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Vempuluru VS, Maniar A, Kaliki S. Global retinoblastoma studies: A review. Clin Exp Ophthalmol 2024; 52:334-354. [PMID: 38263682 DOI: 10.1111/ceo.14357] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 01/05/2024] [Accepted: 01/05/2024] [Indexed: 01/25/2024]
Abstract
In the current era of global health awareness for retinoblastoma (RB), the challenge that lies ahead of us is providing optimal care for children affected with RB in underdeveloped nations. The understanding of similarities and disparities between various nations across the world aids in achieving comparable outcomes. With dissolving geographic barriers and evolving collaboration, global collaborative studies on RB are becoming increasingly common. They provide real-world, robust evidence on several aspects of RB. This review discusses insights gained from global RB studies regarding the demographics, certain aspects of etiopathogenesis and epidemiology, international travel burden, disparities in clinical presentations based on national income levels, management protocols, pathology, treatment outcomes, and the effect of COVID-19 on RB care across the world. These insights are likely to impact individual practice as well as inform policy reforms.
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Affiliation(s)
- Vijitha S Vempuluru
- The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India
| | - Arpita Maniar
- Duke Eye Center, Duke University, Durham, North Carolina, USA
| | - Swathi Kaliki
- The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India
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Kaliki S, Vempuluru VS, Mohamed A, Al-Jadiry MF, Bowman R, Chawla B, Hamid SA, Ji X, Kapelushnik N, Kebudi R, Sthapit PR, Rojanaporn D, Sitorus RS, Yousef YA, Fabian ID. Retinoblastoma in Asia: Clinical Presentation and Treatment Outcomes in 2112 Patients from 33 Countries. Ophthalmology 2024; 131:468-477. [PMID: 37839559 DOI: 10.1016/j.ophtha.2023.10.015] [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: 07/31/2023] [Revised: 09/15/2023] [Accepted: 10/09/2023] [Indexed: 10/17/2023] Open
Abstract
PURPOSE To describe the clinical presentation and treatment outcomes of children who received a diagnosis of retinoblastoma in 2017 throughout Asia. DESIGN Multinational, prospective study including treatment-naïve patients in Asia who received a diagnosis of retinoblastoma in 2017 and were followed up thereafter. PARTICIPANTS A total of 2112 patients (2797 eyes) from 96 retinoblastoma treatment centers in 33 Asian countries. INTERVENTIONS Chemotherapy, radiotherapy, enucleation, and orbital exenteration. MAIN OUTCOME MEASURES Enucleation and death. RESULTS Within the cohort, 1021 patients (48%) were from South Asia (SA), 503 patients (24%) were from East Asia (EA), 310 patients (15%) were from Southeast Asia (SEA), 218 patients (10%) were from West Asia (WA), and 60 patients (3%) were from Central Asia (CA). Mean age at presentation was 27 months (median, 23 months; range, < 1-261 months). The cohort included 1195 male patients (57%) and 917 female patients (43%). The most common presenting symptoms were leukocoria (72%) and strabismus (13%). Using the American Joint Committee on Cancer Staging Manual, Eighth Edition, classification, tumors were staged as cT1 (n = 441 [16%]), cT2 (n = 951 [34%]), cT3 (n = 1136 [41%]), cT4 (n = 267 [10%]), N1 (n = 48 [2%]), and M1 (n = 129 [6%]) at presentation. Retinoblastoma was treated with intravenous chemotherapy in 1450 eyes (52%) and 857 eyes (31%) underwent primary enucleation. Three-year Kaplan-Meier estimates for enucleation and death were 33% and 13% for CA, 18% and 4% for EA, 27% and 15% for SA, 32% and 22% for SEA, and 20% and 11% for WA (P < 0.0001 and P < 0.0001), respectively. CONCLUSIONS At the conclusion of this study, significant heterogeneity was found in treatment outcomes of retinoblastoma among the regions of Asia. East Asia displayed better outcomes with higher rates of globe and life salvage, whereas Southeast Asia showed poorer outcomes compared with the rest of Asia. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Swathi Kaliki
- The Operation Eyesight Universal Institute for Eye Cancer, L.V. Prasad Eye Institute, Hyderabad, India.
| | - Vijitha S Vempuluru
- The Operation Eyesight Universal Institute for Eye Cancer, L.V. Prasad Eye Institute, Hyderabad, India
| | - Ashik Mohamed
- The Operation Eyesight Universal Institute for Eye Cancer, L.V. Prasad Eye Institute, Hyderabad, India
| | - Mazin Faisal Al-Jadiry
- Pediatric Oncology Unit, Children Welfare Teaching Hospital, Medical City, College of Medicine, University of Baghdad, Bagdad, Iraq
| | - Richard Bowman
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom; Department of Ophthalmology, Great Ormond Street Children's Hospital, London, United Kingdom
| | - Bhavna Chawla
- Ocular Oncology Service, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Syed Ahmer Hamid
- Department of Ophthalmology, The Indus Hospital, Karachi, Pakistan
| | - Xunda Ji
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Noa Kapelushnik
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel
| | - Rejin Kebudi
- Department of Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey
| | | | - Duangnate Rojanaporn
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Rita S Sitorus
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | | | - Ido Didi Fabian
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom; Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel
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Berry JL, Pike S, Rajagopalan A, Reid MW, Fabian ID. Retinoblastoma Outcomes in the Americas: A Prospective Analysis of 491 Children With Retinoblastoma From 23 American Countries. Am J Ophthalmol 2024; 260:91-101. [PMID: 37949286 PMCID: PMC10982661 DOI: 10.1016/j.ajo.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE Globally, disparities exist in retinoblastoma treatment outcomes between high- and low-income countries, but independent analysis of American countries is lacking. We report outcomes of American retinoblastoma patients and explore factors associated with survival and globe salvage. DESIGN Subanalysis of prospective cohort study data. METHODS Multicenter analysis at 57 American treatment centers in 23 countries of varying economic levels (low income [LIC], lower-middle income [LMIC], upper-middle income [UMIC], and high income [HIC]) of 491 treatment-naïve retinoblastoma patients diagnosed in 2017 and followed through 2020. Survival and globe salvage rates analyzed with Kaplan-Meier analysis and Cox proportional hazard models. RESULTS Of patients, 8 (1.6%), 58 (11.8%), 235 (47.9%), and 190 (38.7%) were from LIC, LMIC, UMIC, and HIC groups, respectively. Three-year survival rates in LICs were 60.0% (95% confidence interval [CI] 12.6-88.2) compared with 99.2% (95% CI 94.6%-99.9%) in HICs. Death was less likely in patients >4 years of age (vs ≤4 years, HR = 0.45 [95% CI 0.27-0.78], P = .048). Patients with more advanced tumors (eg, cT3 vs cT1, HR = 4.65 × 109 [95% CI 1.25 × 109-1.72 × 1010], P < .001) and females (vs males, HR = 1.98 [95% CI 1.27-3.10], P = .04) were more likely to die. Three-year globe salvage rates were 13.3% (95% CI 5.1%-25.6%) in LMICs and 46.2% (95% CI 38.8%-53.3%) in HICs. At 3 years, 70.1% of cT1 eyes (95% CI 54.5%-81.2%) vs 8.9% of cT3 eyes (95% CI 5.5%-13.3%) were salvaged. Advanced tumor stage was associated with higher enucleation risk (eg, cT3 vs cT1, subhazard ratio = 4.98 [95% CI 2.36-10.5], P < .001). CONCLUSIONS Disparities exist in survival and globe salvage in American countries based on economic level and tumor stage demonstrating a need for childhood cancer programs.
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Affiliation(s)
- Jesse L Berry
- From the University of Southern California Roski Eye Institute (J.L.B., S.P., A.R., M.W.R.), Keck School of Medicine of the University of Southern California, Los Angeles, California, USA; Children's Hospital Los Angeles (J.L.B., S.P., A.R., M.W.R.), Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
| | - Sarah Pike
- From the University of Southern California Roski Eye Institute (J.L.B., S.P., A.R., M.W.R.), Keck School of Medicine of the University of Southern California, Los Angeles, California, USA; Children's Hospital Los Angeles (J.L.B., S.P., A.R., M.W.R.), Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Archeta Rajagopalan
- From the University of Southern California Roski Eye Institute (J.L.B., S.P., A.R., M.W.R.), Keck School of Medicine of the University of Southern California, Los Angeles, California, USA; Children's Hospital Los Angeles (J.L.B., S.P., A.R., M.W.R.), Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Mark W Reid
- From the University of Southern California Roski Eye Institute (J.L.B., S.P., A.R., M.W.R.), Keck School of Medicine of the University of Southern California, Los Angeles, California, USA; Children's Hospital Los Angeles (J.L.B., S.P., A.R., M.W.R.), Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Ido Didi Fabian
- Goldschleger Eye Institute (I.D.F.), Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel; and the International Centre for Eye Health (I.D.F.), London School of Hygiene & Tropical Medicine, London, United Kingdom
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Guo X, Wang L, Beeraka NM, Liu C, Zhao X, Zhou R, Yu H, Fan R, Liu J. Incidence Trends, Clinicopathologic Characteristics, and Overall Survival Prediction in Retinoblastoma Children: SEER Prognostic Nomogram Analysis. Oncologist 2024; 29:e275-e281. [PMID: 37874925 PMCID: PMC10836310 DOI: 10.1093/oncolo/oyad286] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 08/09/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Retinoblastoma is the most common intraocular malignant tumor occurring among children, with an incidence rate of 1/15 000. This study built a joinpoint regression model to assess the incidence trend of retinoblastoma from 2004 to 2015 and constructed a nomogram to predict the overall survival (OS) in children. MATERIALS AND METHODS Patients less than 19 years diagnosed with retinoblastoma from 2004 to 2015 were selected from the SEER database. Joinpoint regression analysis (version 4.9.0.0) was performed to evaluate the trends in retinoblastoma incidence rates from 2004 to 2015. Cox Regression Analysis was applied to investigate prognostic risk factors that influence OS. RESULTS Joinpoint regression revealed that retinoblastoma incidence exhibited no significant increase or decrease from 2004 to 2015. As per the multiple Cox regression, tumor size, laterality, and residence (rural-urban continuum code) were correlated with OS and were used to construct a nomogram. The nomogram exhibited a good C-index of 0.71 (95% CI, 0.63 to 0.79), and the calibration curve for survival probability demonstrated that the predictions corresponded well with actual observations. CONCLUSIONS AND RELEVANCE A prognostic nomogram integrating the risk factors for retinoblastoma was constructed to provide comparatively accurate individual survival predictions. If validated, this type of assessment could be used to guide therapy in patients with retinoblastoma.
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Affiliation(s)
- Xiaohong Guo
- Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan province, People's Republic of China
| | - Li Wang
- Department of Ophthalmology, Fujian Medical University Union Hospital, Fuzhou City, Fujian province, People's Republic of China
| | - Narasimha M Beeraka
- Department of Pharmacology, Raghavendra Institute of Pharmaceutical Education and Research (RIPER), Anantapuramu, Chiyyedu, Andhra Pradesh, India
- Department of Human Anatomy, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya st., Moscow, Russian Federation
- SINELAB Biomedical Research Center, Rochester, MN, USA
- Herman B. Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, 1044 W. Walnut Street, R4-168, Indianapolis, IN 46202, USA
| | - Chunying Liu
- Class 11 of Grade 3, Clinical Medicine of Medical School, Zhengzhou University, Zhengzhou, Henan province, People's Republic of China
| | - Xiang Zhao
- Class 11 of Grade 3, Clinical Medicine of Medical School, Zhengzhou University, Zhengzhou, Henan province, People's Republic of China
| | - Runze Zhou
- Cancer Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan province, People's Republic of China
| | - Huiming Yu
- Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, Hebei province, People's Republic of China
| | - Ruitai Fan
- Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan province, People's Republic of China
- Cancer Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan province, People's Republic of China
| | - Junqi Liu
- Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan province, People's Republic of China
- Cancer Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan province, People's Republic of China
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Black AK, Kahn AE, Lamy C, Warman R, Barengo NC. The association between race and age of diagnosis of retinoblastoma in United States children. J AAPOS 2024; 28:103810. [PMID: 38237725 DOI: 10.1016/j.jaapos.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/29/2023] [Accepted: 11/07/2023] [Indexed: 01/29/2024]
Abstract
PURPOSE To explore the associations between race and retinoblastoma diagnosis in United States children. METHODS In this analytical nonconcurrent cohort study, we used 1988-2018 data from the Surveillance, Epidemiology, and End-Results (SEER) database. Children ages 0-17 with retinoblastoma were included (n = 758); those with missing data were excluded (n = 11; final cohort: n = 747). The exposure variable was race (White, Black, Asian/Pacific Islanders, American Indian/Alaska Native), and the outcome variable was diagnosis of retinoblastoma before versus after 2 years of age. Covariates included sex, rural-urban continuum, ethnicity, decade of diagnosis, and laterality of disease. Unadjusted and adjusted logistic regression analyses were performed to calculate odds ratios and 95% confidence intervals. RESULTS No statistically significant association was found between racial/ethnic groups (OR = 0.61-0.99; P = 0.92) and age at diagnosis (OR = 0.86; P = 0.66). Females were more likely to be diagnosed earlier than males (OR = 0.62; 95% CI, 0.44-0.88; P = 0.042). No association was found between urban versus rural subjects (OR = 1.02; 95% CI, 0.60-1.75) or between decades (OR = 0.81; 95% CI, 0.54-1.22 and OR 0.96; 95% CI, 0.62-1.47). CONCLUSIONS We found no statistically significant difference between racial/ethnic groups for diagnosis of children with retinoblastoma after 2 years of age. Future studies could explore why females are more likely than males to be diagnosed before 2 years of age.
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Affiliation(s)
- Alexander K Black
- Florida International University, Herbert Wertheim College of Medicine, Miami, Florida.
| | - Amanda E Kahn
- Florida International University, Herbert Wertheim College of Medicine, Miami, Florida
| | - Chrisnel Lamy
- Florida International University, Herbert Wertheim College of Medicine, Miami, Florida
| | - Roberto Warman
- Florida International University, Herbert Wertheim College of Medicine, Miami, Florida
| | - Noël C Barengo
- Florida International University, Herbert Wertheim College of Medicine, Miami, Florida
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Bonanomi MTBC, de Almeida MTA, Hollaender MA, Bonanomi RC, Monteiro MLR. Retinoblastoma treatment in a Brazilian population. Presentation and long-term results. Cancer Med 2024; 13:e6683. [PMID: 38243643 PMCID: PMC10905530 DOI: 10.1002/cam4.6683] [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: 07/30/2023] [Revised: 09/17/2023] [Accepted: 10/23/2023] [Indexed: 01/21/2024] Open
Abstract
INTRODUCTION Retinoblastoma is a malignant tumor with a high cure potential when proper therapy is used. The purpose of this paper is to report the clinical features and outcomes of patients with retinoblastoma who were treated with a combination of local and systemic chemotherapy-based protocols. METHOD We retrospectively studied patients treated with systemic chemotherapy plus local treatment between 2003 and 2015 with a follow-up ≥2 years. We correlated clinical and pathological characteristics with decimal visual acuity (VA) and death. RESULTS Among 119 patients, 60% had unilateral disease (UNI), and 52% were male. The median presentation age was 19.5 months, 10% had a positive family history, and the most frequent sign was leukocoria (68.8%). Advanced disease was more frequent in eyes with UNI (98.4%) than in eyes with bilateral retinoblastoma (BIL: 55.3%). Enucleation was performed in 97% of UNI eyes and in 55.8% of BIL eyes. The overall globe salvage was 26.6%, 44.25% of BIL eyes. Bilateral enucleation was required in 5%. High-risk pathologic features occurred in 50% and 37% of eyes enucleated without and with neoadjuvant chemotherapy, respectively. High-risk features were related to the presence of goniosynechiae in the pathologic specimen and were more frequent in children younger than 10 months or older than 40 months. Extraocular disease was present in 5% of patients, and the death rate related to metastasis of the tumor was 8%. The final VA was ≥ 0.7 in 72.8% and ≥0.1 in 91% of BIL patients. CONCLUSIONS Treatment of retinoblastoma with conservative systemic-based chemotherapy was associated with an excellent survival rate (92%). Albeit the low overall globe salvage rate, in BIL patients, approximately half the eyes were conserved, and a satisfactory functional visual result was achieved The evaluated protocol is an important treatment option, especially in developing countries.
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Affiliation(s)
- Maria Teresa Brizzi Chizzotti Bonanomi
- Division of OphthalmologyHospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão PauloBrazil
- Laboratory for Investigation in Ophthalmology (LIM‐33), Faculdade de Medicina FMUSPUniversidade de São PauloSão PauloBrazil
| | - Maria Tereza A. de Almeida
- ITACI (Treatment of Children with Cancer Institute) and Children's InstituteHospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão PauloBrazil
| | - Marianna A. Hollaender
- Division of OphthalmologyHospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão PauloBrazil
| | - Roberta Chizzotti Bonanomi
- Division of OphthalmologyHospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão PauloBrazil
| | - Mario Luiz Ribeiro Monteiro
- Division of OphthalmologyHospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão PauloBrazil
- Laboratory for Investigation in Ophthalmology (LIM‐33), Faculdade de Medicina FMUSPUniversidade de São PauloSão PauloBrazil
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Chen Y, Paul KC, Walker DI, Jones DP, Wang X, Ritz BR, Heck JE. Neonatal per- and polyfluoroalkyl substance exposure in relation to retinoblastoma. Environ Res 2024; 240:117435. [PMID: 37866539 PMCID: PMC10842486 DOI: 10.1016/j.envres.2023.117435] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/29/2023] [Accepted: 10/16/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Neonatal per- and polyfluoroalkyl substance (PFAS) exposure can disrupt hormonal homeostasis and induce neuro- and immunotoxicity in children. In this exploratory study, we investigated associations between PFAS levels in neonatal dried blood spots and retinoblastoma risk. MATERIALS AND METHODS This study included 501 retinoblastoma cases born from 1983 to 2011 and 899 controls frequency-matched by birth year (20:1 matching ratio), born to 755 US-born and 366 Mexico-born mothers in California. Perfluorooctanesulfonic acid (PFOS), perflurooctanoic acid (PFOA), and perfluorononanoic acid (PFNA) feature intensities were identified from neonatal blood spots from California newborn Genetic Disease Screening Program. Using logistic regression, we assessed whether an interquartile range (IQR) increase of PFAS levels or having above-mean levels of PFAS in blood affects retinoblastoma risk overall or its subtypes (i.e., unilateral, bilateral). We assessed children of US-born and Mexico-born mothers, separately. RESULTS AND DISCUSSION Among all children, above-mean PFOS levels at birth increased the odds of retinoblastoma overall by 29% (95% Confidence Interval (CI): 1.00, 1.67) and unilateral retinoblastoma by 42% (95% CI: 1.03, 1.97). For children of Mexico-born mothers, we estimated the highest odds of retinoblastoma overall (adjusted odds ratio (aOR): 1.67; 95% CI: 1.06, 2.66) and bilateral retinoblastoma (aOR: 2.06; 95% CI: 1.12, 3.92) with above-mean PFOS levels. Among children of US-born mothers, higher PFOS levels increased the odds of unilateral retinoblastoma by 15% (95% CI: 0.99, 1.35) for each IQR increase and by 71% among children with above-mean PFOS levels (95% CI: 1.04, 2.90). In addition, for children of US-born mothers, PFOA increased the odds of retinoblastoma overall (aOR: 1.41; 95% CI: 1.00, 2.02 for above-mean levels, aOR: 1.06; 95% CI: 0.98, 1.16 per IQR increase). PFNA was not associated with retinoblastoma risk. CONCLUSIONS Our results suggested that PFOS and PFOA might contribute to retinoblastoma risk in children born in California.
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Affiliation(s)
- Yixin Chen
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Kimberly C Paul
- Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Douglas I Walker
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Dean P Jones
- Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, and Critical Care Medicine, School of Medicine, Emory University, Atlanta, GA, USA; Department of Medicine, Emory University, Atlanta, GA, USA
| | - Xuexia Wang
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Beate R Ritz
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA; Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Julia E Heck
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA; College of Health and Public Service, University of North Texas, Denton, TX, USA.
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Nishath T, Li X, Chandramohan A, Othus M, Ji X, Zou Y, Sultana S, Rashid R, Sherief ST, Cassoux N, Garcia Leon JL, Díaz Coronado R, López AMZ, Ushakova TL, Polyakov VG, Roy SR, Ahmad A, Reddy A, Sagoo MS, Al Harby L, Kim JW, Berry JL, Polski A, Astbury N, Bascaran C, Blum S, Bowman R, Burton MJ, Foster A, Gomel N, Keren-Froim N, Madgar S, Zondervan M, Kaliki S, Fabian ID, Stacey A. Risk factors associated with abandonment of care in retinoblastoma: analysis of 692 patients from 10 countries. Br J Ophthalmol 2023; 107:1818-1822. [PMID: 36113955 PMCID: PMC10017370 DOI: 10.1136/bjo-2022-321159] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 09/04/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Rates of care abandonment for retinoblastoma (RB) demonstrate significant geographical variation; however, other variables that place a patient at risk of abandoning care remain unclear. This study aims to identify the risk factors for care abandonment across a multinational set of patients. METHODS A prospective, observational study of 692 patients from 11 RB centres in 10 countries was conducted from 1 January 2019 to 31 December 2019. Multivariate logistic regression was used to identify risk factors associated with higher rates of care abandonment. RESULTS Logistic regression showed a higher risk of abandoning care based on country (high-risk countries include Bangladesh (OR=18.1), Pakistan (OR=45.5) and Peru (OR=9.23), p<0.001), female sex (OR=2.39, p=0.013) and advanced clinical stage (OR=4.22, p<0.001). Enucleation as primary treatment was not associated with a higher risk of care abandonment (OR=0.59, p=0.206). CONCLUSION Country, advanced disease and female sex were all associated with higher rates of abandonment. In this analysis, enucleation as the primary treatment was not associated with abandonment. Further research investigating cultural barriers can enable the building of targeted retention strategies unique to each country.
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Affiliation(s)
- Thamanna Nishath
- Department of Ophthalmology, University of Washington, Seattle, Washington, USA
| | - Xiudi Li
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Arthika Chandramohan
- Division of Ophthalmology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Megan Othus
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Xunda Ji
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Yang Pu Qu, Shanghai, China
| | - Yihua Zou
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Yang Pu Qu, Shanghai, China
| | - Sadia Sultana
- Department of Oculoplasty and Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh
| | - Riffat Rashid
- Department of Oculoplasty and Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh
| | - Sadik Taju Sherief
- Department of Ophthalmology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Nathalie Cassoux
- Department of Ophthalmology, Institut Curie, Universite de Paris UFR de Medecine de Paris Centre, Paris, France
| | | | | | | | - Tatiana L Ushakova
- Head and Neck Tumors, SRI of Pediatric Oncology and Hematology of NN Blokhin National Medical Research Center Oncology of Russian Federation, Moscow, Russian Federation
- Pediatric Oncology, Medical Academy of Postgraduate Education, Moscow, Russian Federation
| | - Vladimir G Polyakov
- Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology of NN Blokhin National Medical Research Center Oncology of Russian Federation, Moscow, Russian Federation
- Russian Medical Academy of Postgraduate Education, Moscow, Russian Federation
| | - Soma Rani Roy
- Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh
| | - Alia Ahmad
- The Children's Hospital and the Institute of Child Health, Lahore, Pakistan
| | - Ashwin Reddy
- Ophthalmology, Barts Health NHS Trust, London, UK
- Paediatric Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Mandeep S Sagoo
- Ophthalmology, Barts Health NHS Trust, London, UK
- NIHR Biomedical Research Centre for Ophthalmology, Joint Library of Ophthalmology Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | - Lamis Al Harby
- Ocular Oncology, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Barts Health NHS Trust, The Royal London Hospital, London, UK
| | - Jonathan W Kim
- USC Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- The Vision Center, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Jesse L Berry
- USC Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- The Vision Center, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Ashley Polski
- USC Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California, USA
- The Vision Center, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Nick Astbury
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Cova Bascaran
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Sharon Blum
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel
| | - Richard Bowman
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel
| | - Matthew J Burton
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
- UCL Institute of Ophthalmology, London, UK
| | - Allen Foster
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, and International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Nir Gomel
- Sheba Medical Center at Tel Hashomer, Tel Hashomer, Israel
- Division of Ophthalmology, Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
| | - Naama Keren-Froim
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel
| | - Shiran Madgar
- Ophthalmology, Sheba Medical Center at Tel Hashomer, Tel Hashomer, Israel
| | - Marcia Zondervan
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Swathi Kaliki
- The Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Ido Didi Fabian
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Andrew Stacey
- Department of Ophthalmology, University of Washington, Seattle, Washington, USA
- Division of Ophthalmology, Seattle Children's Hospital, Seattle, Washington, USA
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9
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Liu B, Abraham N, Chitsike I, Sylvie CGL, Kambugu J, Stévy NMA, Pondy AHO, Renner L, Parkin DM. Enhancing information on stage at diagnosis for childhood cancer in Africa. Pediatr Blood Cancer 2023; 70:e30555. [PMID: 37432023 DOI: 10.1002/pbc.30555] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/11/2023] [Accepted: 06/28/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND/PURPOSE Stage at diagnosis is an important metric in treatment and prognosis of cancer, and also in planning and evaluation of cancer control. In sub-Saharan Africa (SSA), for the latter, the only data source is the population-based cancer registry (PBCR). For childhood cancers, the 'Toronto Staging Guidelines' have been developed to facilitate abstraction of stage by cancer registry personnel. Although the feasibility of staging using this system has been shown, there is limited information on the accuracy of staging. METHODS A panel of case records of six common childhood cancers was established. A total of 51 cancer registrars from 20 SSA countries staged these records, using Tier 1 of the Toronto guidelines. The stage that they assigned was compared with that decided by two expert clinicians. RESULTS The registrars assigned the correct stage for 53%-83% of cases (71% overall), with the lowest values for acute lymphocytic leukaemia (ALL), retinoblastoma and non-Hodgkin lymphoma (NHL), and the highest for osteosarcoma (81%) and Wilms tumour (83%). For ALL and NHL, many unstageable cases were mis-staged, probably due to confusion over the rules for dealing with missing data; for the cases with adequate information, accuracy was 73%-75%. Some confusion was observed over the precise definition of three stage levels of retinoblastomas. CONCLUSIONS A single training in staging resulted in an accuracy, for solid tumours, that was not much inferior to what has been observed in high-income settings. Nevertheless, some lessons were learned on how to improve both the guidelines and the training course.
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Affiliation(s)
- Biying Liu
- African Cancer Registry Network, Oxford, UK
| | - Natasha Abraham
- National Cancer Registry, National Healh Laboratory Service, Johannesburg, South Africa
| | - Inam Chitsike
- Paediatric Heme-Oncology Unit, University of Zimbabwe, Harare, Zimbabwe
| | | | | | | | - Angèle Hermine Ongotsoyi Pondy
- Faculty of Medicine and Biomedical Sciences and Mother and Child Chantal Biya Foundation Pediatric Teaching Hospital, Biomedicales, University of Yaounde, Yaounde, Cameroon
| | - Lorna Renner
- Korle Bu Teaching Hospital, University of Ghana, Accra, Ghana
| | - Donald Maxwell Parkin
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Cancer Surveillance Unit, International Agency for Research on Cancer, Lyon, France
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10
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Singh S, Nishath T, Fabian ID, Li X, Othus M, Tzukikawa M, Stacey AW. Seasonal Variation in the Diagnosis of Retinoblastoma. Ophthalmic Epidemiol 2023; 30:509-514. [PMID: 36503408 DOI: 10.1080/09286586.2022.2153872] [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: 04/20/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE To determine the seasonal variation in the diagnosis of retinoblastoma in a global sample of children and to investigate predictors of seasonal trends. METHODS Data were collected through a global, multicenter, 1-year cross-sectional analysis that included all treatment- naïve retinoblastoma patients presenting to participating centers between January 1, 2017, and December 31, 2017. Due to variations in days per month, data were normalized to a 30-day/month calendar. Observed data were compared to a simulation study of expected results using a uniform distribution. RESULTS Patient-level data were available for 4,351 children from 276 centers in 153 countries, of which 3,966 had a month of presentation recorded. There were relative peaks in disease presentation in January and July, with lower counts in November and December (p = .0015). No covariates were found to be significantly associated with the seasonal trend. Two covariates, patient age at presentation and extraocular tumor spread, showed a moderate association with month of presentation. CONCLUSION Our findings suggest seasonal trends in the presentation of retinoblastoma across the world. However, these trends do not appear to be related to income level of a country, climate, or other covariates. Any connection between seasonal variation of retinoblastoma presentation and retinoblastoma outcomes remains unclear or not present.
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Affiliation(s)
- Shonar Singh
- Department of Pediatric Ophthalmology, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
| | - Thamanna Nishath
- Department of Ophthalmology, University of Washington, Seattle, Washington, USA
| | - Ido Didi Fabian
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Xiudi Li
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Megan Othus
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Mai Tzukikawa
- Department of Ophthalmology, University of Washington, Seattle, Washington, USA
| | - Andrew W Stacey
- Department of Ophthalmology, University of Washington, Seattle, Washington, USA
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11
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Moin M, Malik TG, Siddiq L. Clinical Patterns And Outcomes Of Retinoblastoma In A Tertiary Care Centre Of A Developing Country. J PAK MED ASSOC 2023; 73:1881-1883. [PMID: 37817703 DOI: 10.47391/jpma.7689] [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] [Indexed: 10/12/2023]
Abstract
A retrospective study was conducted for which records of patients with Retinoblastoma (RB), treated at Lahore General Hospital between 2017 and 2021, were retrieved on February 1, 2022. Staging of RB, neuroimaging, RetCam images, and treatment were analysed. The study included 47 patients (22 females and 25 males). Mean age of presentation was 26.5±15 months. Records of 84 eyes (37 bilateral and 10 unilateral) were examined. Family history was positive in only (n=3) 6.3% cases. Mean follow-up was 22.94±14.4 months. Leucocoria was the commonest presentation, seen in 72 (85.7%) eyes, proptosis in 8 (9.5%), huge fungating mass in 2 (2.4%), while tumour was diagnosed because of screening in 2 (2.4%) patients. Posttreatment complications included cataract in two patients, Ischaemic chorioretinal toxicity, transient macular oedema, orbital oedema and transient intra cranial oedema in one patient each. Two patients had metastasis and underwent systemic chemotherapy. The study showed that patients with retinoblastoma can achieve better results if diagnosed early and treated with newer treatment options.
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Affiliation(s)
- Muhammad Moin
- Ameer ud Din Medical College, Lahore General Hospital, Lahore, Pakistan
| | - Tayyaba Gul Malik
- Ameer ud Din Medical College, Lahore General Hospital, Lahore, Pakistan
| | - Lubna Siddiq
- Ameer ud Din Medical College, Lahore General Hospital, Lahore, Pakistan
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12
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Lloyd P, Westcott M, Kaliki S, Ji X, Zou Y, Rashid R, Sultana S, Sherief ST, Cassoux N, Diaz Coronado RY, Garcia Leon JL, López AMZ, Polyakov VG, Ushakova TL, Roy SR, Ahmad A, Harby LA, Berry JL, Kim J, Polski A, Astbury NJ, Bascaran C, Blum S, Bowman R, Burton MJ, Foster A, Gomel N, Keren-Froim N, Madgar S, Stacey AW, Mohamed A, Zondervan M, Sagoo MS, Fabian ID, Reddy MA. The role of maternal age & birth order on the development of unilateral and bilateral retinoblastoma: a multicentre study. Eye (Lond) 2023; 37:966-970. [PMID: 35361938 PMCID: PMC10050160 DOI: 10.1038/s41433-022-01992-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 01/30/2022] [Accepted: 02/15/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND/OBJECTIVES Retinoblastoma is a common childhood intraocular malignancy, the bilateral form of which most commonly results from a de novo germline pathogenic variant in the RB1 gene. Both advanced maternal age and decreasing birth order are known to increase the risk of de novo germline pathogenic variants, while the influence of national wealth is understudied. This cohort study aimed to retrospectively observe whether these factors influence the ratio of bilateral retinoblastoma cases compared to unilateral retinoblastoma, thereby inferring an influence on the development of de novo germline pathogenic variants in RB1. SUBJECTS/METHODS Data from 688 patients from 11 centres in 10 countries were analysed using a series of statistical methods. RESULTS No associations were found between advanced maternal age, birth order or GDP per capita and the ratio of bilateral to unilateral retinoblastoma cases (p values = 0.534, 0.201, 0.067, respectively), indicating that these factors do not contribute to the development of a de novo pathogenic variant. CONCLUSIONS Despite a lack of a definitive control group and genetic testing, this study demonstrates that advanced maternal age, birth order or GDP per capita do not influence the risk of developing a bilateral retinoblastoma.
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Affiliation(s)
- Philippa Lloyd
- Barts and The London School of Medicine and Dentistry, London, E1 2AD, UK
| | - Mark Westcott
- The Royal London Hospital, Barts Health NHS Trust, London, E1 1FR, UK
- UCL Institute of Ophthalmology, London, EC1V 9EL, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK
| | - Swathi Kaliki
- The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Xunda Ji
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yihua Zou
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Riffat Rashid
- Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka, 1215, Bangladesh
| | - Sadia Sultana
- Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka, 1215, Bangladesh
| | - Sadik Taju Sherief
- Addis Ababa University, School of Medicine, Department of Ophthalmology, Addis Ababa, 3614, Ethiopia
| | - Nathalie Cassoux
- Institut Curie, Université de Paris Medicine Paris V Descartes, Paris, 75248, France
| | | | | | | | - 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, and Medical Academy of Postgraduate Education, Moscow, 115478, Russia
| | - 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, and Medical Academy of Postgraduate Education, Moscow, 115478, Russia
| | - Soma Rani Roy
- Chittagong Eye Infirmary & Training Complex, Chittagong, 4202, Bangladesh
| | - Alia Ahmad
- The Children's Hospital & the Institute of Child Health, Lahore, 54000, Pakistan
| | - Lamis Al Harby
- The Royal London Hospital, Barts Health NHS Trust, London, E1 1FR, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK
| | - Jesse L Berry
- Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90027, USA
| | - Jonathan Kim
- Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90027, USA
| | - Ashley Polski
- Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90027, USA
| | - Nicholas J Astbury
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Covadonga Bascaran
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Sharon Blum
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, 52621, Israel
| | - Richard Bowman
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
- Ophthalmology Department, Great Ormond Street Children's Hospital, London, WC1N 3JH, UK
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Allen Foster
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Nir Gomel
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 39040, Israel
| | - Naama Keren-Froim
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 39040, Israel
| | - Shiran Madgar
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, 52621, Israel
| | - Andrew W Stacey
- Department of Ophthalmology, University of Washington, Seattle, WA, 98195, USA
| | - Ashik Mohamed
- Ophthalmic Biophysics (AMd), L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Marcia Zondervan
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Mandeep S Sagoo
- The Royal London Hospital, Barts Health NHS Trust, London, E1 1FR, UK
- UCL Institute of Ophthalmology, London, EC1V 9EL, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK
- NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology and London Retinoblastoma Service, Royal London Hospital, London, EC1V 2PD, UK
| | - Ido Didi Fabian
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, 52621, Israel
| | - M Ashwin Reddy
- The Royal London Hospital, Barts Health NHS Trust, London, E1 1FR, UK.
- Moorfields Eye Hospital NHS Foundation Trust, London, EC1V 2PD, UK.
- Queen Mary University of London, London, E1 4NS, UK.
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13
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Sánchez-Cañal B, Bosch Canto V. Presence of cataract in patients treated for retinoblastoma at the national institute of pediatrics in Mexico (2011-2021). J Fr Ophtalmol 2023; 46:216-222. [PMID: 36642598 DOI: 10.1016/j.jfo.2022.06.018] [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: 02/12/2022] [Revised: 06/02/2022] [Accepted: 06/11/2022] [Indexed: 01/15/2023]
Abstract
PURPOSE The goal of this study is to describe the presence of secondary cataract in patients with retinoblastoma treated at the National Institute of Pediatrics of Mexico (INP) over the past 10 years. METHODS This was a single center observational, retrospective and descriptive study. We included all eyes diagnosed with retinoblastoma and cataract between June 2011 and June 2021. RESULTS In total, 833 records of patients diagnosed with Retinoblastoma at the National Institute of Pediatrics during the period between June 2011 and June 2021 were reviewed. Out of all of them, only 14 developed cataract (1.6%). The median age at retinoblastoma diagnosis was 10.5 months (Rank: 6-13 months), and the median age at cataract diagnosis was 51.5 months (Rank: 25-73 months). The majority (13, 92.9%) of the patients had bilateral involvement. 42% of the eyes were Stage D according to the international classification of retinoblastoma. Cryotherapy was applied in 57.1%, intravitreal chemotherapy in 85.7%, radiation therapy in 42.6%, and only 7.1% of cases were treated with intra-arterial chemotherapy. CONCLUSIONS The presence of cataract in patients with retinoblastoma is a rare but important entity impacting the development of vision in children and detection of intraocular tumors. These probably occur late as a result of the multiple treatments to which the children have been subjected, without being able to determine in this study which is the risk factor most associated with the development of this pathology.
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Affiliation(s)
- B Sánchez-Cañal
- Insurgentes Sur 3700 Letra C, Insurgentes Cuicuilco, 04530 Mexico City, CDMX, Mexico.
| | - V Bosch Canto
- Insurgentes Sur 3700 Letra C, Insurgentes Cuicuilco, 04530 Mexico City, CDMX, Mexico
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14
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Thaker SK, Shah PK, Das A, Maitra P. Management of Recurrence in Retinoblastoma Based on the Source of Tumor Cells. Middle East Afr J Ophthalmol 2023; 30:24-30. [PMID: 38435107 PMCID: PMC10903713 DOI: 10.4103/meajo.meajo_112_23] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/10/2023] [Accepted: 12/14/2023] [Indexed: 03/05/2024] Open
Abstract
PURPOSE The aim was to study the characteristics of recurrence patterns in the form of scar recurrence, new lesions, and vitreous seeds which is necessary in anticipating future events for the management of retinoblastoma (RB). METHODS This retrospective analytical observational study was conducted in a tertiary care hospital in South India; we included 64 eyes of 45 patients having RB from January 2019 to July 2020. The inclusion criterion was treatment-naïve patients with > 12 months of follow-up period. Recurrence patterns were defined as Pattern 1a and Pattern 1b: local and diffuse dissemination of vitreous seeds, respectively. Pattern 2: Scar recurrences: these are new tumor growths over chemoreduced lesions. Pattern 3: New lesions: local dissemination of subretinal seeds leading to new lesions elsewhere in the retina. RESULTS A noncomparative analysis of 64 eyes of 45 patients having 108 lesions was studied; of which 28/45 (62.22%) were male and 17/45 (37.78%) were female. The mean time of presentation since the first clinical sign was 40 days (range: 10-180). The most common sign at presentation was leukocoria 42/64 (65.6%), followed by squint 4/64 (6.34%). Nineteen patients (42.22%) had bilateral RB, while 26 patients (57.78%) had unilateral RB. Primary enucleation was done for 19/26 eyes with advanced unilateral disease. Out of the total 32 eyes with subretinal tumor seeds at presentation, 17/32 eyes had a recurrence in the form of new lesions (Pattern 3) and 22/32 eyes had scar recurrence (Pattern 2). All of these 32 eyes were salvaged by local tumor consolidation methods. Recurrence due to vitreous seed dissemination was found in 18/64 eyes, in which diffuse dissemination (Pattern 1b) was present in 8/18 eyes (44.4%); all required enucleation even after local and systemic chemotherapeutic measures. Rest 10/18 eyes with local vitreous seeds (Pattern 1a) were cured at the end of the follow-up. Globe salvage was more with Pattern 1a rather than Pattern 1b even after additional intravitreal chemotherapy. CONCLUSION All eyes with Patterns 2 and 3 were salvaged at the end of follow-up with local tumor consolidation methods, while the globe salvage rate with Pattern 1 was poor even with multiple doses of intravitreal chemotherapy. The rate of successful treatment for managing these recurrence patterns depends on early identification by regular follow-ups with detailed retina examination.
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Affiliation(s)
- Shivna K. Thaker
- Fellow, Observer in ROP, Pediatric Retina and Ocular Oncology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Parag K. Shah
- Department of Pediatric Retina and Ocular Oncology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Abhishek Das
- Fellow, Observer in ROP, Pediatric Retina and Ocular Oncology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Puja Maitra
- Fellow, Observer in ROP, Pediatric Retina and Ocular Oncology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
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15
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Guevarra MCB, Eala MAB, Dee EC, Mercado GJV, Collantes ERA. Looking through the scope: retinoblastoma in the Philippines. Eye (Lond) 2022; 36:2356-2357. [PMID: 35418708 PMCID: PMC9674827 DOI: 10.1038/s41433-022-02069-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 03/28/2022] [Accepted: 04/04/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Ma Carmela B Guevarra
- Department of Ophthalmology, Cardinal Santos Medical Center, San Juan, 1502, Philippines
| | | | - Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Gary John V Mercado
- Department of Ophthalmology and Visual Sciences, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Edward Ryan A Collantes
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.
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Beniwal V, Maheshwari G, Beniwal S, Dhanawat A, Tantia P, Adlakha P. Retinoblastoma: A review of clinical profile at a regional cancer center in Northwest India. J Cancer Res Ther 2022; 18:1623-1628. [PMID: 36412421 DOI: 10.4103/jcrt.jcrt_1263_20] [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] [Indexed: 11/04/2022]
Abstract
Background Retinoblastoma is the most common primary intraocular malignancy of childhood. The present study was undertaken to overcome the scarcity of data regarding the epidemiology, demographic and clinical profile, and nature of the first health-care professional consulted. Materials and Methods A retrospective analysis of medical records was performed for all cases of retinoblastoma who presented to the department of ophthalmology and oncology between 2010 and 2017. A total of 54 cases were reviewed. Results Unilateral disease was seen in 85.2% while 14.8% presented with bilateral disease with a median age of 3 years and 2 years, respectively, at diagnosis. The male: female ratio was 2:1. The most common presenting symptom was leukocoria which was noticed in 42 patients (77.7%), followed by red eye (33.3%) and proptosis (20.3%). The most common stage of presentation was Stage I (44.4%), followed by Stage IV (20.4%), Stage III (9.3%), and Stage II (5.6%). The median time to diagnosis was 8.7 months (range, 0.5-98.7 months), and the median time to treatment was 37.4 days (range, 0-645 days). Majority of the patients were referred by local ophthalmologists (48%), followed by general practitioners (20%), nurses (19%), and quacks (13%). Enucleation was the most preferred treatment modality (48.1%), followed by chemotherapy (33.3%), radiotherapy (13%), photocoagulation (3.7%), and exenteration (1.9%). The overall remission rate was 79.6%, while 12.3% had relapse and 7.4% died. Conclusion The study showed a dire need for timely detection and treatment of retinoblastoma which is possible with improved awareness and better accessibility to health-care facilities. It also revealed a decrease in histopathological risk factors with chemoreduction.
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Affiliation(s)
- Vimla Beniwal
- Department of Ophthalmology, Sardar Patel Medical College, Bikaner, Rajasthan, India
| | - Guncha Maheshwari
- Department of Radiation Oncology, Sardar Patel Medical College, Bikaner, Rajasthan, India
| | - Surender Beniwal
- Department of Medical Oncology, Sardar Patel Medical College, Bikaner, Rajasthan, India
| | - Aditya Dhanawat
- Department of Internal Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Pankaj Tantia
- Department of Medical Oncology, Sardar Patel Medical College, Bikaner, Rajasthan, India
| | - Pramila Adlakha
- Department of Radiation Oncology, Sardar Patel Medical College, Bikaner, Rajasthan, India
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Larkin HD. Retinoblastoma Especially Deadly in Children in Low-Income Countries. JAMA 2022; 328:611. [PMID: 35972479 DOI: 10.1001/jama.2022.13268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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18
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Villanueva G, Sampor C, Moreno F, Alderete D, Moresco A, Pinto N, Szijan I, Schaiquevich P, Felice MS, Rose A, Zubizarreta P, Sgroi M, Fandiño A, Chantada G. Subsequent malignant neoplasms in the pediatric age in retinoblastoma survivors in Argentina. Pediatr Blood Cancer 2022; 69:e29710. [PMID: 35451226 DOI: 10.1002/pbc.29710] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 03/02/2022] [Accepted: 03/21/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Retinoblastoma survivors in low- and middle-income countries are exposed to high-intensity treatments that potentially place them at higher risk of early subsequent malignant neoplasms (SMNs). METHODS We followed 714 (403 [56.4%] nonhereditary and 311 [43.5%] hereditary) retinoblastoma survivors diagnosed from August 1987 to December 2016, up to the age of 16 years. We quantified risk of SMNs with cumulative incidence (CI) and standardized incidence ratios (SIR) analysis. Multivariate regression Cox model was used to determine the association of treatments and risk of SMNs. RESULTS Median follow-up was of 9 years (range: 0.18-16.9) and 24 survivors (3.36%) developed 25 SMNs (n = 22 hereditary, n = 2 nonhereditary). SMNs included sarcomas (osteosarcomas, Ewing sarcomas, rhabdomyosarcomas; n = 12), leukemias (n = 5), and central nervous system tumors (CNS; n = 3). All cases of acute myeloid leukemia (AML) and most of Ewing sarcomas occurred within 5 years of retinoblastoma diagnosis. The type of SMN was the main indicator of mortality (five of five patients with leukemias, six of 12 with sarcomas, and zero of three with CNS tumors died). Compared to the general population, radiation increased the risk of Ewing sarcoma in hereditary survivors by 700-fold (95% CI = 252-2422.6) and chemotherapy increased the risk of AML by 140-fold (95% CI = 45.3-436). The CI of SMNs for hereditary survivors was 13.7% (95% CI = 8.4-22.1) at 15 years. CONCLUSION Retinoblastoma survivors from Argentina are at higher risk of developing SMNs early in life compared to the general Argentinean population, especially those treated with radiation plus chemotherapy. AML and Ewing sarcoma presented within 5 years of retinoblastoma diagnosis are associated with chemotherapy and radiation exposure.
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Affiliation(s)
- Gabriela Villanueva
- Hematology and Oncology Department, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Claudia Sampor
- Hematology and Oncology Department, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Florencia Moreno
- Instituto Nacional del Cáncer, Registro Onco-pediatrico Hospitalario Argentino (ROHA), Buenos Aires, Argentina
| | - Daniel Alderete
- Hematology and Oncology Department, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Angelica Moresco
- Department of Genetics, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Natalia Pinto
- Department of Radiotherapy, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Irene Szijan
- Cátedra de Genética, Facultad de Farmacia y Bioquímica, Hospital de Clínicas, University of Buenos Aires, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Paula Schaiquevich
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - María Sara Felice
- Hematology and Oncology Department, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Adriana Rose
- Hematology and Oncology Department, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Pedro Zubizarreta
- Hematology and Oncology Department, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Mariana Sgroi
- Ophthalmology Department, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Adriana Fandiño
- Ophthalmology Department, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Guillermo Chantada
- Hematology and Oncology Department, Hospital JP Garrahan, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
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19
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Luo Y, Zhou C, He F, Fan J, Wen X, Ding Y, Han Y, Ding J, Jin M, Liu Z, Wang S, Han M, Yuan H, Sun H, Xiao Y, Wu L, Wang J, Li Y, Yang H, Yu J, Gong J, Xu Y, Wen Y, Gao Z, Mei L, Ye J, Liu H, Chen Z, Xue S, Liu R, Chen H, Lu W, Liao H, Guo Q, Cui J, Zhu D, Lu F, Tang S, Wu Y, Yangkyi T, Guanghong Z, Wubuli M, Huiyu G, Wang X, He Y, Sheng X, Wang Q, Tan J, Liang J, Sun X, Zhang J, Ji X, Jin L, Zhao J, Yang X, Jia R, Fan X. Contemporary Update of Retinoblastoma in China: Three-Decade Changes in Epidemiology, Clinical Features, Treatments, and Outcomes. Am J Ophthalmol 2022; 236:193-203. [PMID: 34626572 DOI: 10.1016/j.ajo.2021.09.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 03/19/2021] [Revised: 05/30/2021] [Accepted: 09/22/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE To report three-decade changes of clinical characteristics, progress of treatments, and risk factors associated with mortality and enucleation in patients with retinoblastoma in China. DESIGN Retrospective cohort study. METHODS This multicenter study included 2552 patients diagnosed with retinoblastoma in 38 medical centers in 31 provinces in China from 1989 to 2017, with follow-up data. Kendall's tau-b value was used to describe correlation coefficients between the three eras (between 1989 and 2008, between 2009 and 2013, and between 2014 and 2017) and clinical or demographic features. Hazard ratios and odds ratios were applied to measure risk factors. RESULTS A total of 324 (13%) patients died and 1414 (42%) eyes were removed. The 1-year, 3-year, and 5-year overall survival rates were 95%, 86%, and 83%, respectively. Patients were diagnosed at a better stage by International Classification for Retinoblastoma over time (Kendall's tau-b value = -0.084, P < .001). Pathological risk factors were also observed less in recent eras. New conservative therapies were adopted and used in more patients. The eye removal rate gradually decreased (Kendall's tau-b value = -0.167, P < .001). The overall survival rates were 81%, 83%, and 91% in the three eras. By multivariate Cox regression, bilateral tumors and extraocular extension were identified as risk factors for death. Among intraocular disease, Group E indicated higher risk of mortality. By multivariate logistics regression, unilateral tumors, earlier era of diagnosis, and extraocular extension were risk factors for eye salvage failure. Among intraocular retinoblastoma, Groups D and E had higher risk of eye salvage failure. CONCLUSIONS Patients were diagnosed at an earlier stage in recent eras. Conservative therapies, including intra-arterial chemotherapy, were increasingly being used. The above changes may contribute to the decreasing enucleation rate. Although no significant impact was identified on the mortality by the three eras, a decreasing trend was shown.
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Affiliation(s)
- Yingxiu Luo
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, R.J, X.F)
| | - Chuandi Zhou
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, R.J, X.F)
| | - Fanglin He
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, R.J, X.F)
| | - Jiayan Fan
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, R.J, X.F)
| | - Xuyang Wen
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, R.J, X.F)
| | - Yi Ding
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, R.J, X.F)
| | - Yanping Han
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, R.J, X.F)
| | - Jingwen Ding
- Department of Ophthalmology, Beijing Tongren Hospital (J.D)
| | - Mei Jin
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University (M.J, J.Z)
| | - Zhenyin Liu
- Department of Ophthalmology, Guangzhou Women and Children's Medical Center (Z.L, J.Z)
| | - Sha Wang
- Department of Ophthalmology, Central South University Xiangya School of Medicine (S.W, J.T)
| | - Minglei Han
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Department of Ophthalmology, Qilu Children's Hospital of Shandong University (M.H)
| | - Hongfeng Yuan
- Department of Ophthalmology, the First hospital Affiliated with AMU (H.Y)
| | - Hong Sun
- Department of Ophthalmology, Shandong Provincial Hospital (H.S)
| | - Yishuang Xiao
- Department of Ophthalmology, Kunming Children's Hospital (Y.X)
| | - Li Wu
- Department of Ophthalmology, Wuhan University Renmin Hospital (L.W)
| | - Jiancang Wang
- Department of Ophthalmology, Hebei Children's Hospital (J.W)
| | - Yangjun Li
- Department of Ophthalmology, Xi'an Tangdu Hospital of No.4 Military Medical University (Y.L)
| | - Huasheng Yang
- Zhongshan Ophthalmic Center, Sun Yat-sen University (H.Y)
| | - Jiawei Yu
- Department of Ophthalmology, Harbin Children's Hospital (J.Y)
| | - Jianyang Gong
- Ophthalmology of the First Affiliated Hospital Anhui Medical University (J.G)
| | - Yuxin Xu
- Department of Ophthalmology, the Second affiliated Hospital of Anhui Medical University (Y.X)
| | - Yuechun Wen
- Department of Ophthalmology, the Provincial Hospital Affiliated to Anhui Medical University (Y.W)
| | - Ziqing Gao
- Department of Ophthalmology, the First Affiliated Hospital of Bengbu Medical College (Z.G)
| | - Lixin Mei
- Department of Ophthalmogy, Yijishan Hospital, Wannan Medical College (L.M)
| | - Juan Ye
- Department of Ophthalmology, the Second Affiliated Hospital Zhejiang University School of Medicine (J.Y)
| | - Hu Liu
- Jiangsu Province Hospital (H.L)
| | - Zhijun Chen
- Children's Hospital of Nanjing Medical University (Z.C)
| | - Shangcai Xue
- Second Provincial People's Hospital of Gansu (S.X)
| | - Rong Liu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (R.L)
| | - Hong Chen
- Department of Ophthalmology, Union Hospital Affiliated with Tongji Medical College, Huazhong University of Science and Technology, Wuhan (H.C)
| | - Wei Lu
- Department of Ophthalmology, the Second Hospital of Dalian Medical University (W.L)
| | - Hongfei Liao
- Department of Ocular Trauma and Orbital Diseases, Affiliated Eye Hospital of Nanchang University (H.L)
| | - Qing Guo
- The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China (Q.G)
| | - Jizhe Cui
- The Second Hospital of Jilin University (J.C)
| | - Dan Zhu
- The Affiliated Hospital of Inner Mongolia Medical University (D.Z)
| | - Fang Lu
- West China Hospital, Sichuan University (F.L)
| | | | - Yu Wu
- People's Hospital of Guangxi Zhuang Autonomous Region (Y.W)
| | | | - Zhang Guanghong
- Beijing Road Clinical Department of Xinjiang Military Command General Hospital Urumqi (Z.G)
| | | | - Guo Huiyu
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University (G.H)
| | - Xian Wang
- The Affiliated Hospital of Guizhou Medical University (X.W)
| | - Yanjin He
- Tianjin medical university eye hospital (Y.H)
| | - Xunlun Sheng
- Ning Xia Eye Hospital, People's Hospital of Ningxia Hui Autonomous Region (X.S)
| | - Qing Wang
- Qinghai University Affiliated Hospital (Q.W)
| | - Jia Tan
- Department of Ophthalmology, Central South University Xiangya School of Medicine (S.W, J.T)
| | - Jianhong Liang
- Department of Ophthalmology, Peking University People's Hospital (J.L)
| | - Xiantao Sun
- Department of Ophthalmology, Henan Children's Hospital (X.S)
| | - Jing Zhang
- Department of Ophthalmology, Guangzhou Women and Children's Medical Center (Z.L, J.Z)
| | - Xunda Ji
- Department of Ophthalmology, Xinhua Hospital affiliated with Shanghai Jiaotong University School of Medicine (L.J)
| | - Liwen Jin
- Department of Ophthalmology, Quanzhou Women's and Children's Hospital (L.J)
| | - Junyang Zhao
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University (M.J, J.Z)
| | - Xinji Yang
- Department of Ophthalmology, The General Hospital of Chinese People's Armed Police Forces (X.Y)
| | - Renbing Jia
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, R.J, X.F)
| | - Xianqun Fan
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, R.J, X.F).
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20
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Kaliki S, Jakati S, Vempuluru VS, Mallu A, Mishra DK. Retinoblastoma associated with orbital pseudocellulitis and high-risk retinoblastoma: a study of 32 eyes. Int Ophthalmol 2021; 42:19-26. [PMID: 34363179 DOI: 10.1007/s10792-021-01993-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 05/11/2021] [Accepted: 07/24/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To study the correlation between retinoblastoma (RB) associated with orbital pseudocellulitis and high-risk histopathology features. METHODS Retrospective study of 32 patients who underwent primary enucleation for RB presenting with orbital pseudocellulitis. RESULTS All RB patients presented with orbital pseudocellulitis. The mean age at presentation of RB was 30 months (median, 24 months; range, 3-70 months). There were 14 (44%) males and 18 (56%) females. All patients were referred with a diagnosis of RB with orbital pseudocellulitis. Tumor was bilateral in 12 (38%) patients but orbital pseudocellulitis was unilateral in all cases. The pseudocellulitis features included proptosis (n = 9; 28%), eyelid edema (n = 22; 69%), conjunctival congestion (n = 23; 72%), and conjunctival chemosis (n = 15; 47%). Based on clinical features and orbital imaging, all patients were diagnosed to have group E intraocular RB. All patients received intravenous steroids prior to enucleation. On histopathology, tumor necrosis was present in all cases with a mean % necrosis of 60% (median, 60%; range, 10% to 90%). Most tumors (72%) were poorly differentiated. High-risk histopathology features were noted in 23 (72%) cases and adjuvant chemotherapy was advised for all these patients. The most common high-risk histopathology features included post-laminar optic nerve infiltration (34%) and scleral infiltration (22%). Over a mean follow-up period of 34 months (median, 9 months; range, < 1-188 months), there was no event of metastasis or death in any patient. CONCLUSION RB presenting with orbital pseudocellulitis is associated with high incidence of high-risk histopathology features.
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Affiliation(s)
- Swathi Kaliki
- The Operation Eyesight Universal Institute for Eye Cancer (SK, VSV, AM), L V Prasad Eye Institute, Hyderabad, 500034, India.
| | - Saumya Jakati
- Ophthalmic Pathology Laboratory (SJ, DKM), L V Prasad Eye Institute, Hyderabad, India
| | - Vijitha S Vempuluru
- The Operation Eyesight Universal Institute for Eye Cancer (SK, VSV, AM), L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Akhila Mallu
- The Operation Eyesight Universal Institute for Eye Cancer (SK, VSV, AM), L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Dilip K Mishra
- Ophthalmic Pathology Laboratory (SJ, DKM), L V Prasad Eye Institute, Hyderabad, India
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21
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Naser AY, Alrawashdeh HM, Alwafi H, Alyami HS, Dahmash EZ, Ghoul I, Shishtawi AA, Abdelwahab GM, Qadus S, Taybeh E, Abuthawabeh R, Hassanin F, Alhartani YJ, Alyami MH, Salawati EM, Alwan SS. Knowledge and awareness of the general population and healthcare providers about retinoblastoma: It is time to know the glow. Int J Clin Pract 2021; 75:e14298. [PMID: 33928718 DOI: 10.1111/ijcp.14298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 03/07/2021] [Accepted: 04/27/2021] [Indexed: 01/24/2023] Open
Abstract
Retinoblastoma is the most frequent primary intraocular tumour in childhood. Early detection of retinoblastoma is the key to successful management with a higher chance of survival. This study aims to assess the knowledge of the general population and healthcare providers about retinoblastoma in term of presentation, risk factors, timing for diagnosis, and complications. A cross-sectional study using an online survey was conducted in three Arab countries (Jordan, Saudi Arabia, and Iraq) between 28 August and 16 September 2020. The questionnaire tool was constructed based on an extensive literature review to explore the study's aim and objectives. Logistic regression was used to identify predictors of better knowledge about retinoblastoma. A total of 3676 participants were involved in the study (Jordan = 2654, Saudi Arabia = 604, and Iraq = 418). The average retinoblastoma knowledge score for the whole study population was 6.25 (SD = 4.12) out of 21, representing 29.8% (out of the maximum possible total score). Participants aged above 50 years old, married individuals, those with a secondary education level, those who work as professionals in industry, those who have more than four children, and those who reported that they were not in direct contact with a large number of children were less likely to be knowledgeable about retinoblastoma presentation, risk factors, the timing for diagnosis, and complications (P < .05). Early detection is the cornerstone for decreasing morbidity and mortality among children with retinoblastoma. However, the awareness and knowledge about retinoblastoma are very limited in our study population. Efforts should be directed at increasing awareness of both the general population and healthcare providers regarding retinoblastoma. Policymakers are responsible for improving knowledge and awareness about retinoblastoma to facilitate early detection of the disease by conducting awareness campaigns in addition to improve screening skills of healthcare providers and providing them with proper screening and diagnostic tools.
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Affiliation(s)
- Abdallah Y Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | | | - Hassan Alwafi
- Faculty of Medicine, Umm Alqura University, Mecca, Saudi Arabia
| | - Hamad S Alyami
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran, Saudi Arabia
| | - Eman Z Dahmash
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Imene Ghoul
- Paediatric Department, Ibn AL Haytham Hospital, Amman, Jordan
| | | | - Ghada Mohammad Abdelwahab
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Sami Qadus
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Esra' Taybeh
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Rasha Abuthawabeh
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Fadi Hassanin
- Ophthalmology Department, college of medicine, Jeddah University, Jeddah, Saudi Arabia
| | - Yosra J Alhartani
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Mohammad H Alyami
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran, Saudi Arabia
| | - Emad M Salawati
- Family medicine Department, Faculty of medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Salwan Salah Alwan
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
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22
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Mejía-Rodríguez F, Flores-Aldana ME, Quezada-Sánchez AD, Shamah-Levy T, Villalpando S, Contreras-Manzano A, Bhatt-Carreño S, Orjuela-Grimm M. Association between Predictors of Vitamin D Serum Levels and Risk of Retinoblastoma in Children: A Case-Control Study. Nutrients 2021; 13:nu13082510. [PMID: 34444670 PMCID: PMC8399960 DOI: 10.3390/nu13082510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/08/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND vitamin D (VD) may be a protective factor for retinoblastoma, though no temporal association has been reported during pregnancy or the child's first year of life. Serum VD concentrations are determined by both distal (DF) and proximal factors (PF). OBJECTIVE To identify if DF and PF can predict VD insufficiency (VDI) and VD deficiency (VDD) in women of childbearing age; and to test whether maternal exposure to DF and PF during pregnancy and a child's exposure during the first 11.9 months postpartum are associated with sporadic retinoblastoma (SRb) in children. METHODS This is a secondary analysis of data from the Epidemiology of SRb in Mexico (EpiRbMx) study and the National Health and Nutrition Survey 2018-2019 (ENSANUT 2018-2019, for its acronym in Spanish). The association of DF and PF with VDD or VDI was estimated using ENSANUT 2018-2019, and the association of DF and PF with SRb using EpiRbMx. All were estimated using logistic regression, with comparable samples selected from ENSANUT 2018-2019 and EpiRbMx. RESULTS Altitude, latitude and obesity predicted VDI and VDD in ENSANUT women. In EpiRbMx, residence in a rural location during pregnancy increased the risk of SRb. For children, rural residence and latitude increased the risk of SRb, while the number of days exposed to the spring-summer season during months 6 to 11.9 of life was protective. CONCLUSIONS risk of VDI and VDD in women (ENSANUT 2018-2019) increased with altitude, urban dwelling, overweight and obesity. The child and mother's place of residence, including altitude, latitude and rural classification were important predictors of SRb in EpiRbMx.
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Affiliation(s)
- Fabiola Mejía-Rodríguez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública-México, Cuernavaca 62230, Morelos, Mexico; (F.M.-R.); (S.V.); (A.C.-M.)
| | - Mario E. Flores-Aldana
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública-México, Cuernavaca 62230, Morelos, Mexico; (F.M.-R.); (S.V.); (A.C.-M.)
- Correspondence: ; Tel.: + 52-(777)-101-2900 (ext. 7451)
| | - Amado D. Quezada-Sánchez
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública-México, Cuernavaca 62230, Morelos, Mexico; (A.D.Q.-S.); (T.S.-L.)
| | - Teresa Shamah-Levy
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública-México, Cuernavaca 62230, Morelos, Mexico; (A.D.Q.-S.); (T.S.-L.)
| | - Salvador Villalpando
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública-México, Cuernavaca 62230, Morelos, Mexico; (F.M.-R.); (S.V.); (A.C.-M.)
| | - Alejandra Contreras-Manzano
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública-México, Cuernavaca 62230, Morelos, Mexico; (F.M.-R.); (S.V.); (A.C.-M.)
| | - Silvia Bhatt-Carreño
- Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY 10032, USA; (S.B.-C.); (M.O.-G.)
- Department of Pediatrics, Division of Oncology, Columbia University Medical Center, New York, NY 10032, USA
| | - Manuela Orjuela-Grimm
- Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY 10032, USA; (S.B.-C.); (M.O.-G.)
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23
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Roy SR, Kaliki S. Retinoblastoma: A Major Review. Mymensingh Med J 2021; 30:881-895. [PMID: 34226484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Retinoblastoma is the most common primary intraocular tumor with an incidence of 1: 16,000 to 18,000 live birth and represents 11% of cancer that develop in the first year of life. Retinoblastoma may be unilateral (60%) or bilateral (40%). Bilateral cases always heritable and median age of diagnosis is 1 year. Unilateral cases are mostly non heritable but 15% can be heritable and median age of presentation is 2 years. All children with heritable form carry mutation in RB1 gene. Though most frequent symptoms during diagnosis are leucocoria and strabismus, can present as most severe form in under developed countries. Diagnosis is made by fundus examination. Ultrasonography and imaging (CT, MRI) contribute both in diagnosis and assessment of extension of diseases. The aim of treatment is to save the child first, followed by globe and vision salvage. Treatment depends on laterality, size, location and extent of tumor. The main prognosis depends on early detection of tumor and treating the child by multidisciplinary team approach. Due to advancement in treatment modalities for the last two decade the survival rate of retinoblastoma has increased. But long term follow up is mandatory for retinoblastoma survivor as there is risk for development of second cancers in later life. Proper genetic screening and genetic counseling can help parents and patients in their adulthood to understand the disease properly.
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Affiliation(s)
- S R Roy
- Dr Soma Rani Roy, Resident Surgeon, Chittagong Eye Infirmary and Training Complex, Bangladesh; E-mail:
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Abstract
PURPOSE To review the authors' experience in the diagnosis of retinoblastoma and to explore the frequency of intraocular conditions that mimic this malignancy according to patient age at presentation. METHODS This was a retrospective observational study including 549 patients (769 eyes) who were referred for confirmation and/or management of retinoblastoma between October 1998 and June 2019 at a single tertiary center. A detailed ocular examination was done by the same ocular oncologist under general anesthesia for every patient. RESULTS Of 549 patients referred for diagnostic confirmation or management of retinoblastoma, 393 (71.6%) patients were found to have retinoblastoma and 156 (28.4%) patients received the diagnosis of pseudoretinoblastoma. The mean patient age at presentation was 52.1 months, ranging from 1 to 276 months. The most common diagnoses among patients with pseudoretinoblastoma younger than 1 year were persistent fetal vasculature (PFV) (n = 19; 28.8%), Coats disease (n = 7; 10.6%), chorioretinal coloboma (n = 4; 6.1%), retinal dysplasia (n = 4; 6.1%), and retinal detachment (n = 4; 6.1%). In patients with pseudoretinoblastoma who were 1 to 5 years old, the most common diagnoses were Coats disease (n = 10; 25.6%), PFV (n = 7; 17.9%), and optic disc hypoplasia (n = 3; 7.7%). Patients older than 5 years were most likely to have Coats disease (n = 8; 15.7%), optic disc drusen (n = 5; 9.8%), retinopathy of prematurity (n = 4; 7.8%), and combined hamartoma (n = 4; 7.8%). CONCLUSIONS This study shows that 28.4% of patients referred for suspicion or management of retinoblastoma were classified as having pseudoretinoblastoma. The most common conditions causing diagnostic confusion with retinoblastoma included PFV and Coats disease, similar to previous publications from both high-and low-income countries. [J Pediatr Ophthalmol Strabismus. 2021;58(3):161-167.].
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Raval V, DeBenedictis M, Bowen R, Soto H, Davanzo J, Singh A. Retinoblastoma in twins: Risk assessment of genotypic variants. Indian J Ophthalmol 2021; 69:1230-1233. [PMID: 33913866 PMCID: PMC8186642 DOI: 10.4103/ijo.ijo_2811_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/04/2020] [Accepted: 12/10/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To describe methods of risk assessment in twins with retinoblastoma (RB). Methods A case series of four RB probands with a twin sibling. Family status, clinical presentation, and RB1 germline status-based risk assessment were analyzed. Results Two pairs had a positive family history (unilateral and bilateral RB in one of the parents (#1 and #2, respectively) and two pairs (#3 and #4) were sporadic. One of the familial twins (#1) had a high risk (90%) of manifesting RB in the twin. The other case (#2) with an absent RB1 germline mutation in the twin had a 0% risk of developing RB. Among sporadic cases of twins (#3), genetic testing did not identify a germline mutation (tumor sample unavailable) in the proband which downgraded the risk of germline mutation from 15% to <1%. The twin never developed RB (5 years of age at last follow-up). Pathogenic mosaicism for germline RB1 mutation (c.1723C>T) could be identified (tumor tissue available) in the proband (# 4). Identical germline mutation (and RB tumor) was also noted in the twin. In each case, there was concordance between the assessed risk and manifestation of RB. Conclusion Assessment of risk of RB in a twin presents with a unique challenge. Depending upon the genotype variant, the risk of developing RB can vary from 0% to 90%. In addition to family history, clinical manifestation in the proband, zygosity status, and RB1 germline status are critical in formulating risk-appropriate surveillance guidelines.
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Affiliation(s)
- Vishal Raval
- Department of Ocular Oncology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | | | - Randy Bowen
- Department of Ocular Oncology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Hansell Soto
- Department of Ocular Oncology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Jacquelyn Davanzo
- Department of Ocular Oncology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Arun Singh
- Department of Ocular Oncology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Abstract
INTRODUCTION Limited data are available on the incidence of primary ophthalmic cancers worldwide. We describe the incidence and trends of primary ophthalmic cancers in Singapore. METHODS Data on ophthalmic cancers diagnosed in Singapore from 1996 to 2016 were retrieved from the Singapore Cancer Registry for analysis. All were histologically proven primary ophthalmic cancers. Calculations of incidence and age-specific frequency of ophthalmic malignancy were made. RESULTS A total of 297 cases were included, with males constituting 59.9%. The race distribution was 78.5% Chinese, 16.5% Malay, 3.7% Indians and 1.3% others. There was an overall increase in ophthalmic malignancies. The mean age of onset was 47.4 years. The most common cancers were retinoblastoma (93.3%) in patients younger than 15 years, and lymphoma (71.3%) in patients aged 15 years and older. There has been an increase in lymphomas from 16.7% in 1968-1995 to 71.3% in 1996-2016 in those aged 15 years and older. The most common types of ophthalmic cancer according to location are lymphoma of the orbit, conjunctiva, cornea and lacrimal gland; retinoblastoma of the retina; and malignant melanoma of the choroid and ciliary body. CONCLUSION Our study reported the incidence and trends of ophthalmic cancer in the Singapore population and showed an overall increase in ophthalmic malignancies in Singapore from 1996-2016. A substantial increase in lymphomas over the last 2 decades was noted. The data could aid clinicians, epidemiologists and policymakers in implementing strategies to address trends in ophthalmic cancers and spur aetiological research to improve quality of life in patients with such cancers.
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Affiliation(s)
- Chin Sheng Teoh
- Department of Ophthalmology, National University Hospital, Singapore
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Chou JF, Ford JS, Kleinerman RA, Abramson DH, Francis JH, Sklar CA, Oeffinger KC, Robison LL, Dunkel IJ, Friedman DN. General cancer screening practices among adult survivors of retinoblastoma: Results from the Retinoblastoma Survivor Study. Pediatr Blood Cancer 2021; 68:e28873. [PMID: 33501778 PMCID: PMC7904654 DOI: 10.1002/pbc.28873] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/02/2020] [Accepted: 12/12/2020] [Indexed: 11/07/2022]
Abstract
We assessed breast, cervical, and colorectal cancer screening practices in adult retinoblastoma (Rb) survivors and non-Rb controls. We found that most Rb survivors adhered to general population cancer screening recommendations. Rates did not differ among Rb survivors and non-Rb controls, or among survivors by laterality, even though bilateral survivors reported higher levels of concern about future health and cancer risk. Older age, being overweight/obese, and lack of recent contact with medical personnel were independently associated with decreased utilization of Pap smear among female Rb survivors. Future studies are warranted to determine whether these associations might provide an opportunity for intervention.
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Affiliation(s)
- Joanne F. Chou
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Jennifer S. Ford
- Hunter College, Department of Psychology and The Graduate Center, New York, NY United States
| | | | - David H. Abramson
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Weill Cornell Medical College, New York, NY, United States
| | - Jasmine H. Francis
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Weill Cornell Medical College, New York, NY, United States
| | - Charles A. Sklar
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Weill Cornell Medical College, New York, NY, United States
| | | | | | - Ira J. Dunkel
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Weill Cornell Medical College, New York, NY, United States
| | - Danielle Novetsky Friedman
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Weill Cornell Medical College, New York, NY, United States
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Abstract
OBJECTIVE Retinoblastoma is the most common primary intraocular tumor affecting children. We examine the role of parental occupational exposures and risk of retinoblastoma among offspring. METHODS Our population-based case-control study linked data from four nationwide Danish registries and included all cases of retinoblastoma diagnosed in Danish children (<5 y, n = 144) between 1975 and 2014. We focused on two biologically relevant time periods: 90 days preconception to conception for fathers; conception to birth for mothers. Parents were grouped into major industry headings created from Danish industry codes. RESULTS We observed increased risk of all retinoblastoma for children of fathers in the food and drink industry and iron and metal industry. Bilateral disease was associated with paternal work in manufacturing and land transportation. CONCLUSION Our results suggest that some occupational exposures may increase the risk of childhood sporadic retinoblastoma.
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Affiliation(s)
- Negar Omidakhsh
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
- Department of Environmental Health Sciences, School of Public Health, University of California, Los Angeles, CA, USA
| | - Anne L. Coleman
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
- Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Roberta McKean-Cowdin
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jorn Olsen
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Julia E. Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
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Zhao NO, Daewoo P, El-Hadad C, Debnam JM, Ning J, Esmaeli B. Characteristics and Survival Outcomes of Second Primary Cancers in Long-term Retinoblastoma Survivors. Asia Pac J Ophthalmol (Phila) 2021; 10:366-372. [PMID: 33481394 DOI: 10.1097/apo.0000000000000361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Retinoblastoma (RB) is the most common intraocular cancer and is associated with lifelong risks of developing a second primary cancer, especially in patients with hereditary RB and/or childhood exposure to radiotherapy. METHODS The study included all consecutive patients with a history of RB treated for a second primary cancer during 1994-2018. Patient demographics and characteristics of the primary RB and second primary cancer were examined. The associations among radiation or chemotherapy exposure as a treatment for RB, unilateral versus bilateral status, types and multiplicity of second primary cancers, and survival after diagnosis of second primary cancer were analyzed. RESULTS A wide spectrum of second primary cancer types was identified from 62 eligible patients (30 males and 32 females), including sarcoma, breast cancer, various skin cancers, gastrointestinal and genitourinary cancers, and endocrine cancers. Of all patients who had second primary cancers, 40 patients (65%) had bilateral RB and 17 patients (27%) had unilateral RB. Thirty-five patients (56%) who developed second primary cancers received radiation therapy during childhood as the treatment of RB, and 17 patients (27%) received chemotherapy for the treatment of RB. The 5-year and 10-year survival rates for RB patients diagnosed with a second primary cancer were 54.0% and 36.0%, respectively. The median age of onset of second primary cancer among RB survivors was 36.6 years. CONCLUSIONS In contrast to previous studies, we found a broader spectrum of second primary cancer types. All RB survivors, regardless of unilateral or bilateral status, should undergo strict cancer surveillance particularly as they approach the fourth decade of life.
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Affiliation(s)
- Ning O Zhao
- Orbital Oncology & Ophthalmic Plastic Surgery, Department of Plastic Surgery
| | | | - Christian El-Hadad
- Orbital Oncology & Ophthalmic Plastic Surgery, Department of Plastic Surgery
| | - James Matthew Debnam
- Department of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Bita Esmaeli
- Orbital Oncology & Ophthalmic Plastic Surgery, Department of Plastic Surgery
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Yang Z, Wang J, Zhu R. Identification of driver genes with aberrantly alternative splicing events in pediatric patients with retinoblastoma. Math Biosci Eng 2020; 18:328-338. [PMID: 33525094 DOI: 10.3934/mbe.2021017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Retinoblastoma (RB) is one of the most common cancer in children. However, the specific mechanism about RB tumorigenesis has not been fully understood. In this study, to comprehensively characterize the splicing alterations in the tumorigenesis of RB, we analyzed the differential alternative splicing events in RB. Specifically, the isoforms of RB1 were downregulated in the RB samples, and a large proportion of differentially expressed genes had multiple differentially expressed transcripts (64%). We identified 1453 genes with differential alternative splicing, among which, SE accounted for the majority, followed by MXE, RI, A3SS, and A5SS. Furthermore, the biological function related to the normal function of eyes, and E2F family TFs were significantly enriched by the genes with differential alternative splicing. Among the genes associated with visual sense, ABCA4 was found to have two mutually exclusive exons, resulting in two isoforms with different functionalities. Notably, DAZAP1 was identified as one of the critical splicing factors in RB, which was potentially involved in E2F and RB pathways. Functionally, differential binding sites in DAZAP1 protein were significantly observed between RB and normal samples. Based on the comprehensive analysis of the differential alternative splicing events and splicing factors, we identified some driver genes with differential alternative splicing and critical splicing factors involved in RB, which would greatly improve our understanding of the alternative splicing process in the tumorigenesis of RB.
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Affiliation(s)
- Zhenlei Yang
- Department of Ophthalmology, Heilongjiang Province Hospital, Heilongjiang 150036, China
| | - Jie Wang
- Department of Ophthalmology, Heilongjiang Province Hospital, Heilongjiang 150036, China
| | - Ruixi Zhu
- Department of Ophthalmology, Heilongjiang Province Hospital, Heilongjiang 150036, China
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Sankara P, Djiguimde WP, Ahnoux-Zabsonre A, Sanou J, Meda-Hien G, Diomande IA, Dolo-Traore M, Diallo JW, Bouda GC, Sidibe G. [Epidemio-clinical features of retinoblastoma at the Yalgado Ouedraogo University Hospital Center in Burkina Faso: about 32 cases]. Pan Afr Med J 2020; 37:269. [PMID: 33598083 PMCID: PMC7864263 DOI: 10.11604/pamj.2020.37.269.20556] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 02/03/2020] [Indexed: 11/11/2022] Open
Abstract
Retinoblastoma is the most common intraocular cancer of childhood. Its estimated incidence is 1 case per 15 000 to 18 000 births. The purpose of this study is to highlight the epidemiological and clinical features of this disease as well as its management in Burkina Faso. We conducted a retrospective study over a period of 5 years at the Yalgado Ouedraogo University Hospital Center. The average age of patients was 33 months, with predominance of male sex (68.75%). Exophthalmia was the most frequent reason for consultation (59.37%). The predominant pattern was unilateral (75%) associated with eye protrusion (59.38%). Chemotherapy associated with surgery was the treatment of choice, with a 5-year survival rate of 34.37%. Retinoblastoma is one of the most common cancers in children younger than 5 years. In our low-income country this disease is diagnosed late. Patients´ management is complex and is commonly associated with poor prognosis. Mortality and morbidity from this disease are disproportionate in our country facing a shortage of technical equipment. In our low-income country, patient´s management should be based on early detection of the disease as well as on adequate treatment.
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Affiliation(s)
- Paté Sankara
- Centre National de Lutte contre la Cécité, Ministère de la Santé, Ouagadougou, Burkina Faso
| | | | | | - Jérôme Sanou
- Service d´Ophtalmologie, Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - Gertrude Meda-Hien
- Service d´Ophtalmologie, Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - Ibrahim Abib Diomande
- Service d´Ophtalmologie, Centre Hospitalier Universitaire Bouaké, Université Alassane Ouattara, Bouaké, Côte d´Ivoire
| | - Mariam Dolo-Traore
- Service d´Ophtalmologie, Centre Hospitalier Universitaire Sourô Sanou, Bobo-Dioulasso, Burkina Faso
| | - Jean Wenceslas Diallo
- Service d´Ophtalmologie, Centre Hospitalier Universitaire Sourô Sanou, Bobo-Dioulasso, Burkina Faso
| | - Gabrielle Chantal Bouda
- Service de Pédiatrie, Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - Gaoussou Sidibe
- Service d´Ophtalmologie, Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso
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Ancona-Lezama D, Dalvin LA, Shields CL. Modern treatment of retinoblastoma: A 2020 review. Indian J Ophthalmol 2020; 68:2356-2365. [PMID: 33120616 PMCID: PMC7774148 DOI: 10.4103/ijo.ijo_721_20] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/23/2020] [Accepted: 07/07/2020] [Indexed: 12/23/2022] Open
Abstract
Retinoblastoma management remains complex, requiring individualized treatment based on International Classification of Retinoblastoma (ICRB) staging, germline mutation status, family psychosocial factors and cultural beliefs, and available institutional resources. For this 2020 retinoblastoma review, PubMed was searched for articles dated as early as 1931, with an emphasis on articles from 1990 to the present day, using keywords of retinoblastoma, chemotherapy, intravenous chemotherapy, chemoreduction, intra-arterial chemotherapy, ophthalmic artery chemosurgery, intravitreal chemotherapy, intracameral chemotherapy, cryotherapy, transpupillary thermotherapy, laser, radiation, external beam radiotherapy, plaque radiotherapy, brachytherapy, and enucleation. We discuss current treatment modalities as used in the year 2020, including intravenous chemotherapy (IVC), intra-arterial chemotherapy (IAC), intravitreal chemotherapy (IvitC), intracameral chemotherapy (IcamC), consolidation therapies (cryotherapy and transpupillary thermotherapy [TTT]), radiation-based therapies (external beam radiotherapy [EBRT] and plaque radiotherapy), and enucleation. Additionally, we present a consensus treatment algorithm based on the agreement of three North American retinoblastoma treatment centers, and encourage further collaboration amongst the world's most expert retinoblastoma treatment centers in order to develop consensus management plans and continue advancement in the identification and treatment of this childhood cancer.
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Affiliation(s)
- David Ancona-Lezama
- Ocular Oncology Service, Institute of Ophthalmology and Visual Sciences, Tecnologico de Monterrey, Mexico
| | - Lauren A Dalvin
- Department of Ophthalmology, Mayo Clinic, Rochester, MN, USA
| | - Carol L Shields
- Ocular Oncology Service Wills Eye Hospital, Philadelphia, PA, USA
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Tonorezos ES, Friedman DN, Barnea D, Bosscha MI, Chantada G, Dommering CJ, de Graaf P, Dunkel IJ, Fabius AWM, Francis JH, Greer MLC, Kleinerman RA, Kors WA, Laughlin S, Moll AC, Morton LM, Temming P, Tucker MA, van Leeuwen FE, Walsh MF, Oeffinger KC, Abramson DH. Recommendations for Long-Term Follow-up of Adults with Heritable Retinoblastoma. Ophthalmology 2020; 127:1549-1557. [PMID: 32422154 PMCID: PMC7606265 DOI: 10.1016/j.ophtha.2020.05.024] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 05/05/2020] [Accepted: 05/08/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE To generate recommendations for long-term follow-up of adult survivors of heritable retinoblastoma. DESIGN We convened a meeting of providers from retinoblastoma centers around the world to review the state of the science and to evaluate the published evidence. PARTICIPANTS Retinoblastoma is a rare childhood cancer of the retina. Approximately 40% of retinoblastoma cases are heritable, resulting from a germline mutation in RB1. Dramatic improvements in treatment and supportive care have resulted in a growing adult survivor population. However, survivors of heritable retinoblastoma have a significantly increased risk of subsequent malignant neoplasms, particularly bone and soft tissue sarcomas, uterine leiomyosarcoma, melanomas, and radiotherapy-related central nervous system tumors, which are associated with excess morbidity and mortality. Despite these risks, no surveillance recommendations for this population currently are in place, and surveillance practices vary widely by center. METHODS Following the Institute of Medicine procedure for clinical practice guideline development, a PubMed, EMBASE, and Web of Science search was performed, resulting in 139 articles; after abstract and full-text review, 37 articles underwent detailed data abstraction to quantify risk and evidence regarding surveillance, if available. During an in-person meeting, evidence was presented and discussed, resulting in consensus recommendations. MAIN OUTCOME MEASURES Diagnosis and mortality from subsequent neoplasm. RESULTS Although evidence for risk of subsequent neoplasm, especially sarcoma and melanoma, was significant, evidence supporting routine testing of asymptomatic survivors was not identified. Skin examination for melanoma and prompt evaluation of signs and symptoms of head and neck disease were determined to be prudent. CONCLUSIONS This review of the literature confirmed some of the common second cancers in retinoblastoma survivors but found little evidence for a benefit from currently available surveillance for these malignancies. Future research should incorporate international partners, patients, and family members.
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Affiliation(s)
- Emily S Tonorezos
- Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York.
| | | | - Dana Barnea
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | | | | | - Pim de Graaf
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ira J Dunkel
- Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York
| | - Armida W M Fabius
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | | | | | - Ruth A Kleinerman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Wijnanda A Kors
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Suzanne Laughlin
- Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Annette C Moll
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Lindsay M Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | | | - Margaret A Tucker
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | | | | | | | - David H Abramson
- Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York
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Gregersen PA, Olsen MH, Urbak SF, Funding M, Dalton SO, Overgaard J, Alsner J. Incidence and Mortality of Second Primary Cancers in Danish Patients With Retinoblastoma, 1943-2013. JAMA Netw Open 2020; 3:e2022126. [PMID: 33090227 PMCID: PMC7582127 DOI: 10.1001/jamanetworkopen.2020.22126] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
IMPORTANCE In heritable retinoblastoma, there is a significantly increased risk of second primary cancers (SPCs). Improved knowledge about the incidence and influence of heritability and treatment is important during therapy for patients with retinoblastoma. OBJECTIVE To assess the incidence of SPC in patients diagnosed with retinoblastoma in Denmark from 1943 to 2013 with a focus on heritability and the association of external radiotherapy with mortality. DESIGN, SETTING, AND PARTICIPANTS In this retrospective cohort study, data were extracted from the Danish Ocular Oncology Group Database containing complete data on all patients diagnosed with retinoblastoma , and obtained from the Danish Cancer Registry, which includes information on all patients with cancer from 1943 to December 31, 2013. Data analysis was conducted from December 1, 2017, to October 1, 2019. Data on 323 patients were included. EXPOSURES Heritability and retinoblastoma treatment. MAIN OUTCOMES AND MEASURES Standardized incidence rate, excess absolute risk, cumulative incidence of SPC, and mortality from SPC. Association of heritability and treatment with outcomes was estimated. RESULTS Of the 323 patients included in the analysis, 181 were men (56%), 133 had heritable retinoblastoma (41%), and 190 had nonheritable retinoblastoma (59%). The median age at diagnosis of SPC was 32.4 (interquartile range, 15.4-43.9) years in patients with heritable retinoblastoma and 38.6 (interquartile range, 20.5-49.4) years in those with nonheritable retinoblastoma. Twenty-five SPCs were identified in patients with heritable retinoblastoma vs 14 in patients with nonheritable retinoblastoma. Standardized incidence rate (SIR) of SPC in patients with heritable retinoblastoma was 11.39 (95% CI, 7.37-16.81) with an excess absolute risk of 70 cases per 10 000 person-years; the highest SIRs were for sarcoma (181.13; 95% CI, 98.94-303.92) and malignant melanoma (26.78; 95% CI, 9.78-58.30). The SIR for SPC in patients with nonheritable retinoblastoma was 1.52 (95% CI, 0.81-2.60). The cumulative incidence of SPCs at age 60 years was significantly higher in patients with heritable retinoblastoma (51%) compared with those with nonheritable retinoblastoma (13%) (P < .001) (hazard ratio, 5.0; 95% CI, 2.5-10.3). No significant differences were identified in overall risk of SPC in patients with heritable retinoblastoma treated with 3 different modalities: external radiotherapy, plaque (but no external) radiotherapy, and enucleation only, but an increased proportion of sarcomas was noted in the irradiated field. Mortality due to SPC was also higher in survivors of heritable retinoblastoma compared with those with nonheritable retinoblastoma (cumulative mortality, 34% vs 12% at age 60 years; P = .03). CONCLUSIONS AND RELEVANCE The findings of this study suggest that the incidence and mortality associated with SPC were significantly higher in patients with heritable retinoblastoma vs patients with nonheritable retinoblastoma. The largest increases in risk were noted for sarcoma and malignant melanoma. External radiotherapy did not appear to increase the risk. These findings are relevant when treating patients with retinoblastoma to manage the risk for SPC.
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Affiliation(s)
- Pernille A. Gregersen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
- Center for Rare Disorders, Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Maja H. Olsen
- Unit of Survivorship, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Steen F. Urbak
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Mikkel Funding
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Susanne O. Dalton
- Unit of Survivorship, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Naestved, Denmark
| | - Jens Overgaard
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Jan Alsner
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
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Affiliation(s)
- Haran Ratna
- Internal Medicine Department, Elmhurst Hospital Center, Elmhurst, New York
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Dalvin LA, Bas Z, Tadepalli S, Rao R, Vaidya S, Pacheco R, Shields CL. Risk Factors for Tumor Recurrence Following Primary Intravenous Chemotherapy (Chemoreduction) for Retinoblastoma in 869 Eyes of 551 Patients. J Pediatr Ophthalmol Strabismus 2020; 57:224-234. [PMID: 32687206 DOI: 10.3928/01913913-20200417-01] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 02/23/2020] [Accepted: 03/30/2020] [Indexed: 02/04/2023]
Abstract
PURPOSE To identify risk factors for retinoblastoma recurrence following chemoreduction. METHODS This was a retrospective review of patients with retinoblastoma treated from 1994 to 2019 using chemoreduction with analysis for recurrence using Kaplan-Meier, Cox regression, and logistic regression. RESULTS There were 869 eyes of 551 patients with retinoblastoma treated with chemoreduction. Follow-up in 556 eyes revealed main solid tumor recurrence (n = 355, 64%), subretinal seed recurrence (n = 244, 44%), vitreous seed recurrence (n = 162, 29%), and/or new tumor (n = 118, 21%) requiring management with focal therapy (transpupillary thermotherapy, cryotherapy) (n = 294, 53%), intra-arterial chemotherapy (n = 125, 22%), intravitreal chemotherapy (n = 36, 6%), plaque radiotherapy (n = 120, 22%), external beam radiotherapy (n = 57, 10%), and/or enucleation (n = 49, 9%). Of all recurrences, 62% were detected by 1 year, 86% by 2 years, 94% by 3 years, 98% by 5 years, 99% by 10 years, and 100% by 15 years. Risk factors for recurrence on multivariate analysis included younger patient age at presentation (odds ratio [OR] = 1.02 [1.00 to 1.04] per 1 month decrease, P = .02), greater International Classification of Retinoblastoma group (OR = 1.24 [1.05 to 1.47] per 1 more advanced group, P = .01), shorter tumor distance to optic disc (OR = 1.11 [1.01 to 1.21] per 1 mm decrease, P = .03), and presence of subretinal seeds (OR = 1.66 [1.09 to 2.53], P = .02). CONCLUSIONS Retinoblastoma recurrence after chemoreduction is usually detected within the first 3 years following treatment. Younger patients with more advanced, posteriorly located tumors and subretinal seeds at presentation are at increased risk, but recurrence can often be managed with globe-sparing therapy. [J Pediatr Ophthalmol Strabismus. 2020;57(4):224-234.].
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Kleinerman RA, Tucker MA, Sigel BS, Abramson DH, Seddon JM, Morton LM. Patterns of Cause-Specific Mortality Among 2053 Survivors of Retinoblastoma, 1914-2016. J Natl Cancer Inst 2020; 111:961-969. [PMID: 30698734 DOI: 10.1093/jnci/djy227] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/22/2018] [Accepted: 12/05/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Previous studies of hereditary retinoblastoma survivors have reported elevated mortality, particularly for sarcomas, compared with the general population. However, cause-specific mortality patterns for long-term hereditary and nonhereditary retinoblastoma survivors are poorly understood. METHODS Among 2053 retinoblastoma patients diagnosed during 1914-2006 at two major US treatment centers and followed to 2016, we estimated cumulative mortality, standardized mortality ratios (SMRs), and absolute excess risks (AERs) compared with the US general population. RESULTS Most deaths occurred in 1129 hereditary retinoblastoma patients (n = 518 deaths, cumulative mortality 70 years after retinoblastoma = 75.8%, 95% CI = 69.0% to 82.6%; SMR = 8.5, 95% CI = 7.7 to 9.2). Of these, 267 were due to subsequent cancers (SMR = 27.4, 95% CI = 24.2 to 30.9; AER = 72.3 deaths/10 000 person-years), for which SMRs were highest 15-29 years after diagnosis (n = 69, SMR = 89.9, 95% CI = 70.0 to 113.8) but remained statistically significantly elevated at 60 and more years (n = 14, SMR = 6.7, 95% CI = 3.6 to 11.2), whereas AERs increased with time (AER<15years = 38.0; AER60+years = 327.5). Increased risk of death due to cancers of pancreas, large intestines, and kidney were noted for the first time. Overall risk of subsequent cancers was greater for those treated with radiotherapy and chemotherapy compared to radiotherapy alone, although patterns varied by organ site. For 924 patients with nonhereditary retinoblastoma, we noted a modestly increased risk of death for subsequent cancers (n = 27, SMR = 1.8, 95% CI = 1.2 to 2.6) possibly due to treatment or misclassification of hereditary status. Risks of noncancer causes of death were not elevated for hereditary or nonhereditary patients. CONCLUSION Hereditary retinoblastoma survivors died mainly from an excess risk of subsequent cancers up to six decades later, highlighting the need to develop long-term clinical management guidelines for hereditary retinoblastoma survivors treated in the past.
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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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Flegg K, Gelkopf MJ, Johnson SA, Dimaras H. The top 10 retinoblastoma research priorities in Canada as determined by patients, clinicians and researchers: a patient-oriented priority-setting partnership. CMAJ Open 2020; 8:E420-E428. [PMID: 32518094 PMCID: PMC7286623 DOI: 10.9778/cmajo.20190221] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Retinoblastoma is a childhood cancer of the eye that can have lifelong effects on patients and families. The purpose of this study was for people affected by retinoblastoma, clinicians and researchers to jointly determine the top 10 retinoblastoma research priorities in Canada. METHODS An adaptation of the James Lind Alliance Priority Setting Partnership (PSP) methodology was employed. People were invited to participate in any stage of the priority-setting process if they were a resident of Canada, and were a patient with retinoblastoma (or a family member or friend of someone diagnosed with retinoblastoma) or a clinician or researcher interested in retinoblastoma. Patients were full partners in study design and implementation, and result dissemination, through involvement in a national working group (1 patient and 9 nonpatients) and steering committee (4 patients and 11 nonpatients). In phase 1 of the study, participants responded to an online survey that asked, "What questions about retinoblastoma would you like to see answered by research?" In phase 2, the steering committee reviewed and refined the list of survey responses and decided on a list of 30 questions to be ranked by means of the nominal group technique in phase 3, a priority-setting workshop. RESULTS In total, 175 retinoblastoma research questions were suggested by 59 survey participants (38 patients and 21 nonpatients). The categories with the greatest number of questions were genetics and molecular (45 [25.7%]), second cancer (29 [16.6%]) and psychosocial (27 [15.4%]). The top 10 questions as ranked by the workshop participants (10 patients and 10 nonpatients) fell into 7 categories: second cancer (2 questions), follow-up (2), psychosocial (2), treatment (1), diagnosis (1), global health (1) and miscellaneous (1). The early diagnosis of retinoblastoma was identified as the top retinoblastoma research priority in Canada. INTERPRETATION The list of priorities will serve as a resource for advocacy groups, research teams and funding agencies that focus on retinoblastoma. The inclusion of researchers as participants was an adaptation of the James Lind Alliance PSP methodology and enriched the research prioritization process.
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Affiliation(s)
- Kaitlyn Flegg
- Department of Ophthalmology and Vision Sciences (Flegg, Gelkopf, Dimaras), The Hospital for Sick Children, Toronto, Ont.; Department of Neuroscience (Johnson), Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, Fla.; Department of Ophthalmology and Vision Sciences (Dimaras), Faculty of Medicine, and Division of Clinical Public Health (Dimaras), Dalla Lana School of Public Health, University of Toronto; Child Health Evaluative Sciences Program (Dimaras) and Centre for Global Child Health (Dimaras), SickKids Research Institute, Toronto, Ont
| | - Maxwell J Gelkopf
- Department of Ophthalmology and Vision Sciences (Flegg, Gelkopf, Dimaras), The Hospital for Sick Children, Toronto, Ont.; Department of Neuroscience (Johnson), Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, Fla.; Department of Ophthalmology and Vision Sciences (Dimaras), Faculty of Medicine, and Division of Clinical Public Health (Dimaras), Dalla Lana School of Public Health, University of Toronto; Child Health Evaluative Sciences Program (Dimaras) and Centre for Global Child Health (Dimaras), SickKids Research Institute, Toronto, Ont
| | - Sarah A Johnson
- Department of Ophthalmology and Vision Sciences (Flegg, Gelkopf, Dimaras), The Hospital for Sick Children, Toronto, Ont.; Department of Neuroscience (Johnson), Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, Fla.; Department of Ophthalmology and Vision Sciences (Dimaras), Faculty of Medicine, and Division of Clinical Public Health (Dimaras), Dalla Lana School of Public Health, University of Toronto; Child Health Evaluative Sciences Program (Dimaras) and Centre for Global Child Health (Dimaras), SickKids Research Institute, Toronto, Ont
| | - Helen Dimaras
- Department of Ophthalmology and Vision Sciences (Flegg, Gelkopf, Dimaras), The Hospital for Sick Children, Toronto, Ont.; Department of Neuroscience (Johnson), Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, Fla.; Department of Ophthalmology and Vision Sciences (Dimaras), Faculty of Medicine, and Division of Clinical Public Health (Dimaras), Dalla Lana School of Public Health, University of Toronto; Child Health Evaluative Sciences Program (Dimaras) and Centre for Global Child Health (Dimaras), SickKids Research Institute, Toronto, Ont.
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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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Mian LS, Aqil A, Abid K, Moin M. Outcome of interventional treatment modalities for retinoblastoma: Experience at a tertiary care centre in Pakistan. J PAK MED ASSOC 2019; 69:1039-1043. [PMID: 31983743] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Retinoblastoma is the most common intra-ocular malignancy found in children in their infancy. Originating from the retinal cells, the disease has a significant association with mortality and morbidity. A case series study was conducted at the Lahore General Hospital eye department, from November 2016 to January 2018. Nineteen children having retinoblastoma in 19 eyes were included in the study. The retinoblastoma-affected eyes were classified according to the International Classification of Retinoblastoma (ICRB). Treatments assigned were based on the severity of the disease, monetary allowance and intervention availability. The treatment modalities employed were chemo-reduction, Ophthalmic artery chemosurgery (OAC), Intravitreal Melphalan, Cryotherapy and laser photocoagulation. To measure the outcome, the follow up period was between 6 to 12 months. The primary outcome measures among the majority of the patients were regres sion or obliteration of the tumour. Failure of treatments were also recorded which included progression of the malignancy requiring enucleation. This study concludes that the newer modalities such as OAC and Intravitreal Melphalan have shown promising results for tumour regression, leading to vision salvation, even at higher grades of ICRB.
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Affiliation(s)
| | | | - Khadijah Abid
- College of Physicians and Surgeons of Pakistan, Karachi
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Rojanaporn D, Chanthanaphak E, Boonyaopas R, Sujirakul T, Hongeng S, Ayudhaya SSN. Intra-Arterial Chemotherapy for Retinoblastoma: 8-Year Experience from a Tertiary Referral Institute in Thailand. Asia Pac J Ophthalmol (Phila) 2019; 8:211-217. [PMID: 30714357 DOI: 10.22608/apo.2018294] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To study the safety and efficacy of intra-arterial chemotherapy (IAC) as a treatment for intraocular retinoblastoma in Thailand. DESIGN Retrospective, interventional case series. METHODS In this study, IAC was performed as primary or secondary treatment for patients with intraocular retinoblastoma using melphalan with or without additional topotecan or carboplatin. Survival rate, globe salvage rate, and treatment complications were recorded and analyzed. RESULTS Of 27 eyes of 26 patients with retinoblastoma, 7 (26%) had IAC as primary treatment and 20 (74%) had IAC as secondary treatment. The eyes were classified by International Classification of Retinoblastoma (ICRB) as group B (n = 3, 11%), group C (n = 1, 4%), group D (n = 12, 44%), and group E (n = 11, 41%). Catheterization was successful in 75 (94%) of 80 sessions. The median number of IAC sessions was 3 (range, 1-7). At a mean follow-up of 32 months (range, 3-95 months), the overall globe salvage rate was 52%, with 100% in groups B and C, 75% in group D, and 9% in group E. Complications of IAC included occlusive vasculopathy (n = 4, 15%), vitreous hemorrhage (n = 3, 11%), retinal artery precipitation (n = 2, 7%), strabismus (n = 2, 7%), and transient ischemic attack (n = 1, 4%). The overall survival rate was 96% (n = 25). CONCLUSIONS Our experience suggests that IAC is a safe and effective treatment for patients with ICRB group B, C, D, and some group E retinoblastoma. Careful patient selection and experienced surgeons are critical for achieving the best treatment outcome.
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Affiliation(s)
- Duangnate Rojanaporn
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Ekachat Chanthanaphak
- Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Rawi Boonyaopas
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tharikarn Sujirakul
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suradej Hongeng
- Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Darwich R, Ghazawi FM, Rahme E, Alghazawi N, Burnier JV, Sasseville D, Burnier MN, Litvinov IV. Retinoblastoma Incidence Trends in Canada: A National Comprehensive Population-Based Study. J Pediatr Ophthalmol Strabismus 2019; 56:124-130. [PMID: 30889267 DOI: 10.3928/01913913-20190128-02] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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: 09/20/2018] [Accepted: 01/07/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine the incidence rates and geographic distribution of retinoblastoma in Canada to aid cancer control programs. METHODS Patients with retinoblastoma whose data were available from the Canadian Cancer Registry (CCR) and Le Registre Québécois du Cancer (LRQC) were studied. Using third edition International Classification of Diseases for Oncology (ICD-O) codes, the authors examined the incidence rates and geographic distribution of patients with retinoblastoma between 1992 and 2010. Patient data including sex, age, and laterality of the retinoblastoma were analyzed. RESULTS Between 1992 and 2010 in Canada, the average annual incidence rate of retinoblastoma was 11.58 cases per 1 million children younger than 5 years (95% CI [confidence interval]: 10.48 to 12.76). The incidence rate was stable over time, with an average age at diagnosis of 2.30 ± 6.85 years and no gender predilection. The laterality of the reported cases was 81.48% for uni-lateral cases and 18.52% for bilateral cases. Provincially, Nova Scotia had twice the national average and the highest incidence rates of retinoblastoma across the Canadian provinces. CONCLUSIONS This is the first study to define the disease burden of retinoblastoma and to highlight important longitudinal, geographic, and spatial differences in the distribution of retinoblastoma in Canada between 1992 and 2010. The results of this study indicate continuity of clinical trends between Canada, the United States, and other developed countries. [J Pediatr Ophthalmol Strabismus. 2019;56(2):124-130.].
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Parrilla-Vallejo M, Perea-Pérez R, Relimpio-López I, Montero-de-Espinosa I, Rodríguez-de-la-Rúa E, Terrón-León JA, Díaz-Granda MJ, Coca-Gutiérrez L, Ponte-Zuñiga B, Espejo-Arjona F. Retinoblastoma: The importance of early diagnosis. Arch Soc Esp Oftalmol (Engl Ed) 2018; 93:423-430. [PMID: 29954624 DOI: 10.1016/j.oftal.2018.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 04/08/2018] [Accepted: 04/30/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Retinoblastoma is the most frequent malignant intraocular tumour in childhood, and both its cure and the sequelae arising from it, mainly depend on an early diagnosis. There is currently no consensus on its diagnostic and therapeutic management. PATIENTS AND METHODS A descriptive, retrospective, and non-randomised study was conducted on a series of cases (39 patients -58 eyes), treated during the period 2006-2013, in the Regional Reference Centre for Tumours of the National Health Service Quality Agency. RESULTS The most frequent presentation sign is leukocoria (71.8%), followed by strabismus (17.9%). All cases of bilateral tumour had a germline mutation of the RB1 gene, and 20% had a family history. Stage E was observed in 55% of the patients, and 90% required chemotherapy treatment. The eye was maintained in 57% of those who had mild stages, compared to 43% who maintained it in advanced stages. CONCLUSIONS This analysis included 58 eyes. There are no previous studies in our community and there are few series so numerous throughout the country. Based on non-standardised treatment, the most appropriate is chosen according to the characteristics of the tumour. The multidisciplinary management, formed by ophthalmology, paediatric oncology, radiotherapy, and radiophysical oncology, is fundamental for the selection of the most appropriate treatment. Chemo-reduction, along with consolidation treatments, offers encouraging results in the control of these tumours, especially in those of less severity. Enucleation continues to be the method of choice in the most advanced staging with vitreous involvement, with the importance of early diagnosis being highlighted.
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Affiliation(s)
| | - R Perea-Pérez
- Oftalmología, Hospital Universitario Virgen Macarena, Sevilla, España.
| | - I Relimpio-López
- Oftalmología, Hospital Universitario Virgen Macarena, Sevilla, España
| | | | | | - J A Terrón-León
- Oncología radioterápica, Hospital Universitario Virgen Macarena, Sevilla, España
| | - M J Díaz-Granda
- Oftalmología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - L Coca-Gutiérrez
- Oftalmología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - B Ponte-Zuñiga
- Oftalmología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - F Espejo-Arjona
- Oftalmología, Hospital Universitario Virgen Macarena, Sevilla, España
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Akella SS, Francis JH, Knezevic A, Ostrovnaya I, Gobin YP, Friedman D, Guarini E, Eibeler L, Catalanotti F, Abramson DH. Growth patterns of survivors of retinoblastoma treated with ophthalmic artery chemosurgery. PLoS One 2018; 13:e0197052. [PMID: 29734385 PMCID: PMC5937785 DOI: 10.1371/journal.pone.0197052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 04/25/2018] [Indexed: 12/31/2022] Open
Abstract
Although studies from pediatric cancers (largely acute lymphoblastic leukemia) have shown that patients undergoing systemic chemotherapy may experience decreased growth velocity during the treatment phase, no such data exist for retinoblastoma patients treated with systemic chemotherapy or ophthalmic artery chemosurgery (OAC). The purpose of this study is to report growth patterns of our retinoblastoma (Rb) population who were treated with OAC in a retrospective, single center (Memorial Sloan Kettering Cancer Center) review of 341 patients treated between 2006 and 2016. Children who only received OAC were classified as naive; those who were treated initially with systemic chemotherapy and subsequently presented to our center for OAC were termed secondary; and a small group of patients who received single-agent systemic chemotherapy prior to OAC were labeled bridge. For all patients, height and weight were recorded at monthly intervals during OAC (short-term) and then annually during a follow-up period (long-term) up to 3 years after treatment. Excluded from this study were children who received external radiation therapy and those with genetic syndromes, which are independently associated with growth derangements. During OAC, there was no significant difference in growth velocity between the naïve and secondary groups. In either group, number of treatments also did not affect growth rate. Three years after the end of OAC, naïve patients were in the 68th percentile by height (95% CI 61.30, 74.63) compared to secondary patients in the 61st percentile (95% CI 51.1, 71.47). Both groups were in the same weight percentiles during the first two years of follow-up but at the three-year follow-up period, naïve patients were in the 63rd percentile (95% CI 57.4, 69.4) and secondary patients were in the 60th percentile (95% CI 50.4, 69.7). OAC for retinoblastoma does not appear to impact short-term growth velocity, weight gain during the treatment period or after three years.
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Affiliation(s)
- Sruti S. Akella
- Transitional Year Intern, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
- * E-mail:
| | - Jasmine H. Francis
- Department of Surgery, Ophthalmic Oncology Service Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
- Department of Ophthalmology, Weill-Cornell School of Medicine, New York, New York, United States of America
| | - Andrea Knezevic
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Irina Ostrovnaya
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Y. Pierre Gobin
- Department of Radiology and Neurosurgery, New York Presbyterian Hospital, New York, New York, United States of America
| | - Danielle Friedman
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Edith Guarini
- Department of Surgery, Ophthalmic Oncology Service Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Lindsey Eibeler
- Department of Surgery, Ophthalmic Oncology Service Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Federica Catalanotti
- Department of Surgery, Ophthalmic Oncology Service Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - David H. Abramson
- Department of Surgery, Ophthalmic Oncology Service Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
- Department of Ophthalmology, Weill-Cornell School of Medicine, New York, New York, United States of America
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Fernandes AG, Pollock BD, Rabito FA. Retinoblastoma in the United States: A 40-Year Incidence and Survival Analysis. J Pediatr Ophthalmol Strabismus 2018; 55:182-188. [PMID: 29257183 DOI: 10.3928/01913913-20171116-03] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [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: 04/09/2017] [Accepted: 08/24/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine the incidence of retinoblastoma in the United States from 1973 to 2012 (40 years) and characterize the 5-year overall survival rate of the included patients. METHODS Cases of retinoblastoma were derived from the Surveillance, Epidemiology, and End Results (SEER) Program (National Cancer Institute, Rockville, MD). Incidence rates were calculated using U.S. Census Bureau data as the standard population, and trends over time were determined using the chi-square test. Hazard ratios with a 95% confidence interval (CI) were estimated for variables associated with mortality using Cox regression models. Survival rates were calculated using the Kaplan-Meier method and compared among different clinical and demographic categories. RESULTS A total of 879 cases of retinoblastoma were derived from the SEER databases. The annual incidence rates of retinoblastoma for a period of 40 years were 12.14 (95% CI: 11.32 to 12.96) cases per 1 million children 4 years or younger and 0.49 (95% CI: 0.36 to 0.65) cases per 1 million children between the ages of 5 and 9 years. There was no significant trend for children 4 years or younger (P = .6324) or between the ages of 5 and 9 years (P = .7695). The 5-year overall survival rates were 97.6%, 92.7%, 91.1%, and 96.4% for children diagnosed at the first, second, third, and after the third year of life, respectively (P = .0136). The 5-year overall survival rates were 92.5% for bilateral and 96.3% for unilateral cases (P = .0116). The 5-year overall survival rates were 90.8%, 92.5%, 97.6%, 97.3% for increasing time intervals (1973 to 1979, 1980 to 1989, 1990 to 1999, and 2000 to 2012, respectively; P = .0017). CONCLUSIONS The incidence rate of retinoblastoma in the United States has remained stable for the past 40 years. Survival rate analysis indicates a significant effect of laterality of tumor, age at diagnosis, and decade of diagnosis. [J Pediatr Ophthalmol Strabismus. 2018;55(3):182-188.].
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Essuman VA, Braimah IZ, Ndanu TA, Ntim-Amponsah CT. Presentation of children with advanced retinoblastoma for treatment in Ghana: the caretakers' perspectives. West Afr J Med 2018; 35:9-14. [PMID: 29607471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Retinoblastoma, the commonest childhood malignant intraocular tumour, is diagnosed late, with less than 50% survival in developing countries, including Ghana. OBJECTIVES To determine, from caretakers' perspective, contributing factors to late presentation of children with retinoblastoma. METHODS A cross-sectional study involving questionnaire administration to consenting caretakers of consecutive children diagnosed with advanced retinoblastoma at the Eye Unit, Korle-Bu Teaching Hospital, Accra, Ghana, from September 2008-June 2011. Clinical diagnosis was confirmed by CT scan or ultrasonography. Ethical approval was granted by University of Ghana Medical School. RESULTS Forty caretakers aged 22-58 years (mean = 32.8 ± 7.8yrs) were interviewed. Twenty-four (60%) were females, 36(90%) were parents. Thirty-two (80%) had at least primary level of education. Initial symptoms noticed by caretakers were: white spot 35(87.5%), redness 3(7.5%), proptosis 1(2.5%) and squint 1(2.5%). Thirty-five caretakers (87.5%) sought prior treatment between 1-24 months (median=1month) and 7(37%) beyond 3months, mainly from health/eye centres 34(85%). Six caretakers (15.4%) knew their children had cancer, 11(27.5%) had heard about retinoblastoma, but only 2(5.0%) knew treatment existed. Thirty-two caretakers (80%) would accept enucleation with prosthesis and 17(42.5%) without it. Cost: 8(20% respondents) and lack of awareness of prognosis of retinoblastoma 12(30% respondents) were stated as important factors though they did not prove significant. Caretakers' level of education, occupation and gender had no significant association with knowledge about retinoblastoma, awareness of treatment or cure, acceptance of enucleation with or without prosthesis, nor awareness of prognosis without treatment, p>0.05. CONCLUSION Low awareness of the cause, treatment and prognosis of retinoblastoma exists among caretakers of children with advanced retinoblastoma. This may contribute to the late stage of the disease presentation.
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Affiliation(s)
- V A Essuman
- Ophthalmology Unit, Department of Surgery, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
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Moschos MM. From Fungus haematodes to Retinoblastoma. J BUON 2017; 22:1599-1602. [PMID: 29332360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Retinoblastoma is probably the only disease which received 40 different names until its official terminology which was adopted by the medical community in 1926. The official record of retinoblastoma was reported in 1597 by Petrus Pawius (ca. 1564-1617). The development of pathology during the 19th century gave to opportunity to clarify the histological characteristics of the disease. Although in the past retinoblastoma was considered a fatal disease, nowadays with modern treatment the prognosis is better.
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Affiliation(s)
- Marilita M Moschos
- 1st Department of Ophthalmology, Medical School, University of Athens, Athens, Greece
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Abstract
Retinoblastoma (RB) is an embryonic tumor originating from the retinal cells. RB is the most common intraocular cancer of childhood and accounts for 4% of all pediatric malignancies.
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