Defining High-risk Retinoblastoma: A Multicenter Global Survey.
Por:
Kaliki S, Shields CL, Cassoux N, Munier FL, Chantada G, Grossniklaus HE, Yoshikawa H, Fabian ID, Berry JL, McKenzie JD, Kimani K, Reddy MA, Parulekar M, Tanabe M, Furuta M, Grigorovski N, Chevez-Barrios P, Scanlan P, Eagle RC Jr, Rashid R, Coronado RD, Sultana S, Staffieri S, Frenkel S, Suzuki S, Ushakova TL and Ji X
Publicada:
1 ene 2022
Ahead of Print:
1 nov 2021
Categoría:
Ophthalmology
Resumen:
IMPORTANCE: High-risk histopathologic features of retinoblastoma are useful to assess the risk of systemic metastasis. In this era of globe salvage treatments for retinoblastoma, the definition of high-risk retinoblastoma is evolving. OBJECTIVE: To evaluate variations in the definition of high-risk histopathologic features for metastasis of retinoblastoma in different ocular oncology practices around the world. DESIGN, SETTING, AND PARTICIPANTS: An electronic web-based, nonvalidated 10-question survey was sent in December 2020 to 52 oncologists and pathologists treating retinoblastoma at referral retinoblastoma centers. INTERVENTION: Anonymized survey about the definition of high-risk histopathologic features for metastasis of retinoblastoma. MAIN OUTCOMES AND MEASURES: High-risk histopathologic features that determine further treatment with adjuvant systemic chemotherapy to prevent metastasis. RESULTS: Among the 52 survey recipients, the results are based on the responses from 27 individuals (52%) from 24 different retinoblastoma practices across 16 countries in 6 continents. The following were considered to be high-risk features: postlaminar optic nerve infiltration (27 [100%]), involvement of optic nerve transection (27 [100%]), extrascleral tissue infiltration (27 [100%]), massive (=3 mm) choroidal invasion (25 [93%]), microscopic scleral infiltration (23 [85%]), ciliary body infiltration (20 [74%]), trabecular meshwork invasion (18 [67%]), iris infiltration (17 [63%]), anterior chamber seeds (14 [52%]), laminar optic nerve infiltration (13 [48%]), combination of prelaminar and laminar optic nerve infiltration and minor choroidal invasion (11 [41%]), minor (<3 mm) choroidal invasion (5 [19%]), and prelaminar optic nerve infiltration (2 [7%]). The other histopathologic features considered high risk included Schlemm canal invasion (4 [15%]) and severe anaplasia (1 [4%]). Four respondents (15%) said that the presence of more than 1 high-risk feature, especially a combination of massive peripapillary choroidal invasion and postlaminar optic nerve infiltration, should be considered very high risk for metastasis. CONCLUSIONS AND RELEVANCE: Responses to this nonvalidated survey conducted in 2020-2021 showed little uniformity in the definition of high-risk retinoblastoma. Postlaminar optic nerve infiltration, involvement of optic nerve transection, and extrascleral tumor extension were the only features uniformly considered as high risk for metastasis across all oncology practices. These findings suggest that the relevance about their value in the current scenario with advanced disease being treated conservatively needs further evaluation; there is also a need to arrive at consensus definitions and conduct prospective multicenter studies to understand their relevance.
Filiaciones:
Kaliki S:
Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute India, Hyderabad, India
Shields CL:
Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
Cassoux N:
Department of Surgical Oncology, Insitut Curie Université de Paris, Paris, France
Munier FL:
Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, University of Lausanne, Lausanne, Switzerland
Chantada G:
Oncology Department, Hospital Sant Joan de Déu, Barcelona, Spain
Grossniklaus HE:
Department of Pathology, Emory University School of Medicine, Atlanta, Georgia
Yoshikawa H:
Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
Fabian ID:
Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel
Berry JL:
USC Roski Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles
McKenzie JD:
Department of Ophthalmology, Royal Children's Hospital, Melbourne, Victoria, Australia
Kimani K:
Department of Ophthalmology, University of Nairobi, Nairobi, Kenya
Reddy MA:
Retinoblastoma Service, Royal London Hospital, Barts Health National Health Service Trust, London, United Kingdom
Parulekar M:
Retinoblastoma Service, Birmingham Women's and Children's National Health Service Foundation Trust, Birmingham, United Kingdom
Tanabe M:
Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
Furuta M:
Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
Grigorovski N:
Department of Pediatric Oncology, Clinical Division, National Institute of Cancer, Rio de Janeiro, Brazil
Chevez-Barrios P:
Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
Scanlan P:
Department of Pediatrics, Muhimbili National Hospital, Dar es Salaam, Tanzania
Eagle RC Jr:
Department of Pathology, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
Rashid R:
Department of Oculoplasty and Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh
Coronado RD:
Retinoblastoma Service, Instituto Nacional de Enfermedades Neoplasicas, Lima, Perú
Sultana S:
Department of Oculoplasty and Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh
Staffieri S:
Department of Ophthalmology, Royal Children's Hospital, Melbourne, Victoria, Australia
Retinoblastoma Service, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
Frenkel S:
Division of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
Suzuki S:
Department of Ophthalmic Oncology, National Cancer Center Hospital, Tokyo, Japan
Ushakova TL:
Department of Pediatric Oncology and Hematology, N. N. Blokhin National Medical Research Center Oncology of Russian Federation, Moscow, Russia
Retinoblastoma Service, Medical Academy of Postgraduate Education, Moscow, Russia
Ji X:
Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Green Published
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