Abstract
Purpose
To analyze the risk factors and estimate the risk period for tumor recurrence in intraocular retinoblastoma (RB).
Methods
Retrospective study of 60 RB patients.
Results
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.
Conclusion
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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Data is available with the authors.
References
Cassoux N, Lumbroso L, Levy-Gabriel C et al (2017) Retinoblastoma: update on current management. Asia Pac J Ophthalmol (Phila) 6:290–295
Abramson DH, Shields CL, Munier FL, Chantada GL (2015) Treatment of retinoblastoma in 2015: agreement and disagreement. JAMA Ophthalmol 133:1341–1347
Shields CL, Mashayekhi A, Au AK et al (2006) The International Classification of Retinoblastoma predicts chemoreduction success. Ophthalmology 113:2276–2280
Shields CL, Manjandavida FP, Lally SE et al (2014) Intra-arterial chemotherapy for retinoblastoma in 70 eyes: outcomes based on the international classification of retinoblastoma. Ophthalmology 121:1453–1460
Francis JH, Roosipu N, Levin AM et al (2018) Current Treatment of bilateral retinoblastoma: the impact of intraarterial and intravitreous chemotherapy. Neoplasia 20:757–763
Shields CL, Alset AE, Say EA et al (2016) Retinoblastoma control with primary intra-arterial chemotherapy: outcomes before and during the intravitreal chemotherapy Era. J Pediatr Ophthalmol Strabismus 53:275–284
Berry JL, Kogachi K, Murphree AL et al (2019) A review of recurrent retinoblastoma: Children’s Hospital Los Angeles Classification and Treatment Guidelines. Int Ophthalmol Clin 59:65–75
Mallipatna AC, Gallie BL, Chévez-Barrios P et al (2017) Retinoblastoma. In: Amin MB, Edge SB, Greene FL et al (eds) AJCC cancer staging manual, 8th edn. Springer, Switzerland, pp 819–831
Shields CL, Mashayekhi A, Cater J et al (2004) Chemoreduction for retinoblastoma. Analysis of tumor control and risks for recurrence in 457 tumors. Am J Ophthalmol 138:329–337
Francis JH, Levin AM, Zabor EC et al (2018) Ten-year experience with ophthalmic artery chemosurgery: Ocular and recurrence-free survival. PLoS ONE 13:e0197081
Shields CL, Honavar SG, Shields JA et al (2002) Factors predictive of recurrence of retinal tumors, vitreous seeds, and subretinal seeds following chemoreduction for retinoblastoma. Arch Ophthalmol 120:460–464
Abramson DH, Gamell LS, Ellsworth RM et al (1994) Unilateral retinoblastoma: new intraocular tumours after treatment. Br J Ophthalmol 78:698–701
Abramson DH, Greenfield DS, Ellsworth RM (1992) Bilateral retinoblastoma. Correlations between age at diagnosis and time course for new intraocular tumors. Ophthalmic Paediatr Genet 13:1–7
Shields CL, Shelil A, Cater J et al (2003) Development of new retinoblastomas after 6 cycles of chemoreduction for retinoblastoma in 162 eyes of 106 consecutive patients. Arch Ophthalmol 121:1571–1576
Gelaw Y, Shoukry SM, Othman IS (2016) Unusually very late-onset new growth of intraocular retinoblastoma: a case report and review of literature. Am J Ophthalmol Case Rep 5:130–133
Ytteborg J, Arnesen K (1972) . Late recurrence of retinoblastoma. Acta Ophthalmol (Copenh) 50:367–374
Dalvin LA, Bas Z, Tadepalli S et al (2020) Risk factors for tumor recurrence following primary intravenous chemotherapy (Chemoreduction) for retinoblastoma in 869 Eyes of 551 patients. J Pediatr Ophthalmol Strabismus 57:224–234
Funding
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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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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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 41, 2033–2039 (2021). https://doi.org/10.1007/s10792-021-01759-4
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DOI: https://doi.org/10.1007/s10792-021-01759-4