A Multicenter, International Collaborative Study for American Joint Committee on Cancer Staging of Retinoblastoma Part I: Metastasis-Associated Mortality
Por:
Tomar AS, Finger PT, Gallie B, Mallipatna A, Kivelä TT, Zhang C, Zhao J, Wilson MW, Kim J, Khetan V, Ganesan S, Yarovoy A, Yarovaya V, Kotova E, Yousef YA, Nummi K, Ushakova TL, Yugay OV, Polyakov VG, Ramirez-Ortiz MA, Esparza-Aguiar E, Chantada G, Schaiquevich P, Fandino A, Yam JC, Lau WW, Lam CP, Sharwood P, Moorthy S, Long QB, Essuman VA, Renner LA, Català-Mora J, Correa-Llano G and American Joint Committee on Cancer Ophthalmic Oncology Task Force
Publicada:
1 dic 2020
Ahead of Print:
6 jun 2020
Categoría:
Ophthalmology
Resumen:
Purpose: To evaluate the ability of the 8th edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual to estimate metastatic and mortality rates for children with retinoblastoma (RB).
Design: International, multicenter, registry-based retrospective case series.
Participants: A total of 2190 patients from 18 ophthalmic oncology centers from 13 countries over 6 continents.
Methods: Patient-specific data fields for RB were designed and selected by subcommittee. All patients with RB with adequate records to allow tumor staging by the AJCC criteria and follow-up for metastatic disease were studied.
Main Outcome Measures: Metastasis-related 5- and 10-year survival data after initial tumor staging were estimated with the KaplaneMeier method depending on AJCC clinical (cTNM) and pathological (pTNM) tumor, node, metastasis category and age, tumor laterality, and presence of heritable trait.
Results: Of 2190 patients, the records of 2085 patients (95.2%) with 2905 eyes were complete. The median age at diagnosis was 17.0 months. A total of 1260 patients (65.4%) had unilateral RB. Among the 2085 patients, tumor categories were cT1a in 55 (2.6%), cT1b in 168 (8.1%), cT2a in 197 (9.4%), cT2b in 812 (38.9%), cT3 in 835 (40.0%), and cT4 in 18 (0.9%). Of these, 1397 eyes in 1353 patients (48.1%) were treated with enucleation. A total of 109 patients (5.2%) developed metastases and died. The median time (n = 92) from diagnosis to metastasis was 9.50 months. The 5-year KaplaneMeier cumulative survival estimates by clinical tumor categories were 100% for category cT1a, 98% (95% confidence interval [CI], 97-99) for cT1b and cT2a, 96% (95% CI, 95-97) for cT2b, 89% (95% CI, 88-90) for cT3 tumors, and 45% (95% CI, 31-59) for cT4 tumors. Risk of metastasis increased with increasing cT (and pT) category (P < 0.001). Cox proportional hazards regression analysis confirmed a higher risk of metastasis in category cT3 (hazard rate [HR], 8.09; 95% CI, 2.55-25.70; P < 0.001) and cT4 (HR, 48.55; 95% CI, 12.86-183.27; P < 0.001) compared with category cT1. Age, tumor laterality, and presence of heritable traits did not influence the incidence of metastatic disease.
Conclusions: Multicenter, international, internet-based data sharing facilitated analysis of the 8th edition AJCC RB Staging System for metastasis-related mortality and offered a proof of concept yielding quantitative, predictive estimates per category in a large, real-life, heterogeneous patient population with RB. (C) 2020 by the American Academy of Ophthalmology. This is an open access article under the CC BY-NC-ND license
Filiaciones:
Tomar AS:
Department of Ocular Tumor and Orbital Disease, The New York Eye Cancer Center, New York, New York, USA
Finger PT:
Department of Ocular Tumor and Orbital Disease, The New York Eye Cancer Center, New York, New York, USA
Gallie B:
The Eye Cancer Clinic, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
Mallipatna A:
Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, Canada
Kivelä TT:
Ocular Oncology Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
Zhang C:
Pediatric Oncology Center, Beijing Children's Hospital, Beijing, China
Zhao J:
Pediatric Oncology Center, Beijing Children's Hospital, Beijing, China
Wilson MW:
Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee, USA.5Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
Kim J:
USC Roski Eye Institute, Keck Medical School of the University of Southern California, Los Angeles, California
The Vision Center at Children's Hospital Los Angeles, Los Angeles, California, USA
Khetan V:
Department of Vitreoretina Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
Ganesan S:
Department of Vitreoretina Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
Yarovoy A:
Ocular Oncology Department, The S.N. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation
Yarovaya V:
Ocular Oncology Department, The S.N. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation
Kotova E:
Ocular Oncology Department, The S.N. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation
Yousef YA:
Department of Surgery (Ophthalmology), King Hussein Cancer Center, Amman, Jordan
Nummi K:
Ocular Oncology Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
Ushakova TL:
SRI of Pediatric Oncology and Hematology of N.N. Blokhin National Medical Research Center Oncology of Russian Federation, Moscow, Russian Federation
Medical Academy of Postgraduate Education, Moscow, Russian Federation
Yugay OV:
SRI of Pediatric Oncology and Hematology of N.N. Blokhin National Medical Research Center Oncology of Russian Federation, Moscow, Russian Federation
Polyakov VG:
SRI of Pediatric Oncology and Hematology of N.N. Blokhin National Medical Research Center Oncology of Russian Federation, Moscow, Russian Federation
Medical Academy of Postgraduate Education, Moscow, Russian Federation
Ramirez-Ortiz MA:
Department of Ophthalmology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
Esparza-Aguiar E:
Department of Ophthalmology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
Chantada G:
Precision Medicine Coordination Hospital JP Garrahan, Buenos Aires, Argentina and CONICET, National Scientific and Technical Research Council, Argentina
Schaiquevich P:
Precision Medicine Coordination Hospital JP Garrahan, Buenos Aires, Argentina and CONICET, National Scientific and Technical Research Council, Argentina
Fandino A:
Ophthalmology Service Hospital JP Garrahan, Buenos Aires, Argentina
Yam JC:
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
Lau WW:
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
Lam CP:
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
Sharwood P:
Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, University of Sydney, Australia
Moorthy S:
KK Women's and Children's Hospital, Singapore
Long QB:
KK Women's and Children's Hospital, Singapore
Essuman VA:
Ophthalmology Unit, Department of Surgery, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana
Renner LA:
Department of Child Health, University of Ghana Medical School, Accra, Ghana
Català-Mora J:
Retinoblastoma Unit, Department of Ophthalmology, Hospital Sant Joan de Déu. Esplugues de Llobregat. Barcelona, Spain
:
Retinoblastoma Unit, Department of Oncology, Hospital Sant Joan de Déu. Esplugues de Llobregat. Barcelona, Spain
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