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Eye-Preserving Therapies for Advanced Retinoblastoma

Authors :
Jingwen Ding
Guanghong Zhang
Junyang Zhao
Qing Wang
Xunda Ji
Wei Lu
Jianhong Liang
Xian Wang
Yanjin He
Li Wu
Shangcai Xue
Xianqun Fan
Song Tang
Yishuang Xiao
Juan Ye
Zhangsheng Yu
Jiancang Wang
Jizhe Cui
Xunlun Sheng
Xiantao Sun
Miershalijiang Wubuli
Yi Ding
Hongfei Liao
Yuechun Wen
Chuandi Zhou
Yu Wu
Yingxiu Luo
Sha Wang
Dan Zhu
Jia Tan
Huiyu Guo
Fang Lu
Jiawei Yu
Xinji Yang
Jing Zhang
Yangjun Li
Minglei Han
Jiayan Fan
Zhenyin Liu
Rong Liu
Xuyang Wen
Tseden Yangkyi
Renbing Jia
Hongfeng Yuan
Zhijun Chen
Mei Jin
Jinlei Qi
Liwen Jin
Source :
Ophthalmology. 129:209-219
Publication Year :
2022
Publisher :
Elsevier BV, 2022.

Abstract

Purpose This study attempted to estimate the impact of eye-preserving therapies for the long-term prognosis of patients with advanced retinoblastoma with regard to overall survival and ocular salvage. Design Retrospective cohort study covering all 31 provinces (38 retinoblastoma treating centers) of mainland China. Participants One thousand six hundred seventy-eight patients diagnosed with group D or E retinoblastoma from January 2006 through May 2016. Methods Chart review was performed. The patients were divided into primary enucleation and eye-preserving groups, and they were followed up for survival status. The impact of initial treatment on survival was evaluated by Cox analyses. Main Outcome Measures Overall survival and final eye preservation. Results After a median follow-up of 43.9 months, 196 patients (12%) died, and the 5-year overall survival was 86%. In total, the eyeball preservation rate was 48%. In this cohort, 1172 patients (70%) had unilateral retinoblastoma, whereas 506 patients (30%) had bilateral disease. For patients with unilateral disease, 570 eyes (49%) underwent primary enucleation, and 602 patients (51%) received eye-preserving therapies initially. During the follow-up (median, 45.6 months), 59 patients (10%) from the primary enucleation group and 56 patients (9.3%) from the eye-preserving group died. Multivariate Cox analyses indicated no significant difference in overall survival between the 2 groups (hazard ratio [HR], 1.25; 95% confidence interval [CI], 0.85–1.84; P = 0.250). For patients with bilateral disease, 95 eyes (19%) underwent primary enucleation, and 411 patients (81%) received eye-preserving therapies initially. During the follow-up (median, 40.1 months), 12 patients (13%) from the primary enucleation group and 69 patients (17%) from the eye-preserving group died. For bilateral retinoblastoma with the worse eye classified as group E, patients undergoing primary enucleation exhibited better overall survival (HR, 2.35; 95% CI, 1.10–5.01; P = 0.027); however, this survival advantage was not evident until passing 22.6 months after initial diagnosis. Conclusions Eye-preserving therapies have been used widely for advanced retinoblastoma in China. Patients with bilateral disease whose worse eye was classified as group E and who initially underwent eye-preserving therapies exhibited a worse overall survival. The choice of primary treatment for advanced retinoblastoma should be weighed carefully.

Details

ISSN :
01616420
Volume :
129
Database :
OpenAIRE
Journal :
Ophthalmology
Accession number :
edsair.doi...........45b888ca262805f44bac4b6d1d346ddc
Full Text :
https://doi.org/10.1016/j.ophtha.2021.09.002