Metastatic Death Based on Presenting Features and Treatment for Advanced Intraocular Retinoblastoma A Multicenter Registry-Based Study
Por:
Tomar AS, Finger PT, Gallie B, Kivelä TT, Mallipatna A, Zhang C, Zhao J, Wilson MW, Brennan RC, Burges M, Kim J, Berry JL, Jubran R, Khetan V, Ganesan S, Yarovoy A, Yarovaya V, Kotova E, Volodin D, 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, Semenova E, Català-Mora J, Correa-Llano G and Carreras-Bertran E
Publicada:
1 ago 2022
Ahead of Print:
1 jul 2022
Categoría:
Ophthalmology
Resumen:
Purpose: To evaluate presenting features, tumor size, and treatment methods for risk of metastatic death due to advanced intraocular retinoblastoma (RB).
Design: International, multicenter, registry-based retrospective case series.
Participants: A total of 1841 patients with advanced RB.
Methods: Advanced RB was defined by 8th edition American Joint Committee on Cancer (AJCC) categories cT2 and cT3 and new AJCC-Ophthalmic Oncology Task Force (OOTF) Size Groups (1: < 50% of globe volume, 2: > 50% but < 2/3, 3: > 2/3, and 4: diffuse infiltrating RB). Treatments were primary enucleation, systemic chemotherapy with secondary enucleation, and systemic chemotherapy with eye salvage.
Main Outcome Measures: Metastatic death.
Results: The 5-year Kaplan-Meier cumulative survival estimates by patient-level AJCC clinical subcategories were 98% for cT2a, 96% for cT2b, 88% for cT3a, 95% for cT3b, 92% for cT3c, 84% for cT3d, and 75% for cT3e RB. Survival estimates by treatment modality were 96% for primary enucleation, 89% for systemic chemotherapy and secondary enucleation, and 90% for systemic chemotherapy with eye salvage. Risk of metastatic mortality increased with increasing cT subcategory (P < 0.001). Cox proportional hazards regression analysis confirmed a higher risk of metastatic mortality in categories cT3c (glaucoma, hazard ratio [HR], 4.9; P = 0.011), cT3d (intraocular hemorrhage, HR, 14.0; P < 0.001), and cT3e (orbital cellulitis, HR, 19.6; P < 0.001) than in category cT2a and with systemic chemotherapy with secondary enucleation (HR, 3.3; P < 0.001) and eye salvage (HR, 4.9; P < 0.001) than with primary enucleation. The 5-year Kaplan-Meier cumulative survival estimates by AJCC-OOTF Size Groups 1 to 4 were 99%, 96%, 94%, and 83%, respectively. Mortality from metastatic RB increased with increasing Size Group (P < 0.001). Cox proportional hazards regression analysis revealed that patients with Size Group 3 (HR, 10.0; P = 0.002) and 4 (HR, 41.1; P < 0.001) had a greater risk of metastatic mortality than Size Group 1.
Conclusions: The AJCC-RB cT2 and cT3 subcategories and size-based AJCC-OOTF Groups 3 (> 2/3 globe volume) and 4 (diffuse infiltrating RB) provided a robust stratification of clinical risk for metastatic death in advanced intraocular RB. Primary enucleation offered the highest survival rates for patients with advanced intraocular RB. (C) 2022 by the American Academy of Ophthalmology.
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, and 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
Mallipatna A:
The Eye Cancer Clinic, Princess Margaret Cancer Centre, and Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, Canada
Department of Ocular Oncology, Narayana Nethralaya Eye Hospital, Bangalore, India
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, and Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
Brennan RC:
Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, College of Medicine, and Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
Burges M:
Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, College of Medicine, and Department of Oncology, 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
Berry JL:
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
Jubran R:
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
Volodin D:
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:
Hemato-Oncology service, Hospital Sant Joan de Déu, Barcelona, Spain
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, Hong Kong Eye Hospital, Kowloon, Hong Kong
Lau WW:
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon, Hong Kong
Lam CP:
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, 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, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
Renner LA:
Department of Child Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
Semenova E:
Department of Ocular Tumor and Orbital Disease, The New York Eye Cancer Center, New York, New York, USA
Català-Mora J:
Retinoblastoma Unit, Department of Ophthalmology, Hospital Sant Joan de Déu. Esplugues de Llobregat. Barcelona, Spain
:
Retinoblastoma Unit, Department of Ophthalmology, Hospital Sant Joan de Déu. Esplugues de Llobregat. Barcelona, Spain
Carreras-Bertran E:
Retinoblastoma Unit, Department of Ophthalmology, Hospital Sant Joan de Déu. Esplugues de Llobregat. Barcelona, Spain
Green Submitted, hybrid
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