- National Cancer Center, Dharmais Cancer Hospital, Jakarta, Indonesia
| | - Luiz F Teixeira
- Pediatric Oncology Institute, Federal University of São Paulo, São Paulo, Brazil
- Ophthalmology Department, Federal University of São Paulo, São Paulo, Brazil
| | - Kok Hoi Teh
- Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | | | - Helen Toledano
- Department of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Doan L Trang
- Vietnam National Institute of Ophthalmology, Ha Noi, Vietnam
| | - Fousseyni Traoré
- Pediatric Oncology Service, Gabriel Toure Hospital, Bamako, Mali
| | | | - Samuray Tuncer
- Department of Ophthalmology, Faculty of Medicine, Ocular Oncology Service, Istanbul University, Istanbul, Turkey
| | | | - Ali B Umar
- Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria
| | - Emel Unal
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Ankara University, Ankara, Turkey
| | | | - Steen F Urbak
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Tatiana L Ushakova
- Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology, N.N. Blokhin Russian Cancer Research Center, Moscow, Russia
- Russian Medical Academy of Postgraduate Education, Moscow, Russia
| | | | | | | | - Adisai Varadisai
- Vitreo-Retina Research Unit, Department of Ophthalmology, Chulalongkorn University, Bangkok, Thailand
| | | | | | - Nevyana V Veleva-Krasteva
- Eye Clinic, Department of Ophthalmology, University Hospital Alexandrovska, Medical University, Sofia, Sofia, Bulgaria
| | | | - Andi A Victor
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, and Dr Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | | | | | - Vicktoria Vishnevskia-Dai
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel
| | | | | | | | - Keith Waddell
- Ruharo Eye Centre, Ruharo Mission Hospital, Mbarara, Uganda
| | | | | | - Yi-Zhuo Wang
- Department of Paediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Avery Weiss
- Department of Ophthalmology, University of Washington, Seattle
| | - Matthew W Wilson
- Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Amelia D C Wime
- National Ophthalmological Institute of Angola, Luanda, Angola
| | | | | | | | - Phanthipha Wongwai
- Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Daoman Xiang
- Department of Pediatric Ophthalmology, Guangzhou Children's Hospital and Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | | | - Jason C Yam
- Hong Kong Eye Hospital, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Huasheng Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jenny M Yanga
- Service d'Ophtalmologie, Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | | | - Vera A Yarovaya
- S.Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
| | - Andrey A Yarovoy
- S.Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
| | - Huijing Ye
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | | | - Putu Yuliawati
- Department of Ophthalmology, Faculty of Medicine, Udayana University, Sanglah Eye Hospital, Bali, Indonesia
| | | | - Ekhtelbenina Zein
- Assistante Hospitalo Universitaire, Faculte de Medecine de Nouakchott Medecin Oncopediatre, Center National d'Oncologie, Nouakchott, Mauritania
| | - Chengyue Zhang
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Yi Zhang
- Department of Paediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Junyang Zhao
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Xiaoyu Zheng
- Department of Ophthalmology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | | | - Nida Zia
- The Indus Hospital, Karachi, Pakistan
| | - Othman A O Ziko
- Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Marcia Zondervan
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Richard Bowman
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Ophthalmology Department, Great Ormond Street Hospital, London, United Kingdom
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Jiménez I, Laé M, Tanguy ML, Savignoni A, Gauthier-Villars M, Desjardins L, Cassoux N, Dendale R, Rodriguez J, Doz F, Brisse HJ, Aerts I. Craniofacial second primary tumors in patients with germline retinoblastoma previously treated with external beam radiotherapy: A retrospective institutional analysis. Pediatr Blood Cancer 2020; 67:e28158. [PMID: 31904159 DOI: 10.1002/pbc.28158] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND The long-term survival of germline retinoblastoma patients is decreased due to the risk of second primary tumors (SPTs) that occur years after the diagnosis of retinoblastoma. This risk is related to genetic predisposition and other factors, such as the treatment of retinoblastoma by external beam radiotherapy (EBRT). PROCEDURE We studied the incidence, risk factors, and prognosis of specific craniofacial SPTs developed within the margins of radiation field in a cohort of 209 patients with germline retinoblastoma treated with EBRT at our institution between 1977 and 2010. Clinical characteristics, survival, incidence, and histology of craniofacial SPTs were recorded. RESULTS Fifty-three of the 209 patients developed 60 distinct craniofacial SPTs in irradiated field with a median time from EBRT of 16.9 years (4-35) and a median follow-up of 24.8 years (5.3-40). Osteosarcoma (33.3%) and undifferentiated sarcoma (23.3%) were the more prevalent histological entities. Benign tumors (16.7%) also occurred. The cumulative incidence of craniofacial SPTs reached 32.6% at 35 years after EBRT, and the median survival after diagnosis was five years. In our series, irradiation under 12 months of age, bilateral EBRT, or previous treatment of retinoblastoma with chemotherapy did not significantly increase the risk of craniofacial SPTs. CONCLUSIONS This work presents a strong argument to avoid EBRT in the management of retinoblastoma and emphasizes the high risk and poor prognosis of specific craniofacial SPTs. This study also points to the question of the need and benefits of special programs for early detection of craniofacial SPTs in survivors of irradiated germline retinoblastoma.
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Affiliation(s)
- Irene Jiménez
- Institut Curie, SIREDO Oncology Center (Care, Innovation and Research for children and AYA with Cancer), PSL Research University, Paris, France
| | - Marick Laé
- Institut Curie, Department of Pathology, PSL Research University, Paris, France.,Centre Henri Becquerel, Department of Pathology, INSERM U1245, UNIROUEN, University of Normandie, Rouen, France
| | - Marie-Laure Tanguy
- Institut Curie, Biostatistics Department, PSL Research University, Paris, France
| | - Alexia Savignoni
- Institut Curie, Biostatistics Department, PSL Research University, Paris, France
| | | | - Laurence Desjardins
- Institut Curie, Ocular Oncology Service, PSL Research University, Paris, France
| | - Nathalie Cassoux
- Institut Curie, Ocular Oncology Service, PSL Research University, Paris, France.,Université de Paris, Paris, France
| | - Rémi Dendale
- Institut Curie, Radiation Oncology Service, PSL Research University, Paris, France
| | - Joseph Rodriguez
- Hôpital Jean Bernard, Department of Surgery, Head and Neck Surgery, Valenciennes, France
| | - François Doz
- Université de Paris, Paris, France.,Institut Curie, SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), Paris, France
| | - Hervé J Brisse
- Institut Curie, Imaging Department, PSL Research University, Paris, France
| | - Isabelle Aerts
- Institut Curie, SIREDO Oncology Center (Care, Innovation and Research for children and AYA with Cancer), PSL Research University, Paris, France
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12
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Desjardins L. [Living with retinoblastoma]. Rev Prat 2020; 70:407-408. [PMID: 32877098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Laurence Desjardins
- Centre de référence pour le rétinoblastome, institut Curie et association Retinostop. www.retinostop.org
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13
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Kivelä T, Piperno-Neumann S, Desjardins L, Schmittel A, Bechrakis N, Midena E, Leyvraz S, Zografos L, Grange JD, Ract-Madoux G, Marshall E, Damato B, Eskelin S. Addendum to: Validation of a Prognostic Staging for Metastatic Uveal Melanoma: A Collaborative Study of the European Ophthalmic Oncology Group. Am J Ophthalmol 2020. [DOI: 10.1016/j.ajo.2019.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Choucair ML, Brisse HJ, Fréneaux P, Desjardins L, Dorfmüller G, Puget S, Dendale R, Chevrier M, Doz F, Lumbroso-Le Rouic L, Aerts I. Management of advanced uni- or bilateral retinoblastoma with macroscopic optic nerve invasion. Pediatr Blood Cancer 2020; 67:e27998. [PMID: 31571399 DOI: 10.1002/pbc.27998] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 08/05/2019] [Accepted: 09/04/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND Retinoblastoma with macroscopic optic nerve (ON) invasion depicted by imaging at diagnosis remains a major problem and carries a poor prognosis. We sought to describe the treatment and outcome of these high-risk patients. METHODS Retrospective mono-institutional clinical, radiological, and histological review of patients with uni- or bilateral retinoblastoma with obvious ON invasion, defined by radiological optic nerve enlargement (RONE) depicted by computed tomography scan or magnetic resonance imaging (MRI), was performed. RESULTS Between 1997 and 2014, among the 936 patients with retinoblastoma treated at Institut Curie, 11 had detectable RONE. Retinoblastoma was unilateral in 10 and bilateral in one. Median age at diagnosis was 28 months (range, 11-96). ON enlargement extended to the orbital portion in three patients, to the optic canal in five, to the prechiasmatic portion in two, and to the optic chiasm in one. Nine patients received neoadjuvant chemotherapy and partial response was obtained in all. Enucleation was performed in 10/11 patients-by an anterior approach in three and by anterior and subfrontal approaches in seven. Three patients had a positive ON resection margin (2/3 after primary enucleation). All enucleated patients received adjuvant treatment (conventional chemotherapy: 10, high-dose chemotherapy: seven, radiotherapy: five). Leptomeningeal progression occurred in four patients. Seven are in first complete remission (median follow up: 8 years [3.5-19.4]). CONCLUSION Neoadjuvant chemotherapy and microscopic complete resection have a pivotal role in the management of retinoblastoma with RONE. MRI is recommended for initial and pre-operative accurate staging. Surgery should be performed by neurosurgeons in case of posterior nerve invasion. Radiotherapy is required in case of incomplete resection.
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Affiliation(s)
- Marie-Louise Choucair
- Oncology Center SIREDO: Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer, Institut Curie, Paris, France
| | - Hervé J Brisse
- Radiology Department, Institut Curie, Paris, France.,Paris Sciences et Lettres Research University, Paris, France
| | - Paul Fréneaux
- Paris Sciences et Lettres Research University, Paris, France.,Tumor Biology Department, Institut Curie, Paris, France
| | - Laurence Desjardins
- Paris Sciences et Lettres Research University, Paris, France.,Ocular Oncology, Institut Curie, Paris, France
| | - Georg Dorfmüller
- Pediatric Neurosurgery Department, Fondation Rothschild, Paris, France
| | - Stéphanie Puget
- Department of Pediatric Neurosurgery, Necker Hospital, Paris, France.,Université Paris Descartes, Paris, France
| | - Rémi Dendale
- Paris Sciences et Lettres Research University, Paris, France.,Radiation Oncology Department, Institut Curie, Paris, France
| | - Marion Chevrier
- Paris Sciences et Lettres Research University, Paris, France.,Biostatistics Department, Institut Curie, Paris, France
| | - François Doz
- Oncology Center SIREDO: Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer, Institut Curie, Paris, France.,Université Paris Descartes, Paris, France
| | - Livia Lumbroso-Le Rouic
- Paris Sciences et Lettres Research University, Paris, France.,Ocular Oncology, Institut Curie, Paris, France
| | - Isabelle Aerts
- Oncology Center SIREDO: Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer, Institut Curie, Paris, France.,Paris Sciences et Lettres Research University, Paris, France
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15
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Desjardins L. Specificities of Ophthalmic Tumors: Usefulness of A National Network. ONCOLOGIE 2020. [DOI: 10.32604/oncologie.2020.012377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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16
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Toutée A, Angi M, Dureau S, Lévy-Gabriel C, Rouic LLL, Dendale R, Desjardins L, Cassoux N. Long-Term Visual Outcomes for Small Uveal Melanoma Staged T1 Treated by Proton Beam Radiotherapy. Cancers (Basel) 2019; 11:cancers11081047. [PMID: 31344948 PMCID: PMC6721317 DOI: 10.3390/cancers11081047] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/16/2019] [Accepted: 07/17/2019] [Indexed: 11/16/2022] Open
Abstract
There is increasing evidence of the survival benefit of treating uveal melanoma in an early stage, however it is important to discuss with the patient the associated risk of visual loss. We investigated visual outcomes for uveal melanomas staged T1 (T1UM) treated by proton beam radiotherapy (PBR) as a function of their distance to fovea-optic disc. This retrospective study included a cohort of 424 patients with T1UM treated with PBR between 1991 and 2010 with at least a 5-year follow-up. Visual acuity (VA) was analyzed for patients with posterior edge of tumor located at ≥3 mm (GSup3) or <3 mm (GInf3) from fovea-optic disc. The mean follow-up duration was 122 months, no tumor recurrence was observed. The mean baseline and final VA were 20/25 and 20/32 for GSup3 (n = 75), and 20/40 and 20/80 for GInf3 (n = 317) respectively. The frequency of a 20/200 or greater visual conservation was 93.2%(CI95%:87.7-99.1) and 60.1%(CI95%:54.9-65.9) for GSup3 and GInf3 respectively. This difference between groups was statistically significant (p < 0.001). The risk factors for significant VA loss (less than 20/200) were GInf3 location (p < 0.001), tumor touching optic disc (p = 0.04), initial VA inferior to 20/40 (p < 0.001), documented growth (p = 0.002), and age greater than 60 years (p < 0.001). In summary, PBR for T1UM yields excellent tumor control and good long-term visual outcomes for tumors located ≥3 mm from fovea-optic disc.
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Affiliation(s)
- Adélaïde Toutée
- Department of Ocular Oncology, Institut Curie, 26, rue Ulm, 75005 Paris, France.
| | - Martina Angi
- Department of Ocular Oncology, Institut Curie, 26, rue Ulm, 75005 Paris, France
- National Cancer Institute IRCCS Foundation, via Venezian, 1, 20133 Milan, Italy
| | - Sylvain Dureau
- Department of Biostatistics, Institut Curie, 26, rue Ulm, 75005 Paris, France
| | | | | | - Rémi Dendale
- Department of Radiation Oncology, Institut Curie, 26, rue Ulm, 75005 Paris, France
| | - Laurence Desjardins
- Department of Ocular Oncology, Institut Curie, 26, rue Ulm, 75005 Paris, France
| | - Nathalie Cassoux
- Department of Ocular Oncology, Institut Curie, 26, rue Ulm, 75005 Paris, France
- School of Medicine Paris V Descartes, PSL University, 12 rue de l'Ecole de Medecine, 75006 Paris, France
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17
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Jouhi S, Jager MJ, de Geus SJ, Desjardins L, Eide NA, Grange JD, Kiilgaard JF, Seregard S, Midena E, Parrozzani R, Caujolle JP, Rospond-Kubiak I, Kivelä TT. The Small Fatal Choroidal Melanoma Study. A Survey by the European Ophthalmic Oncology Group. Am J Ophthalmol 2019; 202:100-108. [PMID: 30772347 DOI: 10.1016/j.ajo.2019.01.031] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 01/07/2019] [Accepted: 01/30/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine the size at which choroidal melanomas can metastasize and to report the characteristics of small fatal choroidal melanomas (SFCM). DESIGN Retrospective case series. METHODS Ten ocular oncology services submitted 45 patients with a choroidal melanoma 3 mm or less in thickness and 9 mm or less in largest basal diameter (LBD), when treated, who developed metastases. RESULTS Median tumor thickness was 2.4 mm (range, 1.0-3.0 mm) and LBD 7.3 mm (range, 3.0-9.0 mm). Of 14 (31%) tumors that were first observed, 12 grew a median of 0.5 mm (range, 0.1-1.2 mm) in thickness and 1.0 mm (range, 0-3.0 mm) in LBD within a median of 7 months; 3 were initially smaller than 3 mm in LBD. Number of risk factors for growth and metastasis was 0 for 4% of the tumors; 60% were over 2 mm in thickness, 63% had subretinal fluid, 84% caused symptoms, 57% had orange pigment, and 92% were within 3 mm of the disc. Local recurrence occurred in 8 of 31 eyes (26%) treated conservatively. Median metastasis-free survival was 4.5 years (range, 0.8-15.7 years). Kaplan-Meier estimate of metastasis developing was 15% (95% confidence interval [CI], 7-26), 51% (95% CI, 36-64) and 85% (95% CI, 71-92) by 2, 5, and 10 years, respectively. By the time of analysis, 37 patients had died of metastasis after a median of 7 months. CONCLUSIONS Choroidal melanomas less than 3.0 mm in LBD are highly unlikely to metastasize. Risk factors of an SFCM are similar to those for all choroidal melanomas of similar size.
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18
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Leblanc A, Lumbroso-Le Rouic L, Desjardins L, Dendale R, Cassoux N. Diffuse Iris Melanoma: Conservative Treatment with Proton Beam Therapy after Limbal Stem Cell Preservation or Enucleation? Ocul Oncol Pathol 2019; 5:396-401. [PMID: 31768362 DOI: 10.1159/000496847] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 01/11/2019] [Indexed: 11/19/2022] Open
Abstract
Objectives Iris melanomas represent 2-3% of uveal melanomas; the diffuse variant accounts for approximately 10% of all iris melanomas. Different treatment modalities for diffuse iris melanomas (DIM) have been proposed depending on the local status as well as the age and general condition of the patient. Methods This study is a single-centre retrospective case series describing the diagnosis, treatments and outcomes of DIM. Treatment consisted of enucleation or proton beam therapy (PT) of the whole anterior segment. Patients who were treated with PT benefitted from limbal stem cell preservation before irradiation. Results Between 1996 and 2016, a total of 14 patients with DIM presented to our institution and were included in the database. The global survival was 86%. The median follow-up was 4.6 years (range 4 months to 15 years). Only 1 patient (7%) developed metastatic disease of the DIM (gastric location). No patient developed liver metastasis. Seven patients were treated by enucleation and 7 by PT after limbal stem cell preservation. After a conservative attempt, local tumour recurrence occurred in 2 patients at 2 years, requiring enucleation. The cornea was clear after irradiation in all patients. Cataract (n = 6) and glaucoma (n = 4) were the main complications after irradiation. Conclusions DIM is a very rare tumour. The global survival is excellent. Conservative treatment with PT is an efficient alternative to enucleation and allows good local tumour control. Cataract and glaucoma are the main radiation-related complications, but the corneal status was excellent due to the stem cell harvest prior to radiotherapy.
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Affiliation(s)
- Alice Leblanc
- Département d'Ophtalmologie, Institut Curie, Paris, France.,Département d'Ophtalmologie, Institut Curie, Poitiers, France
| | | | | | - Rémi Dendale
- ICPO - Centre de Protonthérapie de l'Institut Curie à Orsay, Paris, France
| | - Nathalie Cassoux
- Département d'Ophtalmologie, Institut Curie, Paris, France.,Université Paris V Descartes, Paris, France
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19
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Chaussade A, Millot G, Wells C, Brisse H, Laé M, Savignoni A, Desjardins L, Dendale R, Doz F, Aerts I, Jimenez I, Cassoux N, Stoppa Lyonnet D, Gauthier Villars M, Houdayer C. Correlation between RB1germline mutations and second primary malignancies in hereditary retinoblastoma patients treated with external beam radiotherapy. Eur J Med Genet 2019; 62:217-223. [DOI: 10.1016/j.ejmg.2018.07.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 06/21/2018] [Accepted: 07/17/2018] [Indexed: 11/16/2022]
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20
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Msika LC, Desjardins L, Cockenpot V, Dendale R, Berges O, Aït Raïs K, Pierron G, Barnhill RL, Cassoux N, Matet A. Iris melanoma relapsing sixteen years after proton-beam therapy: The importance of lifelong follow-up. Am J Ophthalmol Case Rep 2019; 13:89-92. [PMID: 30619969 PMCID: PMC6305799 DOI: 10.1016/j.ajoc.2018.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/29/2018] [Accepted: 12/04/2018] [Indexed: 11/28/2022] Open
Abstract
Purpose To report a case of locally recurrent spindle-cell iris amelanotic melanoma 16 years after proton-beam therapy. Observations In 2001, a 45-year-old man presented with an amelanotic iris melanoma, extending from the 5 to 10 o'clock positions on his left eye. High-frequency ultrasonography showed extension of melanoma into the ciliary body. He was initially managed with proton-beam therapy (60 Gy delivered in four fractions over four consecutive days) and underwent ocular and systemic examination at regular intervals over the following years. Local tumor control was achieved, and the patient did not develop metastasis during sixteen consecutive years. In 2017, 16 years after he received proton-beam therapy, the patient developed a focal amelanotic lesion strongly suggestive of a local recurrence of iris melanoma, although it extended from the 1 to 6 o'clock positions. He also presented with treatment-resistant glaucoma with an intraocular pressure (IOP) of 37 mmHg, despite maximal topical IOP-lowering therapy. Since a second irradiation of the anterior segment was contraindicated, the eye was enucleated. Pathological analysis confirmed the diagnosis of iris melanoma and demonstrated iridocorneal angle invasion extending from the initial site to the recurrent tumor location. Conclusions and importance Regular ophthalmological surveillance for life with gonioscopy and high-frequency ultrasonography is recommended in patients with iris melanoma, due to the possibility of delayed local recurrence more than a decade after the initial treatment.
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Affiliation(s)
- Laetitia-Claire Msika
- Institut Curie, PSL Research University, Department of Ophthalmology, F-75005, Paris, France
| | - Laurence Desjardins
- Institut Curie, PSL Research University, Department of Ophthalmology, F-75005, Paris, France
| | - Vincent Cockenpot
- Institut Curie, PSL Research University, Department of Pathology, F-75005, Paris, France
| | - Rémi Dendale
- Institut Curie, PSL Research University, Department of Radiation Therapy, F-75005, Paris, France
| | - Olivier Berges
- Fondation Ophtalmologique Adolphe de Rothschild, Department of Medical Imaging, F-75019, Paris, France
| | - Khadija Aït Raïs
- Institut Curie, PSL Research University, Somatic Genetic Unit, Department of Genetic, F-75005, Paris, France
| | - Gaëlle Pierron
- Institut Curie, PSL Research University, Somatic Genetic Unit, Department of Genetic, F-75005, Paris, France
| | - Raymond L Barnhill
- Institut Curie, PSL Research University, Department of Pathology, F-75005, Paris, France
| | - Nathalie Cassoux
- Institut Curie, PSL Research University, Department of Ophthalmology, F-75005, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, F-75005, Paris, France
| | - Alexandre Matet
- Institut Curie, PSL Research University, Department of Ophthalmology, F-75005, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, F-75005, Paris, France
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21
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Smith JR, Pe'er J, Belfort RN, Cardoso F, Carvajal RD, Carvalho C, Coupland SE, Desjardins L, Francis JH, Gallie BL, Gombos DS, Grossniklaus HE, Heegaard S, Jager MJ, Kaliki S, Ksander BR, Maeurer M, Moreno E, Pulido JS, Ryll B, Singh AD, Zhao J, Parreira A, Wilson DJ, O'Brien JM. Proceedings of the Association for Research in Vision and Ophthalmology and Champalimaud Foundation Ocular Oncogenesis and Oncology Conference. Transl Vis Sci Technol 2019; 8:9. [PMID: 30652059 PMCID: PMC6333107 DOI: 10.1167/tvst.8.1.9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 12/21/2018] [Indexed: 12/16/2022] Open
Abstract
The 2018 Ocular Oncogenesis and Oncology Conference was held through a partnership of the Association for Research in Vision and Ophthalmology (ARVO) and the Champalimaud Foundation. Twenty-one experts from international ocular oncology centers, from the Champalimaud Clinical Centre and the Champalimaud Foundation Cancer Research Program, and from patient advocacy organizations, delivered lectures on subjects that ranged from global ocular oncology, to basic research in mechanisms of ocular malignancy, to clinical research in ocular cancers, and to anticipated future developments in the area. The scientific program of the conference covered a broad range of ocular tumors-including uveal melanoma, retinoblastoma, ocular surface tumors, and adnexal and intraocular lymphomas-and pathogenesis and management were deliberated in the context of the broader systemic cancer discipline. In considering the latest basic and clinical research developments in ocular oncogenesis and oncology, and providing the opportunity for cross-talk between ocular cancer biologists, systemic cancer biologists, ocular oncologists, systemic oncologists, patients, and patient advocates, the forum generated new knowledge and novel insights for the field. This report summarizes the content of the invited talks at the 2018 ARVO-Champalimaud Foundation Ocular Oncogenesis and Oncology Conference.
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Affiliation(s)
- Justine R. Smith
- Eye & Vision Health, Flinders University College of Medicine & Public Health, Adelaide, Australia
| | - Jacob Pe'er
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Rubens N. Belfort
- Ophthalmology Department, Federal University of São Paulo, São Paulo, Brazil
| | - Fatima Cardoso
- Champalimaud Foundation, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Richard D. Carvajal
- Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Carlos Carvalho
- Champalimaud Foundation, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Sarah E. Coupland
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool and Royal Liverpool University Hospital, Liverpool, UK
| | | | - Jasmine H. Francis
- Ophthalmic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Brenda L. Gallie
- Department of Ophthalmology and Vision Science, SickKids Hospital, Toronto, Canada
| | - Dan S. Gombos
- Section of Ophthalmology, M.D. Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Hans E. Grossniklaus
- Departments of Ophthalmology and Pathology, Emory University School of Medicine, Atlanta, GA, USA
| | - Steffen Heegaard
- Departments of Ophthalmology and Pathology, Rigshospitalet, Copenhagen, Denmark
| | - Martine J. Jager
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Swathi Kaliki
- Operation Eyesight Universal Institute for Eye Cancer, L.V. Prasad Eye Institute, Hyderabad, India
| | - Bruce R. Ksander
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Markus Maeurer
- Champalimaud Foundation, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Eduardo Moreno
- Champalimaud Foundation, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Jose S. Pulido
- Departments of Ophthalmology and Molecular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Bettina Ryll
- Melanoma Patient Network Europe, Knivsta, Sweden
| | - Arun D. Singh
- Department of Ophthalmic Oncology, Cleveland Clinic, Cleveland, OH, USA
| | - Junyang Zhao
- Department of Ophthalmology, Beijing Children's Hospital, Beijing, China
| | - António Parreira
- Champalimaud Foundation, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - David J. Wilson
- Casey Eye Institute and Department of Ophthalmology, Oregon Health & Science University, Portland, OR, USA
| | - Joan M. O'Brien
- Scheie Eye Institute and Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA, USA
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22
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Pant Pai N, Smallwood M, Desjardins L, Goyette A, Birkas KG, Vassal AF, Joseph L, Thomas R. An Unsupervised Smart App-Optimized HIV Self-Testing Program in Montreal, Canada: Cross-Sectional Study. J Med Internet Res 2018; 20:e10258. [PMID: 30465709 PMCID: PMC6290269 DOI: 10.2196/10258] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 08/23/2018] [Accepted: 09/14/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although HIV self-testing strategies have been recommended by the World Health Organization, HIV self-tests are not yet approved in Canada. Currently approved HIV self-tests offer toll-free lines that are insufficient for initiating expedited linkages to counseling and care, accurate interpretation, and support during HIV self-testing. We developed an innovative, multilingual software app called HIVSmart! to plug these gaps. OBJECTIVE This study aimed to test our app-optimized oral HIV self-testing strategy for feasibility in men who have sex with men (MSM) who presented to test at a large sexual health clinic (Clinique Médicale L'Actuel) in Montreal. METHODS Between July 2016 and February 2017, we offered a strategy consisting of the OraQuick In-Home HIV Test (an investigational device) and a tablet installed with the HIVSmart! app to study participants, who presented at a private office in the clinic, mimicking an unsupervised home environment. We evaluated the strategy for its feasibility, acceptability, and preference. Using the HIVSmart! app, participants were guided through the self-testing process. We determined feasibility with a metric defined as the completion rate, which consisted of the following 3 steps: (1) self-test conduct; (2) self-test interpretation; and (3) linkages to care. Participants independently performed, interpreted, recorded their self-test and result, engaged in pre- and posttest counseling, and sought linkages to care. Laboratory tests (p24, Western Blot, and RNA), as per country algorithms, were expedited, and linkages based on the rapid test status were arranged. RESULTS Mean age of the 451 participants enrolled was 34 (range, 18-73) years. Of all participants, 97.1% (438/451) completed and submitted the survey through the HIVSmart! app. In total, 84.7% (371/438) of the participants were well educated (beyond high school) and 52.5% (230/438) had been tested within the past 6 months. Of the 451, 11.5% (52/451) were on pre-exposure prophylaxis. Feasibility (completion rate), an average proportion of the 3 steps, was computed to be 96.6% (419/451). The acceptability of the strategy was high at 98.5% (451/458). A majority of the participants (448/451, 99.3%) were found to be self-tested and lab-confirmed negative and were counseled after self- and rapid tests. In total, 0.7% (3/451) of the participants who self-tested positive and were lab-confirmed positive were linked to a physician within the same day. Furthermore, 98.8% (417/422) of the participants found the app to be useful and 94.0% (424/451) were willing to recommend it to a friend or partner. CONCLUSIONS The HIVSmart! app-optimized strategy was feasible, accepted, and preferred by an educated, urban MSM population of Montreal. With the app, participants were able to perform, interpret, store results, and get rapidly linked to care. The HIVSmart!-optimized, self-testing strategy could be adapted and contextualized to many at-risk populations within Canada and worldwide, thereby maximizing its public health impact.
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Affiliation(s)
- Nitika Pant Pai
- Department of Medicine, McGill University, Montreal, QC, Canada.,Division of Clinical Epidemiology, Research Institute of McGill University Health Centre, Montreal, QC, Canada
| | - Megan Smallwood
- Division of Clinical Epidemiology, Research Institute of McGill University Health Centre, Montreal, QC, Canada
| | | | | | - Krisztian G Birkas
- Division of Clinical Epidemiology, Research Institute of McGill University Health Centre, Montreal, QC, Canada
| | | | - Lawrence Joseph
- Division of Clinical Epidemiology, Research Institute of McGill University Health Centre, Montreal, QC, Canada
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Lemaître S, Gardrat S, Vincent-Salomon A, Galatoire O, Lévy-Gabriel C, Desjardins L. Malignant Transformation of a Multi-Operated Divided Nevus of the Eyelids. Ocul Oncol Pathol 2018; 4:112-115. [PMID: 30320091 DOI: 10.1159/000479069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 06/23/2017] [Indexed: 11/19/2022] Open
Abstract
A woman in her early fifties had regular follow-up for a medium-sized divided nevus of the eyelids which had undergone several surgical excisions during childhood for functional and esthetic reasons. Malignant transformation of the nevus occurred in the inferior eyelid, with the appearance of a new pigmented flat lesion. Histology showed in situ melanoma, and an NRAS activating mutation was found. A full-thickness excision of the inferior eyelid was performed, followed by reconstruction. Local recurrence of the melanoma occurred 1 year after surgery. Lifelong follow-up of divided nevi of the eyelids is recommended, even if very few cases of malignant transformation have been reported so far.
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Affiliation(s)
- Stéphanie Lemaître
- Institut Curie, Institut Curie, Paris, France.,Université Paris Descartes, Institut Curie, Paris, France.,Ocular Oncology, Institut Curie, Paris, France
| | - Sophie Gardrat
- Institut Curie, Institut Curie, Paris, France.,Pathology and Tumor Biology, Institut Curie, Paris, France
| | - Anne Vincent-Salomon
- Institut Curie, Institut Curie, Paris, France.,Pathology and Tumor Biology, Institut Curie, Paris, France
| | | | - Christine Lévy-Gabriel
- Institut Curie, Institut Curie, Paris, France.,Ocular Oncology, Institut Curie, Paris, France
| | - Laurence Desjardins
- Institut Curie, Institut Curie, Paris, France.,Ocular Oncology, Institut Curie, Paris, France
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Mathis T, Cassoux N, Tardy M, Piperno S, Gastaud L, Dendale R, Maschi C, Nguyen AM, Meyer L, Bonnin N, Baillif S, Tick S, Mouriaux F, Jaspart F, Dellis J, Rosier L, Desjardins L, Herault J, Caujolle JP, Thariat J. [Management of uveal melanomas, guidelines for oncologists]. Bull Cancer 2018; 105:967-980. [PMID: 30217336 DOI: 10.1016/j.bulcan.2018.07.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 07/08/2018] [Accepted: 07/12/2018] [Indexed: 10/28/2022]
Abstract
Uveal melanomas are the most frequent primary malignant eye tumor. Enucleation was historically the gold standard. Since then, several studies showed that conservative treatments did not increase the risk of metastasis or survival. Choroidal melanomas are both radioresistant and located close to visual structures (the optic nerve and macula) of the eye, which may be preserved in some settings without compromising tumor control, as this is the first priority. Different types of radiation therapy may be used for such tumors: brachytherapy and charged particles, including proton beam therapy. If visual prognosis is dependent to the local treatment, the vital prognosis is dependent on the metastatic risk, with a risk of liver involvement in 20 to 50% of patients, depending on tumor size and genomics. Median survival after the discovery of liver metastases is about 15 months. The management of these patients is often complex. Systemic therapies (chemotherapy, targeted therapies, immunotherapy, etc.) yield limited response rates and although local treatments of liver metastases are promising, they are only feasible in selected patients. The mission of the MELACHONAT national network is to improve the management of patients regardless of the stage of the disease. The patient association ANPACO is dedicated to help uveal melanoma patients in their health care path and to promote knowledge dissemination within the patient community. The aim of this review is to focus on the local treatments of uveal melanomas as well as the management of their metastatic evolution.
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Affiliation(s)
- Thibaud Mathis
- Hôpital de la Croix-Rousse, 103 grande rue de la Croix-Rousse, 69004 Lyon, France
| | | | - Magali Tardy
- Hôpital Pasteur, 30, voie romaine, 06000 Nice, France
| | - Sophie Piperno
- Institut Curie, 26, rue de l'ulm, 75248 Paris cedex 05, France
| | | | - Rémi Dendale
- Institut Curie, 26, rue de l'ulm, 75248 Paris cedex 05, France
| | - Celia Maschi
- Hôpital Pasteur, 30, voie romaine, 06000 Nice, France
| | - Anh-Minh Nguyen
- Hôpital de la Croix-Rousse, 103 grande rue de la Croix-Rousse, 69004 Lyon, France
| | - Laurent Meyer
- Hôpitaux civils de Colmar, 39, avenue de la liberté, 68024 Colmar, France
| | - Nicolas Bonnin
- Centre d'ophtalmologie du Zénith, 63800 Cournon D'auvergne, France
| | | | - Sarah Tick
- CHNO des XV-XX, 28, rue de Charenton, 75012 Paris, France
| | - Fréderic Mouriaux
- Centre hospitalier universitaire Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes, France
| | - Franck Jaspart
- Polyclinique du Parc, route d'Assevent, 59600 Maubeuge, France
| | - Josette Dellis
- Association nationale des patients atteints du cancer de l'œil, ANPACO, 5, rue de Fontfrède, 15230 Pierrefort, France
| | - Laurence Rosier
- Centre Retine Gallien, 68, rue du palais-Gallien, 33000 Bordeaux, France
| | | | - Joel Herault
- Centre Lacassagne, 227, avenue Valombrose, 06200 Nice, France
| | | | - Juliette Thariat
- Centre François Baclesse, ARCHADE, service de radiothérapie, 3, avenue du général-Harris, 14000 Caen, France.
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25
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Lukamba RM, Yao JJA, Kabesha TA, Budiongo AN, Monga BB, Mwembo AT, Bey P, Chenge GB, Desjardins L, Luboya ON, Doz F, Stefan CD. Retinoblastoma in Sub-Saharan Africa: Case Studies of the Republic of Côte d'Ivoire and the Democratic Republic of the Congo. J Glob Oncol 2018; 4:1-8. [PMID: 30241234 PMCID: PMC6223407 DOI: 10.1200/jgo.17.00056] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE In most low-income countries, the diagnosis of retinoblastoma is delayed, resulting in a severe prognosis. The objectives of this study were to describe the access to diagnosis and care of children diagnosed with retinoblastoma and the challenges in two sub-Saharan African countries: the Republic of Côte d'Ivoire and the Democratic Republic of the Congo. PATIENTS AND METHODS A descriptive cross-sectional study was conducted. Data were collected from the medical records of patients admitted during the period of January 1, 2013 to December 31, 2014. Data were entered and analyzed using Epi Info7.1 software and SAS 9.3. RESULTS One hundred sixteen cases of retinoblastoma were collected, including 60 boys and 56 girls. The median diagnosis age was 3 years for both countries. Ninety-eight patients (84%) had unilateral retinoblastoma. Most of the patients presented with advanced disease (76% had extraocular retinoblastoma). Median time between initial symptoms and diagnosis was 8.5 months (range, 0.4 to 116.7 months). Median time between diagnosis and treatment initiation was 31 days (range, 0 to 751 days). The median cost for the treatment of the disease was estimated at $1,954 per patient. CONCLUSION Late diagnosis of retinoblastoma, with extraocular disease, occurs frequently in both African countries. It is associated with delay in initiating treatment, and the cost of the treatment remains unaffordable for most of the families. Support groups for parents of affected children and the support of the Franco-African Pediatric Oncology Group remain important in improving early diagnosis and providing treatment in sub-Saharan African countries.
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Affiliation(s)
- Robert M. Lukamba
- Robert M. Lukamba and Oscar N. Luboya, University Clinics of Lubumbashi; Robert M. Lukamba, Ben B. Monga, Albert T. Mwembo, Gabrielle B. Chenge, Oscar N. Luboya, University of Lubumbashi, Lubumbashi; Theophile A. Kabesha, Official University of Bukavu, Bukavu; Aleine N. Budiongo, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo; Robert M. Lukamba, Pierre Bey, Gabrielle B. Chenge, and Laurence Desjardins, Alliance Mondale Contre le Cancer; Pierre Bey, Laurence Desjardins, and François Doz, Institut Curie; François Doz, University Paris Descartes, Paris; Pierre Bey, University of Lorraine, Lorraine; Cristina D. Stefan, International Prevention Research Institute, Lyon, France; and Jean-Jacques A. Yao, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d’Ivoire
| | - Jean-Jacques A. Yao
- Robert M. Lukamba and Oscar N. Luboya, University Clinics of Lubumbashi; Robert M. Lukamba, Ben B. Monga, Albert T. Mwembo, Gabrielle B. Chenge, Oscar N. Luboya, University of Lubumbashi, Lubumbashi; Theophile A. Kabesha, Official University of Bukavu, Bukavu; Aleine N. Budiongo, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo; Robert M. Lukamba, Pierre Bey, Gabrielle B. Chenge, and Laurence Desjardins, Alliance Mondale Contre le Cancer; Pierre Bey, Laurence Desjardins, and François Doz, Institut Curie; François Doz, University Paris Descartes, Paris; Pierre Bey, University of Lorraine, Lorraine; Cristina D. Stefan, International Prevention Research Institute, Lyon, France; and Jean-Jacques A. Yao, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d’Ivoire
| | - Theophile A. Kabesha
- Robert M. Lukamba and Oscar N. Luboya, University Clinics of Lubumbashi; Robert M. Lukamba, Ben B. Monga, Albert T. Mwembo, Gabrielle B. Chenge, Oscar N. Luboya, University of Lubumbashi, Lubumbashi; Theophile A. Kabesha, Official University of Bukavu, Bukavu; Aleine N. Budiongo, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo; Robert M. Lukamba, Pierre Bey, Gabrielle B. Chenge, and Laurence Desjardins, Alliance Mondale Contre le Cancer; Pierre Bey, Laurence Desjardins, and François Doz, Institut Curie; François Doz, University Paris Descartes, Paris; Pierre Bey, University of Lorraine, Lorraine; Cristina D. Stefan, International Prevention Research Institute, Lyon, France; and Jean-Jacques A. Yao, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d’Ivoire
| | - Aleine N. Budiongo
- Robert M. Lukamba and Oscar N. Luboya, University Clinics of Lubumbashi; Robert M. Lukamba, Ben B. Monga, Albert T. Mwembo, Gabrielle B. Chenge, Oscar N. Luboya, University of Lubumbashi, Lubumbashi; Theophile A. Kabesha, Official University of Bukavu, Bukavu; Aleine N. Budiongo, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo; Robert M. Lukamba, Pierre Bey, Gabrielle B. Chenge, and Laurence Desjardins, Alliance Mondale Contre le Cancer; Pierre Bey, Laurence Desjardins, and François Doz, Institut Curie; François Doz, University Paris Descartes, Paris; Pierre Bey, University of Lorraine, Lorraine; Cristina D. Stefan, International Prevention Research Institute, Lyon, France; and Jean-Jacques A. Yao, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d’Ivoire
| | - Ben B. Monga
- Robert M. Lukamba and Oscar N. Luboya, University Clinics of Lubumbashi; Robert M. Lukamba, Ben B. Monga, Albert T. Mwembo, Gabrielle B. Chenge, Oscar N. Luboya, University of Lubumbashi, Lubumbashi; Theophile A. Kabesha, Official University of Bukavu, Bukavu; Aleine N. Budiongo, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo; Robert M. Lukamba, Pierre Bey, Gabrielle B. Chenge, and Laurence Desjardins, Alliance Mondale Contre le Cancer; Pierre Bey, Laurence Desjardins, and François Doz, Institut Curie; François Doz, University Paris Descartes, Paris; Pierre Bey, University of Lorraine, Lorraine; Cristina D. Stefan, International Prevention Research Institute, Lyon, France; and Jean-Jacques A. Yao, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d’Ivoire
| | - Albert T. Mwembo
- Robert M. Lukamba and Oscar N. Luboya, University Clinics of Lubumbashi; Robert M. Lukamba, Ben B. Monga, Albert T. Mwembo, Gabrielle B. Chenge, Oscar N. Luboya, University of Lubumbashi, Lubumbashi; Theophile A. Kabesha, Official University of Bukavu, Bukavu; Aleine N. Budiongo, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo; Robert M. Lukamba, Pierre Bey, Gabrielle B. Chenge, and Laurence Desjardins, Alliance Mondale Contre le Cancer; Pierre Bey, Laurence Desjardins, and François Doz, Institut Curie; François Doz, University Paris Descartes, Paris; Pierre Bey, University of Lorraine, Lorraine; Cristina D. Stefan, International Prevention Research Institute, Lyon, France; and Jean-Jacques A. Yao, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d’Ivoire
| | - Pierre Bey
- Robert M. Lukamba and Oscar N. Luboya, University Clinics of Lubumbashi; Robert M. Lukamba, Ben B. Monga, Albert T. Mwembo, Gabrielle B. Chenge, Oscar N. Luboya, University of Lubumbashi, Lubumbashi; Theophile A. Kabesha, Official University of Bukavu, Bukavu; Aleine N. Budiongo, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo; Robert M. Lukamba, Pierre Bey, Gabrielle B. Chenge, and Laurence Desjardins, Alliance Mondale Contre le Cancer; Pierre Bey, Laurence Desjardins, and François Doz, Institut Curie; François Doz, University Paris Descartes, Paris; Pierre Bey, University of Lorraine, Lorraine; Cristina D. Stefan, International Prevention Research Institute, Lyon, France; and Jean-Jacques A. Yao, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d’Ivoire
| | - Gabrielle B. Chenge
- Robert M. Lukamba and Oscar N. Luboya, University Clinics of Lubumbashi; Robert M. Lukamba, Ben B. Monga, Albert T. Mwembo, Gabrielle B. Chenge, Oscar N. Luboya, University of Lubumbashi, Lubumbashi; Theophile A. Kabesha, Official University of Bukavu, Bukavu; Aleine N. Budiongo, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo; Robert M. Lukamba, Pierre Bey, Gabrielle B. Chenge, and Laurence Desjardins, Alliance Mondale Contre le Cancer; Pierre Bey, Laurence Desjardins, and François Doz, Institut Curie; François Doz, University Paris Descartes, Paris; Pierre Bey, University of Lorraine, Lorraine; Cristina D. Stefan, International Prevention Research Institute, Lyon, France; and Jean-Jacques A. Yao, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d’Ivoire
| | - Laurence Desjardins
- Robert M. Lukamba and Oscar N. Luboya, University Clinics of Lubumbashi; Robert M. Lukamba, Ben B. Monga, Albert T. Mwembo, Gabrielle B. Chenge, Oscar N. Luboya, University of Lubumbashi, Lubumbashi; Theophile A. Kabesha, Official University of Bukavu, Bukavu; Aleine N. Budiongo, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo; Robert M. Lukamba, Pierre Bey, Gabrielle B. Chenge, and Laurence Desjardins, Alliance Mondale Contre le Cancer; Pierre Bey, Laurence Desjardins, and François Doz, Institut Curie; François Doz, University Paris Descartes, Paris; Pierre Bey, University of Lorraine, Lorraine; Cristina D. Stefan, International Prevention Research Institute, Lyon, France; and Jean-Jacques A. Yao, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d’Ivoire
| | - Oscar N. Luboya
- Robert M. Lukamba and Oscar N. Luboya, University Clinics of Lubumbashi; Robert M. Lukamba, Ben B. Monga, Albert T. Mwembo, Gabrielle B. Chenge, Oscar N. Luboya, University of Lubumbashi, Lubumbashi; Theophile A. Kabesha, Official University of Bukavu, Bukavu; Aleine N. Budiongo, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo; Robert M. Lukamba, Pierre Bey, Gabrielle B. Chenge, and Laurence Desjardins, Alliance Mondale Contre le Cancer; Pierre Bey, Laurence Desjardins, and François Doz, Institut Curie; François Doz, University Paris Descartes, Paris; Pierre Bey, University of Lorraine, Lorraine; Cristina D. Stefan, International Prevention Research Institute, Lyon, France; and Jean-Jacques A. Yao, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d’Ivoire
| | - François Doz
- Robert M. Lukamba and Oscar N. Luboya, University Clinics of Lubumbashi; Robert M. Lukamba, Ben B. Monga, Albert T. Mwembo, Gabrielle B. Chenge, Oscar N. Luboya, University of Lubumbashi, Lubumbashi; Theophile A. Kabesha, Official University of Bukavu, Bukavu; Aleine N. Budiongo, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo; Robert M. Lukamba, Pierre Bey, Gabrielle B. Chenge, and Laurence Desjardins, Alliance Mondale Contre le Cancer; Pierre Bey, Laurence Desjardins, and François Doz, Institut Curie; François Doz, University Paris Descartes, Paris; Pierre Bey, University of Lorraine, Lorraine; Cristina D. Stefan, International Prevention Research Institute, Lyon, France; and Jean-Jacques A. Yao, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d’Ivoire
| | - Cristina D. Stefan
- Robert M. Lukamba and Oscar N. Luboya, University Clinics of Lubumbashi; Robert M. Lukamba, Ben B. Monga, Albert T. Mwembo, Gabrielle B. Chenge, Oscar N. Luboya, University of Lubumbashi, Lubumbashi; Theophile A. Kabesha, Official University of Bukavu, Bukavu; Aleine N. Budiongo, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo; Robert M. Lukamba, Pierre Bey, Gabrielle B. Chenge, and Laurence Desjardins, Alliance Mondale Contre le Cancer; Pierre Bey, Laurence Desjardins, and François Doz, Institut Curie; François Doz, University Paris Descartes, Paris; Pierre Bey, University of Lorraine, Lorraine; Cristina D. Stefan, International Prevention Research Institute, Lyon, France; and Jean-Jacques A. Yao, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d’Ivoire
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Barnhill R, Vermeulen P, Daelemans S, van Dam P, Roman‐Roman S, Servois V, Hurbain I, Gardrat S, Raposa G, Nicolas A, Dendale R, Pierron G, Desjardins L, Cassoux N, Piperno‐Neumann S, Mariani P, Lugassy C. Replacement and desmoplastic histopathological growth patterns: A pilot study of prediction of outcome in patients with uveal melanoma liver metastases. J Pathol Clin Res 2018; 4:227-240. [PMID: 29917326 PMCID: PMC6174621 DOI: 10.1002/cjp2.105] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 06/07/2018] [Accepted: 06/08/2018] [Indexed: 12/12/2022]
Abstract
Up to 50% of uveal melanomas (UM) metastasise to the liver within 10 years of diagnosis, and these almost always prove rapidly fatal. As histopathological growth patterns (HGPs) of liver metastases of the replacement and desmoplastic type, particularly from colon and breast carcinoma, may import valuable biological and prognostic information, we have studied HGP in a series of 41 UM liver metastases originating from 41 patients from the period 2006–2017. Twenty patients underwent enucleation while 21 had radiation therapy. Analysis of UM by array comparative genomic hybridisation revealed: 25 (64%) patients with high risk (monosomy3/8q gain); 13 (33%) intermediate risk (M3/8normal or disomy3/8q gain); and 1 low risk (disomy3/8normal). The principal HGP was replacement in 30 (73%) cases and desmoplastic in 11 (27%) cases. Cases with replacement demonstrated striking vascular co‐option/angiotropism. With the development of liver metastasis, only the replacement pattern, largest primary tumour diameter, and R2 (incomplete resection) status predicted diminished overall survival (OS; p < 0.041, p < 0.017, p < 0.047, respectively). On multivariate analysis, only HGP (hazard ratio; HR = 6.51, p = 0.008) and resection status remained significant. The genomic high‐risk variable had no prognostic value at this stage of liver metastasis. Chi‐square test showed no association of HGP with monosomy 3 or 8q gain. Eighteen of 41 (44%) patients are alive with disease and 23 (56%) patients died with follow‐up ranging from 12 to 318 months (mean: 70 months, median: 47 months). In conclusion, we report for the first time the frequency of the replacement and desmoplastic HGPs in liver UM metastases resected from living patients, and their potential important prognostic value for UM patients, as in other solid cancers. These results may potentially be utilised to develop radiological correlates and therapeutic targets for following and treating patients with UM metastases.
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Affiliation(s)
- Raymond Barnhill
- Department of PathologyInstitut CurieParisFrance
- University of Paris Réné Descartes Faculty of MedicineParisFrance
| | - Peter Vermeulen
- HistoGeneXAntwerpenBelgium
- Faculty of Medicine and Health SciencesUniversity of Antwerp – MIPRO Center for Oncological Research (CORE) ‐ TCRU, GZA Sint‐AugustinusAntwerpenBelgium
| | - Sofie Daelemans
- HistoGeneXAntwerpenBelgium
- Faculty of Medicine and Health SciencesUniversity of Antwerp – MIPRO Center for Oncological Research (CORE) ‐ TCRU, GZA Sint‐AugustinusAntwerpenBelgium
| | - Pieter‐Jan van Dam
- HistoGeneXAntwerpenBelgium
- Faculty of Medicine and Health SciencesUniversity of Antwerp – MIPRO Center for Oncological Research (CORE) ‐ TCRU, GZA Sint‐AugustinusAntwerpenBelgium
| | | | | | - Ilse Hurbain
- Institut CuriePSL Research University, CNRSParisFrance
- Sorbonne UniversitésUPMC Univ Paris 06, CNRSParisFrance
- Cell and Tissue Imaging Core Facility PICT‐IBiSAInstitut CurieParisFrance
| | | | - Graça Raposa
- Institut CuriePSL Research University, CNRSParisFrance
- Sorbonne UniversitésUPMC Univ Paris 06, CNRSParisFrance
- Cell and Tissue Imaging Core Facility PICT‐IBiSAInstitut CurieParisFrance
| | | | - Rémi Dendale
- Department of RadiotherapyInstitut Curie OrsayParisFrance
| | | | | | - Nathalie Cassoux
- University of Paris Réné Descartes Faculty of MedicineParisFrance
- Department of OphthalmologyInstitut CurieParisFrance
| | | | | | - Claire Lugassy
- Department of Translational ResearchInstitut CurieParisFrance
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27
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Traoré F, Sylla F, Togo B, Kamaté B, Diabaté K, Diakité AA, Diall H, Dicko F, Sylla M, Bey P, Desjardins L, Gagnepain-Lacheteau A, Coze C, Harif M, Doz F. Treatment of retinoblastoma in Sub-Saharan Africa: Experience of the paediatric oncology unit at Gabriel Toure Teaching Hospital and the Institute of African Tropical Ophthalmology, Bamako, Mali. Pediatr Blood Cancer 2018; 65:e27101. [PMID: 29697190 DOI: 10.1002/pbc.27101] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 03/17/2018] [Accepted: 03/19/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Retinoblastoma (Rb) is the most common intraocular primary malignancy in children. In industrialised countries, the cure rate is about 95%. We present the results of a prospective study on the management of Rb in the paediatric oncology unit of Gabriel Touré Teaching Hospital and African Institute of Tropical Ophthalmology, from November 1, 2011 to December 31, 2015. PROCEDURE The aims of this prospective study were to evaluate the treatment of localised Rb, ocular prosthesis after enucleation, conservative management for bilateral Rb as well as survival rates in all patients. Patients with early stage Rb at diagnosis were included. The treatment was performed according to the retinoblastoma treatment guidelines of the French-African Paediatric Oncology Group. RESULTS Eighty-eight patients were included in the study. Sex ratio was 1:1 (M = 44, F = 44). Median age at diagnosis was 3 years (range: 2 months-5 years). Unilateral intraocular Rb was predominant (n = 50; 56.8%). Conservative treatments were performed on nine eyes in nine patients. Overall survival and event-free survival of the entire cohort at the end of 4 years were 73% (95% CI 60.8-81.2%) and 59% (95% CI 47.9-69.5%), respectively, with a median follow-up of 3.7 years (0.1-5.6 years). In conclusion, early enucleation in early stage of Rb can improve outcomes in resource-limited countries. Delayed enucleation and refusal of adherence to treatment are still major concerns and remain a barrier to improving overall patient survival.
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Affiliation(s)
- Fousseyni Traoré
- Pediatric Department, Pediatric Oncology Unit, CHU Gabriel Touré, Bamako, Mali
| | - Fatou Sylla
- Pediatric Ophtalmology Department, Institute of African Tropical Ophthalmology, Bamako, Mali
| | - Boubacar Togo
- Pediatric Department, Pediatric Oncology Unit, CHU Gabriel Touré, Bamako, Mali
| | | | | | - Abdoul Aziz Diakité
- Pediatric Department, Pediatric Oncology Unit, CHU Gabriel Touré, Bamako, Mali
| | - Hawa Diall
- Pediatric Department, Pediatric Oncology Unit, CHU Gabriel Touré, Bamako, Mali
| | - Fatoumata Dicko
- Pediatric Department, Pediatric Oncology Unit, CHU Gabriel Touré, Bamako, Mali
| | - Mariam Sylla
- Pediatric Department, Pediatric Oncology Unit, CHU Gabriel Touré, Bamako, Mali
| | - Pierre Bey
- Pediatric Oncology Department, Institut Curie, Paris, France
| | | | | | - Carole Coze
- Pediatric Unit, Assistance Publique Hopitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Mhamed Harif
- Pediatric Oncology Department, CHU Mohammed VI, Marrakech, Morrocco
| | - François Doz
- Pediatric Oncology Department, Centre SIREDO (Soins, Innovation, Recherche en oncologie de l'enfant, l'adolescent et l'adulte jeune), Institut Curie et Université Paris-Descartes, Paris, France
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Aerts I, Blanc R, Saint Martin C, Savignoni A, Cassoux N, Desjardins L, Doz FP, Levy-gabriel C, Lumbroso-LE Rouic L. Prospective study of ophthalmic artery chemosurgery (OAC) as alternative to enucleation in retinoblastoma. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.10555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Neumann SP, Dureau S, Rodrigues MJ, Desjardins L, Pierron G, Levy-gabriel C, Lumbroso L, Servois V, Najean M, Savignoni A, Cassoux N, Mariani P. Long-term survival in metastatic uveal melanoma (MUM). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e21501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Lemaître S, Lévy-Gabriel C, Desjardins L, González-Candial M, Gardrat S, Dendale R, Cassoux N, Couturaud B. Outcomes after surgical resection of lower eyelid tumors and reconstruction using a nasal chondromucosal graft and an upper eyelid myocutaneous flap. J Fr Ophtalmol 2018; 41:412-420. [PMID: 29778279 DOI: 10.1016/j.jfo.2017.10.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 10/10/2017] [Accepted: 10/20/2017] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Surgical excision of large malignant lower eyelid tumors may cause important full-thickness eyelid defects. The reconstruction of such defects must restore the physiologic function of the eyelid and also re-establish an acceptable aesthetic result. MATERIALS AND METHODS We report the outcomes of full-thickness excision of tumors extending over half of the horizontal lid length, followed by reconstruction using a nasal chondromucosal graft (coming from the ipsilateral ala of the nose) and an upper eyelid myocutaneous flap. Histological analysis of the specimen identified the tumor type and surgical margins for each patient. RESULTS A total of 25 patients were operated using this reconstruction technique between March 2009 and June 2015: 17 basal cell carcinomas, 3 spindle cell carcinomas and 5 conjunctival melanomas (out of which 2 were associated with lentigo maligna). Mean duration of follow-up after surgery was respectively 36, 41 and 17 months for each of these 3 tumor types. We found a single local tumor recurrence and this was a basal cell carcinoma in a xeroderma pigmentosum patient. After surgery, none of the patients had lagophthalmos or ocular surface complications. Only 4 patients had a 1mm scleral show postoperatively; 3 other patients developed a small retraction of the eyelid after adjuvant radiotherapy and a 1mm scleral show occurred. CONCLUSION In malignant tumors, complete surgical excision with histological margins adapted to tumor type prevents local recurrence in most cases. Our repair strategy of nasal chondromucosal graft and skin-muscle flap for large inferior eyelid defects provides good functional and aesthetic results.
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Affiliation(s)
- S Lemaître
- Institut Curie, 26, rue d'Ulm, 75248 Paris cedex 05, France; Université Paris-Descartes, 12, rue de l'École-de-Médecine, 75270 Paris cedex 06, France; Hospital Universitari de Girona Doctor Josep Trueta, Avinguda de França, 17007 Girona, Spain.
| | - C Lévy-Gabriel
- Institut Curie, 26, rue d'Ulm, 75248 Paris cedex 05, France
| | - L Desjardins
- Institut Curie, 26, rue d'Ulm, 75248 Paris cedex 05, France
| | - M González-Candial
- Hospital Universitari de Girona Doctor Josep Trueta, Avinguda de França, 17007 Girona, Spain
| | - S Gardrat
- Institut Curie, 26, rue d'Ulm, 75248 Paris cedex 05, France
| | - R Dendale
- Centre de protonthérapie, Institut Curie, campus universitaire d'Orsay, bâtiment 101, 91400 Orsay, France
| | - N Cassoux
- Institut Curie, 26, rue d'Ulm, 75248 Paris cedex 05, France; Université Paris-Descartes, 12, rue de l'École-de-Médecine, 75270 Paris cedex 06, France
| | - B Couturaud
- Institut Curie, 26, rue d'Ulm, 75248 Paris cedex 05, France
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Sid Ahmed S, Messali Z, Poyer F, Lumbroso-Le Rouic L, Desjardins L, Cassoux N, Thomas CD, Marco S, Lemaitre S. Iterative Variance Stabilizing Transformation Denoising of Spectral Domain Optical Coherence Tomography Images Applied to Retinoblastoma. Ophthalmic Res 2018; 59:164-169. [PMID: 29587271 DOI: 10.1159/000486283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 12/12/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Due to the presence of speckle Poisson noise, the interpretation of spectral domain-optical coherence tomography (SD-OCT) images frequently requires the use of data averaging to improve the signal-to-noise ratio. This implies long acquisition times and requires patient sedation in some cases. Iterative variance stabilizing transformation (VST) is a possible approach by which to remove speckle Poisson noise on single images. METHODS We used SD-OCT images of human and murine (LH Beta-Tag mouse model) retinas with and without retinoblastoma acquired with 2 different imaging devices (Bioptigen and Micron IV). These images were processed using a denoising workflow implemented in Matlab. RESULTS We demonstrated the presence of speckle Poisson noise, which can be removed by a VST-based approach. This approach is robust as it works in all used imaging devices and in both human and mouse retinas, independently of the tumor status. The implemented algorithm is freely available from the authors on demand. CONCLUSIONS On a single denoised image, the proposed method provides results similar to those expected from the SD-OCT averaging. Because of the friendly user interface, it can be easily used by clinicians and researchers in ophthalmology.
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Affiliation(s)
- Soumia Sid Ahmed
- Faculty of Science and Technology, Mohamed El Bachir El Ibrahimi University, Bordj Bou Arreridj, Algeria
| | - Zoubeida Messali
- Faculty of Science and Technology, Mohamed El Bachir El Ibrahimi University, Bordj Bou Arreridj, Algeria
| | - Florent Poyer
- INSERM, U1196, Université Paris Sud, Université Paris-Saclay, Orsay, France.,Institut Curie, PSL Research University, CNRS UMR3348, Orsay, France
| | | | - Laurence Desjardins
- Institut Curie, Claudius Regaud Hospital, Ocular Oncology Department, Paris, France
| | - Nathalie Cassoux
- Institut Curie, Claudius Regaud Hospital, Ocular Oncology Department, Paris, France.,Paris Descartes University, Paris, France
| | - Carole D Thomas
- INSERM, U1196, Université Paris Sud, Université Paris-Saclay, Orsay, France.,Institut Curie, PSL Research University, CNRS UMR3348, Orsay, France
| | - Sergio Marco
- INSERM, U1196, Université Paris Sud, Université Paris-Saclay, Orsay, France.,Institut Curie, PSL Research University, CNRS UMR3348, Orsay, France
| | - Stéphanie Lemaitre
- INSERM, U1196, Université Paris Sud, Université Paris-Saclay, Orsay, France.,Institut Curie, PSL Research University, CNRS UMR3348, Orsay, France.,Institut Curie, Claudius Regaud Hospital, Ocular Oncology Department, Paris, France.,Paris Descartes University, Paris, France
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Mahdjoubi A, Najean M, Lemaitre S, Dureau S, Dendale R, Levy C, Rouic LLL, Desjardins L, Cassoux N. Intravitreal bevacizumab for neovascular glaucoma in uveal melanoma treated by proton beam therapy. Graefes Arch Clin Exp Ophthalmol 2017; 256:411-420. [DOI: 10.1007/s00417-017-3834-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 09/21/2017] [Accepted: 10/16/2017] [Indexed: 12/15/2022] Open
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Pai NP, Smallwood M, Desjardins L, Goyette A, Vassal AF, Thomas R. Can an HIVSmart! App-optimized Self-Testing Strategy be Operationalized in Canada? Open Forum Infect Dis 2017. [PMCID: PMC5631212 DOI: 10.1093/ofid/ofx163.1075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Although HIV self-tests are recommended by the WHO, they are not yet approved in Canada. Service delivery gaps such as linkages to counseling and care remain unachieved by offering self-tests without adequate support. In this first Canadian study, we evaluated the feasibility of operationalizing an innovative HIVSmart! app-optimized oral HIV self-testing strategy in men who have sex with men (MSM), presenting at a large sexual health clinic in Montreal. Methods Between July 2016 to February 2017, participants were offered the OraQuick In-Home HIV Test, and a tablet installed with the HIVSmart! app, at a private office in the clinic to simulate an unsupervised home environment. With the HIVSmart! app, participants independently performed and interpreted self-tests, and were linked to in-person post-test counseling and care. Self-test results were confirmed by laboratory tests (p24, Western Blot, RNA as needed). Results The mean age of the 451 participants was 34 years (18–73); 85% were well educated (beyond high school, n = 371/438); 53% (230/438) were frequent testers (past 6 months), and 13% were on PrEP (52/451). 99% (417/422) of participants found the HIVSmart! app helpful in guiding them through the self-testing procedure; 93% (418/451) of participants interpreted their tests accurately; and 94% (395/419) stated they would recommend the app-optimized self-testing strategy to their partners. Feasibility (completion rate of self-testing) was 93% (419/451), and acceptability of the strategy was high at 99% (451/458). All HIV self-test negative participants (448/451, 100%) were counseled following the self-test. Three participants self-tested positive, were confirmed HIV positive (0.7% prevalence), and were rapidly linked to care with a physician. Conclusion The HIVSmart! app-optimized strategy was feasible, and highly accepted by an educated, frequently testing, urban MSM population of Montréal. With the app, participants were able to interpret their test results accurately and were rapidly linked to care. Innovations like HIVSmart! which engage, aid, and facilitate linkages to care, can be adapted to suit the needs of many populations in Canada and internationally, maximizing global impact through reverse innovation. Disclosures All authors: No reported disclosures.
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Affiliation(s)
- Nitika Pant Pai
- McGill University Division of Clinical Epidemiology, Montreal, QC, Canada
| | - Megan Smallwood
- Clinical Epidemiology, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
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Jouhi S, Jager M, Desjardins L, Eide N, Rospond-Kubiak I, Caujolle J, Grange J, Kiilgaard J, Scheen L, Midena E, Raffaele P, Kivelä T. Small fatal choroidal melanomas: A survey by the European Ophthalmic Oncology Group. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.03641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S. Jouhi
- Ocular Oncology Service; Department of Ophthalmology; University of Helsinki and Helsinki University Hospital, Ophthalmology; Helsinki Finland
| | - M. Jager
- Leiden University Medical Center, Ophthalmology; Leiden The Netherlands
| | | | - N. Eide
- Oslo University Hospital-HF and University of Oslo, Ophthalmology; Oslo Norway
| | | | - J.P. Caujolle
- Saint-Roch University Hospital, Ophthalmology; Nice France
| | - J.D. Grange
- Croix-Rousse Hospital, Ophthalmology; Lyon France
| | - J.F. Kiilgaard
- Copenhagen University Hospital Glostrup, Ophthalmology; Copenhagen Denmark
| | - L. Scheen
- St. Erik′s Eye Hospital, Ophthalmology; Stockholm Sweden
| | - E. Midena
- University of Padova, Ophthalmology; Padova Italy
| | - P. Raffaele
- Ocular Oncology and Toxicology Research Unit, Ophthalmology; Rome Italy
| | - T. Kivelä
- Helsinki University Hospital, Ophthalmology; Helsinki Finland
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Desjardins L, Cassoux N, LumbrosoLeRouic L, Dendale R. Circumscribed irido-ciliary melanoma: surgery versus irradiation. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.02653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - N. Cassoux
- Ophtalmic Oncology; Institut Curie; Paris France
| | | | - R. Dendale
- Ophtalmic Oncology; Institut Curie; Paris France
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Lumbroso L, Sellam A, Coscas F, Dendale R, Levy C, Coscas G, Desjardins L, Cassoux N. Macular features assessed by optical coherence tomography-angiography after proton beam therapy for choroidal melanoma. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.03646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - A. Sellam
- Ophthalmology; Institut Curie; Paris France
| | - F. Coscas
- Ophthalmology; Centre ophtalmologique de l'Odéon; Paris France
| | - R. Dendale
- Radiation Oncology; Institut Curie; Paris France
| | - C. Levy
- Ophthalmology; Institut Curie; Paris France
| | - G. Coscas
- Ophthalmology; Centre ophtalmologique de l'Odéon; Paris France
| | | | - N. Cassoux
- Ophthalmology; Institut Curie; Paris France
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Desjardins L, cassoux N, LumbrosoLeRouic L, Levy C, Dendale R. Suspicious naevi: treat. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.02347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - N. cassoux
- Ophtalmic Oncology; Institut Curie; Paris France
| | | | - C. Levy
- Ophtalmic Oncology; Institut Curie; Paris France
| | - R. Dendale
- Ophtalmic Oncology; Institut Curie; Paris France
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Sellam A, Coscas F, Lumbroso-Le Rouic L, Dendale R, Lupidi M, Coscas G, Desjardins L, Cassoux N. Optical Coherence Tomography Angiography of Macular Features After Proton Beam Radiotherapy for Small Choroidal Melanoma. Am J Ophthalmol 2017. [PMID: 28647462 DOI: 10.1016/j.ajo.2017.06.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE To describe the macular features of patients treated with proton beam therapy for choroidal melanoma (CM), using optical coherence tomography angiography (OCTA). DESIGN Retrospective case-control study. METHODS This study included patients treated with proton beam radiotherapy (PBR) for a small CM. Only patients who had received 100% of the dose of 60 Gy external beam radiation to the macular area were included in the analysis. All the patients had undergone a full ophthalmologic examination, including visual acuity, optical coherence tomography B-scan, and OCTA. Qualitative and quantitative vascular features of the retinal plexus and the choriocapillaris were analyzed on OCTA and compared with those in healthy subjects matched on age and sex. RESULTS Thirty-seven patients had undergone an OCTA after PBR for a small CM. Seventeen patients (9 men and 8 women) were included. The mean age of the patients was 56.6 years (range, 28-86). At presentation, the mean tumor thickness was 3.39 mm (range, 1.3-7.0 mm). The mean follow-up duration was 35.8 months (range, 11-72 months). Thirteen patients (76.5%) had a clinical radiation maculopathy; 8 patients (47.1%) had macular cysts on OCT-B scan. All patients (100%) had abnormalities on OCTA. Some "signal void" spots were detected at the level of the choriocapillaris in 15 patients (88.2%). The mean vascular density (regarding the full retina) was significantly lower in the patients treated with PBR than in healthy subjects (P < .0001). CONCLUSION Patients treated with PBR for CM (with 100% of the dose given to the macula) present major changes at both plexuses but also a vascular rarefaction of the choriocapillaris.
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Cassoux N, Aerts I, Lumbroso-Le Rouic L, Freneaux P, Desjardins L. Eye Salvage with Combination of Intravitreal and Intracameral Melphalan Injection for Recurrent Retinoblastoma with Anterior Chamber Involvement: Report of a Case. Ocul Oncol Pathol 2017; 3:129-132. [PMID: 28868284 PMCID: PMC5566760 DOI: 10.1159/000452305] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 10/03/2016] [Indexed: 11/19/2022] Open
Abstract
AIMS Herein we report successful eye salvage following combined intravitreal and intracameral administration of melphalan for anterior chamber recurrence of retinoblastoma. METHODS A 12-month-old boy was referred with a sporadic bilateral retinoblastoma staged as group D and V in the right eye and group E and V in the left eye. Treatment initially involved 6 cycles of 3 drugs followed by focal treatments. The left eye was enucleated. Three months after the end of systemic chemotherapy, multiple recurrent lesions were noted in the ciliary body and the anterior chamber. A series of intravitreal (IVT) and intracameral (IC) injections of melphalan combined with a 7th cycle of systemic chemotherapy was performed. The therapeutic schedule alternated: week A an IVT of melphalan (30 μg/0.1 mL) for a total of 4 versus week B IC injections of melphalan (15 μg/0.05 mL) 4 IC in total. Each injection was preceded by an anterior chamber. Cryotherapy to the injection punctures was systematically performed. RESULTS Rapidly, iris and ciliary body nodules regressed completely based on clinical and ultrasound biomicroscopic examinations. After 3 years of follow-up, the patient has shown no evidence of recurrence. CONCLUSION In our patient, combined IVT and IC administration of melphalan proved highly efficacious in eradicating the ciliary body and anterior chamber disease and salvage of his one remaining functional eye.
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Affiliation(s)
- Nathalie Cassoux
- Department of Ocular Oncology, Paris, France
- Department of Surgical Oncology, Paris, France
- Department of University René Descartes Paris V, Paris, France
| | | | | | - Paul Freneaux
- Department of Pathology, Institut Curie, Paris, France
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Bherer L, Lussier M, Desjardins L, Fraser S, Li K, Berryman N, Bosquet L, Vu T. EFFECTS OF PHYSICAL EXERCISE, COGNITIVE TRAINING, AND COMBINED INTERVENTION ON EXECUTIVE FUNCTIONS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.5023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- L. Bherer
- Dept. of Psychology and PERFORM Centre, Concordia University, Montreal, Quebec, Canada,
- Centre de recherche de l’institut universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada,
| | - M. Lussier
- Centre de recherche de l’institut universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada,
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada,
| | - L. Desjardins
- Centre de recherche de l’institut universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada,
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada,
| | - S. Fraser
- Centre de recherche de l’institut universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada,
- Social Work, McGill University, Montreal, Quebec, Canada,
| | - K.Z. Li
- Dept. of Psychology and PERFORM Centre, Concordia University, Montreal, Quebec, Canada,
- Centre for Research in Human Development, Concordia University, Montreal, Quebec, Canada,
| | - N. Berryman
- Centre de recherche de l’institut universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada,
| | - L. Bosquet
- Faculté des sciences du sport, Université de Poitiers, Poitiers, France,
- Centre de recherche de l’institut universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada,
| | - T. Vu
- Centre de recherche de l’institut universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada,
- Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
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Mahdjoubi A, Desjardins L, Bergès O, Couprie J, Cassoux N. Detection of an Iris Pigmented Epithelium Cyst in a Child by High Frequency Ultrasonography. J Pediatr Ophthalmol Strabismus 2017; 54:e31-e33. [PMID: 28665440 DOI: 10.3928/01913913-20170531-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 01/11/2017] [Indexed: 11/20/2022]
Abstract
An 18-month-old boy presented with an iris pigmented epithelium cyst. The diagnosis was confirmed using high frequency ultrasonography. The cyst was determined to be in an intermediate location, thus needing no treatment provided that any potential complications were noted. However, continued monitoring is required to detect any changes to adapt management. [J Pediatr Ophthalmol Strabismus. 2017;54:e31-e33.].
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Lemaitre S, Poyer F, Marco S, Fréneaux P, Doz F, Aerts I, Desjardins L, Cassoux N, Thomas CD. Looking for the Most Suitable Orthotopic Retinoblastoma Mouse Model in Order to Characterize the Tumoral Development. ACTA ACUST UNITED AC 2017. [DOI: 10.1167/iovs.17-21760] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Stéphanie Lemaitre
- Institut Curie, Research Center, PSL Research University, Chemistry, Modelisation and Imaging for Biology (CMIB), Centre Universitaire, Orsay, France 2INSERM U 1196, CNRS UMR 9187, Paris-Saclay University, Paris-Sud University, Centre Universitaire, Orsay, France 3Institut Curie, Hospital, Ophthalmology Department, Paris, France 4Sorbonne Paris Cité, Paris Descartes University, Paris, France
| | - Florent Poyer
- Institut Curie, Research Center, PSL Research University, Chemistry, Modelisation and Imaging for Biology (CMIB), Centre Universitaire, Orsay, France 2INSERM U 1196, CNRS UMR 9187, Paris-Saclay University, Paris-Sud University, Centre Universitaire, Orsay, France
| | - Sergio Marco
- Institut Curie, Research Center, PSL Research University, Chemistry, Modelisation and Imaging for Biology (CMIB), Centre Universitaire, Orsay, France 2INSERM U 1196, CNRS UMR 9187, Paris-Saclay University, Paris-Sud University, Centre Universitaire, Orsay, France
| | - Paul Fréneaux
- Institut Curie, Hospital, Biopathology Department, Paris, France
| | - François Doz
- Sorbonne Paris Cité, Paris Descartes University, Paris, France 6Institut Curie, Hospital, Pediatric, Adolescent and Young Adult Department, Paris, France
| | - Isabelle Aerts
- Institut Curie, Hospital, Pediatric, Adolescent and Young Adult Department, Paris, France
| | | | - Nathalie Cassoux
- Institut Curie, Hospital, Ophthalmology Department, Paris, France 4Sorbonne Paris Cité, Paris Descartes University, Paris, France
| | - Carole D. Thomas
- Institut Curie, Research Center, PSL Research University, Chemistry, Modelisation and Imaging for Biology (CMIB), Centre Universitaire, Orsay, France 2INSERM U 1196, CNRS UMR 9187, Paris-Saclay University, Paris-Sud University, Centre Universitaire, Orsay, France
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Piperno-Neumann S, Rodrigues MJ, Servois V, Pierron G, Gastaud L, Negrier S, Levy-Gabriel C, Lumbroso L, Cassoux N, Bidard FC, Michielin O, Lacour JP, Durando X, Mariani P, Plancher C, Asselain B, Armanet S, Mosseri V, Desjardins L. A randomized multicenter phase 3 trial of adjuvant fotemustine versus surveillance in high risk uveal melanoma (UM) patients (FOTEADJ). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.9502] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9502 Background: Up to 30% of UM patients will develop metastases, with a median survival of 12 months in the metastating setting. Prognostic factors combine clinical features of the primary tumor (diameter, thickness, retinal detachment, extra-scleral extension) and genetic factors (monosomy 3, 8 q gain and class 1 /2 gene expression profiling).The genomic analysis is feasible by fine needle aspiration biopsies before radiotherapy for small UM or on enucleated eyes. Methods: Multicenter randomized phase 3 trial with adjuvant fotemustine, 6 cycles, 100 mg/m2 versus surveillance for 3 years (liver tests/3 months, liver MRI or CT/6 months, whole body CT/12 months) in patients with high risk of recurrence, defined by clinical criteria (diameter > 15 mm with extra scleral extension and/or retinal detachment or diameter > 18 mm) or genomic high risk signature by array-CGH (monosomy 3 or deletion of 3p associated with gain of chromosome 8). The primary objective was 5-year Metastasis Free Survival (MFS). With an expected increase of 5-year MFS from 50 to 70%, 302 patients and 99 events were required to achieve an 95%-power with a 5% type I error rate. Secondary objectives were overall survival (OS), safety (NCI-CTC v3), quality of life (QLQ-C30). Interim analyses were planned for safety and after 50 events, disclosed to an independent safety monitoring board. Results: The trial was stopped for futility after 244 patients had been recruited between June 2009 and January 2016. No unexpected toxicity was found in the chemotherapy group. The study was amended to go on with intensive surveillance in new high risk patients. Ninety-one metastases and 43 deaths were reported, with no treatment-related death. With a median follow-up of 3 years, the 3-year MFS is 60.3% in the chemo group and 60.7% in the surveillance group (HR 0.97 [0.64-1.47]). The 3-year OS is 79.4% [73.2-85.7], with no difference between the 2 groups of patients. Conclusions: FOTEADJ is the first adjuvant randomized phase 3 trial based on genomic analysis in high risk UM patients. Despite negative results, it shows the feasibility of multicenter adjuvant studies in this rare cancer and provides genomic data in small tumors for future trials. Clinical trial information: NCT02843386.
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Affiliation(s)
| | | | | | | | | | | | | | - Livia Lumbroso
- Department of Ophthalmology, Institut Curie, Paris, France
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Cassoux N, Lumbroso L, Levy-Gabriel C, Aerts I, Doz F, Desjardins L. Retinoblastoma: Update on Current Management. Asia Pac J Ophthalmol (Phila) 2017; 6:290-295. [PMID: 28558178 DOI: 10.22608/apo.201778] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 05/12/2017] [Indexed: 11/08/2022] Open
Abstract
Retinoblastoma is a rare cancer in children, where in less than a century of dire mortality there has been a cure in industrialized countries. Unfortunately, mortality remains high in emerging countries. The evolution of treatment makes it possible to go further by preserving the eyeball but this must not be done at the cost of the reappearance of metastases. Herein we outline the evolution of treatment from the beginning of the 20th century until the last recent evolutions, trying to imagine what could be the future treatments. In this pathology, the ophthalmologist is a doctor who must cure his patient and enucleation is considered a failure. This situation should not lead to shizophrenic situations where to keep an eye one would take risks with the life of the child. New international classifications, international prospective multicentric studies, and the search for blood biomarkers that can predict the risk of micrometastases could allow for better stratification of patients.
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Affiliation(s)
- Nathalie Cassoux
- Ocular Oncology, Institut Curie, Paris, France
- Paris Science Letter University, School of Medicine, Université René Descartes, Paris, France
| | | | | | | | - François Doz
- Paris Science Letter University, School of Medicine, Université René Descartes, Paris, France
- Pediatric Oncology, Institut Curie, Paris, France
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45
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Lemaître S, Zmuda M, Jacomet PV, Lévy-Gabriel C, Dendale R, Berges O, Fréneaux P, Mariani P, Desjardins L, Galatoire O, Cassoux N. Small Choroidal Melanoma Revealed by a Large Extrascleral Extension. Ocul Oncol Pathol 2017; 3:240-246. [PMID: 29071276 DOI: 10.1159/000455870] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 01/04/2017] [Indexed: 11/19/2022] Open
Abstract
AIMS Orbital extraocular extension of choroidal melanoma is very rare with small melanomas. We report the case of a patient whose small choroidal melanoma was initially overlooked and was revealed by a large extrascleral extension. METHODS A 48-year-old Caucasian woman presented with sudden total visual loss in the right eye. Multicolor imaging of the fundus showed right optic disc edema and an orange and green lesion near the optic disc. The diagnosis of unilateral optic neuritis was made. Magnetic resonance imaging showed an extraocular mass adjacent to the optic nerve; on ultrasound, this mass was acoustically hollow and a small intraocular component was visible. RESULTS Choroidal melanoma with a large extrascleral extension was diagnosed (T4eN0M0, stage IIIC according to the AJCC 7th TNM classification, 2010). The size of the extraocular nodule was 13 × 5 mm. Treatment consisted of enucleation followed by adjuvant external beam orbital radiotherapy. Tumor analysis showed a mixed cell type melanoma with monosomy 3. The patient developed liver metastasis 10 months after local treatment. CONCLUSION Extraocular extension of choroidal melanoma can occur with small lesions. Prognosis is generally poor according to AJCC TNM. This case is a reminder that fundus examination may reveal the nature of the mass in some patients with orbital tumors.
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Affiliation(s)
- Stéphanie Lemaître
- Institut Curie, Paris, France.,Université Paris Descartes, Paris, France
| | - Mathieu Zmuda
- Fondation ophtalmologique Adolphe de Rothschild, Paris, France
| | | | | | - Rémi Dendale
- Institut Curie, ICPO (Protontherapy Center), Orsay, France
| | - Olivier Berges
- Fondation ophtalmologique Adolphe de Rothschild, Paris, France
| | | | | | | | | | - Nathalie Cassoux
- Institut Curie, Paris, France.,Université Paris Descartes, Paris, France
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Mahdjoubi A, Cassoux N, Levy-Gabriel C, Desjardins L, Klos J, Caly M, Vlajnic T, Gardrat S, Klijanienko J. Adult ocular medulloepithelioma diagnosed by transscleral fine needle aspiration: A case report. Diagn Cytopathol 2017; 45:561-564. [PMID: 28217870 DOI: 10.1002/dc.23694] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 01/20/2017] [Accepted: 02/08/2017] [Indexed: 11/10/2022]
Abstract
Ocular medulloepithelioma (ME) is a rare congenital tumor which occurs usually during childhood but is also reported in adults. They have seen an intraocular tumor in an 89 years-old female with a history of small cell lung carcinoma. Transscleral fine needle aspiration was performed. Aspirates were rich and composed of two distinctive populations of cells. The first consisted of epithelioid large cohesive cells with rare rosettes. Nuclei were oval and chromatin was delicate with small nucleoli. The second population consisted of smaller and dispersed cells with regular nuclei and dusty chromatin. Immunohistochemistry performed on paraffin-embedded cell block sections showed that the larger cells and rosettes were cytokeratin AE1/AE3, Synaptophysin, Chromogranin A, CD56, NSE, and EMA positive, whereas the smaller cells were always negative. Interestingly smaller cells expressed only weak nuclear positivity for TTF1, whereas larger cells were TTF1 negative. Melanocytic markers were negative in both populations. Morphological patterns and immunohistochemical staining confirmed ocular ME and allowed to exclude pulmonary metastasis or primary malignant melanoma. The patient was successfully treated by brachytherapy alone and is alive and well 10 months after treatment. Diagn. Cytopathol. 2017;45:561-564. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Amir Mahdjoubi
- Department of Ophtalmology, Institut Curie 26, Rue d'Ulm, 75248, Paris Cedex, France
| | - Nathalie Cassoux
- Department of Ophtalmology, Institut Curie 26, Rue d'Ulm, 75248, Paris Cedex, France
| | | | - Laurence Desjardins
- Department of Ophtalmology, Institut Curie 26, Rue d'Ulm, 75248, Paris Cedex, France
| | - Jan Klos
- Department of Pathology, Institut Curie 26, Rue d'Ulm, 75248, Paris Cedex, France
| | - Martial Caly
- Department of Pathology, Institut Curie 26, Rue d'Ulm, 75248, Paris Cedex, France
| | - Tatjana Vlajnic
- Department of Pathology, Institut Curie 26, Rue d'Ulm, 75248, Paris Cedex, France
| | - Sophie Gardrat
- Department of Pathology, Institut Curie 26, Rue d'Ulm, 75248, Paris Cedex, France
| | - Jerzy Klijanienko
- Department of Pathology, Institut Curie 26, Rue d'Ulm, 75248, Paris Cedex, France
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Mahdjoubi A, Dendale R, Lumbroso-Le Rouic L, Desjardins L, Cassoux N. Retinal cavernous haemangioma treated by proton beam therapy. Int Ophthalmol 2017; 38:759-762. [DOI: 10.1007/s10792-017-0475-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 02/16/2017] [Indexed: 11/30/2022]
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Lemaître S, Lecler A, Lévy-Gabriel C, Reyes C, Desjardins L, Gentien D, Zmuda M, Jacomet PV, Lumbroso-Le Rouic L, Dendale R, Vincent-Salomon A, Pierron G, Galatoire O, Cassoux N. Evisceration and ocular tumors: What are the consequences? J Fr Ophtalmol 2017; 40:93-101. [PMID: 28126270 DOI: 10.1016/j.jfo.2016.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 10/04/2016] [Accepted: 10/05/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Evisceration can be performed for blind, painful eyes. This surgery can promote the dissemination of tumor cells within the orbit if an ocular tumor has been missed preoperatively. METHODS We reviewed the medical records of patients who were eviscerated for blind, painful eyes between 2009 and 2014 and who were referred after the surgery to the Institut Curie or the Rothschild Foundation in Paris. We included the patients with a histological diagnosis of ocular tumor or orbital recurrence. Cytogenetic analysis was performed whenever possible. RESULTS Four patients turned out to have an ocular tumor after evisceration (two choroidal melanomas, a rhabdoid tumor and an adenocarcinoma of the retinal pigment epithelium); two had a history of prior ocular trauma. The tumors were diagnosed either on histological analysis of the intraocular contents (2 patients) or biopsy of orbital recurrence (2 patients). Prior to evisceration, fundus examination was not performed in 3 patients. One had preoperative imaging but no intraocular tumor was suspected. At the time of this study, 3 patients had had an orbital recurrence and died. We also found 2 patients who had an evisceration despite a past history of choroidal melanoma treated with proton beam therapy. CONCLUSION We showed that evisceration of eyes with unsuspected ocular malignancies was associated with a poor prognosis due to orbital recurrence and metastasis. The evisceration specimen should therefore always be sent for histological analysis in order to perform prompt adjuvant orbital radiotherapy if an ocular tumor is found.
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Affiliation(s)
- S Lemaître
- Institut Curie, 26, rue d'Ulm, 75005 Paris, France; Université Paris Descartes, 12, rue de l'École-de-Médecine, 75270 Paris cedex 06, France.
| | - A Lecler
- Fondation ophtalmologique Adolphe de Rothschild, 25-29, rue Manin, 75019 Paris, France
| | | | - C Reyes
- Institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - L Desjardins
- Institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - D Gentien
- Institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - M Zmuda
- Fondation ophtalmologique Adolphe de Rothschild, 25-29, rue Manin, 75019 Paris, France
| | - P V Jacomet
- Fondation ophtalmologique Adolphe de Rothschild, 25-29, rue Manin, 75019 Paris, France
| | | | - R Dendale
- Institut Curie, 26, rue d'Ulm, 75005 Paris, France; ICPO centre de protonthérapie, 15, rue Georges-Clemenceau, 91400 Orsay, France
| | | | - G Pierron
- Institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - O Galatoire
- Fondation ophtalmologique Adolphe de Rothschild, 25-29, rue Manin, 75019 Paris, France
| | - N Cassoux
- Institut Curie, 26, rue d'Ulm, 75005 Paris, France
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Lemaître S, Lévy-Gabriel C, Desjardins L, Plancher C, Asselain B, Vincent-Salomon A, Lumbroso-Le Rouic L, Dendale R, Rouzier R, Delacroix S, Cassoux N. Choroidal melanoma and pregnancy. Acta Ophthalmol 2016; 94:e652-e660. [PMID: 27009598 DOI: 10.1111/aos.12984] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 12/09/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE Choroidal melanoma is a rare tumour in adults. The mean age at diagnosis is 60, but the tumour can affect women of childbearing age. A negative effect of pregnancy on patients' survival has not been formally excluded to date. The aim of the present study is to evaluate the effect of pregnancy on the prognosis of choroidal melanoma. METHODS We conducted a single-centre retrospective study at the Institut Curie on the population of women of childbearing age who were diagnosed with choroidal melanoma between June 1980 and October 2013. We took a particular interest in the prognosis of those who were pregnant at the time of diagnosis and in the prognosis of those who chose to get pregnant after the treatment. RESULTS We found 27 pregnant patients at the time of diagnosis and 13 patients who became pregnant after the treatment. There was no difference in the survival between these two groups of patients and the group of other women of childbearing age diagnosed with choroidal melanoma (p = 0.52). There was also no difference in metastasis-free survival (p = 0.91). Most women were able to carry their pregnancies to term (67% had a term pregnancy, and only 7% had an abortion). For women who were pregnant when they were diagnosed with choroidal melanoma, a conservative treatment was chosen in 85% of cases, and proton beam therapy was the most widely used treatment. CONCLUSIONS Survival in women of childbearing age does not appear to be influenced by pregnancy. We show that proton beam therapy can be used to treat women who are pregnant at the time of choroidal melanoma diagnosis.
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Affiliation(s)
| | | | | | | | | | | | | | - Rémi Dendale
- Protontherapy Center (ICPO); Institut Curie; Paris France
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Costa J, Klijanienko J, Desjardins L, Cassoux N, Machet MC, Pacquement H. Fine needle aspiration in intraocular metastasis from pleuropulmonary blastoma. A case report and a review of the literature. Diagn Cytopathol 2016; 45:156-160. [PMID: 27718333 DOI: 10.1002/dc.23618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 09/03/2016] [Indexed: 11/09/2022]
Abstract
Pleuropulmonary blastoma (PPB) is a rare primitive intrathoracic malignant neoplasm that occurs almost exclusively in children and adolescents. PPB is classified into three types according to the presence of cystic and solid areas. We report a case of PPB with an intraocular metastasis diagnosed by fine needle aspiration (FNA): 3-year-old female was treated for type II PPB by neoadjuvant chemotherapy and surgery. Four years later, she presented with an intraocular lesion. To differentiate between metastasis or other malignancy, a transcleral FNA was performed and showed two cellular populations represented by roundish malignant cells and spindle-shaped cells. The patient was treated with chemotherapy and diode laser ablation. A year later, the patient had enucleation and rare residual cells were found on the histological specimen. Patient remains disease-free 66 months after the last surgical treatment. Diagn. Cytopathol. 2017;45:156-160. © 2016 Wiley Periodicals, Inc.
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