Risk factors for recurrent retinoblastoma after intravenous chemotherapy



To analyze the risk factors and estimate the risk period for tumor recurrence in intraocular retinoblastoma (RB).


Retrospective study of 60 RB patients.


The mean age at presentation with RB was 16 months (median 11 months; range 1–84 months). Tumor was unilateral in 13 (22%) and bilateral in 47 (78%) patients. Of 83 eyes with intraocular RB, group B (n = 27; 33%) tumors were more common based on International Classification of Intraocular Retinoblastoma. All cases received intravenous chemotherapy as a primary treatment. Over a mean follow-up period of 57 months (median 38 months; range 12–185 months) post-primary treatment, 44 (73%) patients developed tumor recurrence. The mean interval between the completion of primary treatment and first tumor recurrence was 5 months (median 3 months; range 1–24 months). The total duration of treatment for complete tumor control including treatment of tumor recurrences was 20 months (median 19 months; 2–58 months). By multivariate analysis, the factors predictive of tumor recurrence were multiple tumors (p = 0.008) and retinal detachment (p = 0.003) at presentation. Kaplan–Meier estimate of tumor recurrence at 6 months, 1 year, 3 years, and 5 years was 20%, 31%, 68%, and 73%, respectively. There was no tumor recurrence beyond 5 years since primary treatment.


Multiple tumors and retinal detachment at presentation are risk factors for tumor recurrence in RB. Close follow-up is mandatory for at least 5 years since the initiation of treatment for RB.

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This work is supported by Hyderabad Eye Research Foundation, Hyderabad, India, and The Operation Eyesight Universal Institute for Eye Cancer, Hyderabad, India.

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VSV and YP were responsible for data collection and critical review of the manuscript. AM was responsible for data analysis and critical review of the manuscript. SK was responsible for the concept and formulation of the work, data interpretation, and drafting of the manuscript.

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Correspondence to Swathi Kaliki.

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No conflicting relationships exist for any author. No conflicts of interest exist for any author. This work involved demographic and clinical information of human participants. All procedures performed were in accordance with the ethical standards of the institutional ethics committee and adhered to the Declaration of Helsinki, 1964 and its later amendments or comparable ethical standards. Informed consent has been obtained from all study participants.

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Research involved demographic and clinical information of human participants. All procedures performed were in accordance with the ethical standards of the institutional ethical standards of the institutional ethics committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Support provided by The Operation Eyesight Universal Institute for Eye Cancer (SK) and Hyderabad Eye Research Foundation (SK), Hyderabad, India. The funders had no role in the preparation, review, or approval of the manuscript.

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Kaliki, S., Vempuluru, V.S., Priya, Y. et al. Risk factors for recurrent retinoblastoma after intravenous chemotherapy. Int Ophthalmol (2021). https://doi.org/10.1007/s10792-021-01759-4

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  • Eye
  • Tumor
  • Cancer
  • Retinoblastoma
  • Recurrence