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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, Carreras E. High-risk Pathologic Features Based on Presenting Findings in Advanced Intraocular Retinoblastoma: A Multicenter, International Data-Sharing American Joint Committee on Cancer Study. Ophthalmology 2022; 129:923-932. [PMID: 35436535 PMCID: PMC9329269 DOI: 10.1016/j.ophtha.2022.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/20/2022] [Accepted: 04/08/2022] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To determine the value of clinical features for advanced intraocular retinoblastoma as defined by the eighth edition of the American Joint Committee on Cancer (AJCC) cT3 category and AJCC Ophthalmic Oncology Task Force (OOTF) Size Groups to predict the high-risk pathologic features. DESIGN International, multicenter, registry-based retrospective case series. PARTICIPANTS Eighteen ophthalmic oncology centers from 13 countries over 6 continents shared evaluations of 942 eyes enucleated as primary treatment for AJCC cT3 and, for comparison, cT2 retinoblastoma. METHODS International, multicenter, registry-based data were pooled from patients enrolled between 2001 and 2013. High-risk pathologic features were defined as AJCC categories pT3 and pT4. In addition, AJCC OOTF Size Groups were defined as follows: (1) less than half, (2) more than half but less than two thirds, (3) more than two thirds of globe volume involved, and (4) diffuse infiltrating retinoblastoma. MAIN OUTCOME MEASURES Statistical risk of high-risk pathologic features corresponding to AJCC cT3 subcategories and AJCC OOTF Size Groups. RESULTS Of 942 retinoblastoma eyes treated by primary enucleation, 282 (30%) showed high-risk pathologic features. Both cT subcategories and AJCC OOTF Size Groups (P < 0.001 for both) were associated with high-risk pathologic features. On logistic regression analysis, cT3c (iris neovascularization with glaucoma), cT3d (intraocular hemorrhage), and cT3e (aseptic orbital cellulitis) were predictive factors for high-risk pathologic features when compared with cT2a with an odds ratio of 2.3 (P = 0.002), 2.5 (P = 0.002), and 3.3 (P = 0.019), respectively. Size Group 3 (more than two-thirds globe volume) and 4 (diffuse infiltrative retinoblastoma) were the best predictive factors with an odds ratio of 3.3 and 4.1 (P < 0.001 for both), respectively, for high-risk pathologic features when compared with Size Groups 1 (i.e., < 50% of globe volume). CONCLUSIONS The AJCC retinoblastoma staging clinical cT3c-e subcategories (glaucoma, intraocular hemorrhage, and aseptic orbital cellulitis, respectively) as well as the AJCC OOTF Size Groups 3 (tumor more than two thirds of globe volume) and 4 (diffuse infiltrative retinoblastoma) both allowed stratification of clinical risk factors that can be used to predict the presence of high-risk pathologic features and thus facilitate treatment decisions.
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Affiliation(s)
- Ankit Singh Tomar
- Department of Ocular Tumor and Orbital Disease, The New York Eye Cancer Center, New York, New York
| | - Paul T. Finger
- Department of Ocular Tumor and Orbital Disease, The New York Eye Cancer Center, New York, New York
| | - Brenda Gallie
- The Eye Cancer Clinic, Princess Margaret Cancer Centre, and Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, Canada
| | - Tero T. Kivelä
- Ocular Oncology Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ashwin Mallipatna
- 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
| | - Chengyue Zhang
- Pediatric Oncology Center, Beijing Children’s Hospital, Beijing, China
| | - Junyang Zhao
- Pediatric Oncology Center, Beijing Children’s Hospital, Beijing, China
| | - Matthew W. Wilson
- 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
| | - Rachel C. Brennan
- 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
| | - Michala Burges
- 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
| | - Jonathan Kim
- USC Roski Eye Institute, Keck Medical School, University of Southern California, and The Vision Center at Children’s Hospital Los Angeles, Los Angeles, California
| | - Jesse L. Berry
- USC Roski Eye Institute, Keck Medical School, University of Southern California, and The Vision Center at Children’s Hospital Los Angeles, Los Angeles, California
| | - Rima Jubran
- USC Roski Eye Institute, Keck Medical School, University of Southern California, and The Vision Center at Children’s Hospital Los Angeles, Los Angeles, California
| | - Vikas Khetan
- Department of Vitreoretina Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Suganeswari Ganesan
- Department of Vitreoretina Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Andrey Yarovoy
- Ocular Oncology Department, The S.N. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation
| | - Vera Yarovaya
- Ocular Oncology Department, The S.N. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation
| | - Elena Kotova
- Ocular Oncology Department, The S.N. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation
| | - Denis Volodin
- Ocular Oncology Department, The S.N. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation
| | - Yacoub A. Yousef
- Department of Surgery (Ophthalmology), King Hussein Cancer Center, Amman, Jordan
| | - Kalle Nummi
- Ocular Oncology Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tatiana L. Ushakova
- SRI of Pediatric Oncology and Hematology, N.N. Blokhin National Medical Research Center Oncology of Russian Federation, Moscow, Russian Federation.,Department of Ophthalmology, Medical Academy of Postgraduate Education, Moscow, Russian Federation
| | - Olga V. Yugay
- SRI of Pediatric Oncology and Hematology, N.N. Blokhin National Medical Research Center Oncology of Russian Federation, Moscow, Russian Federation
| | - Vladimir G. Polyakov
- SRI of Pediatric Oncology and Hematology, N.N. Blokhin National Medical Research Center Oncology of Russian Federation, Moscow, Russian Federation.,Department of Ophthalmology, Medical Academy of Postgraduate Education, Moscow, Russian Federation
| | - Marco A. Ramirez-Ortiz
- Department of Ophthalmology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | | | - Guillermo Chantada
- Precision Medicine Coordination Hospital JP Garrahan, and CONICET, National Scientific and Technical Research Council, Buenos Aires, Argentina.,Hemato-Oncology Service, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Paula Schaiquevich
- Precision Medicine Coordination Hospital JP Garrahan, and CONICET, National Scientific and Technical Research Council, Buenos Aires, Argentina
| | - Adriana Fandino
- Ophthalmology Service, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Jason C. Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon, Hong Kong
| | - Winnie W. Lau
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon, Hong Kong
| | - Carol P. Lam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon, Hong Kong
| | - Phillipa Sharwood
- Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Sonia Moorthy
- KK Women’s and Children’s Hospital, Singapore, Republic of Singapore
| | - Quah Boon Long
- KK Women’s and Children’s Hospital, Singapore, Republic of Singapore
| | - Vera Adobea Essuman
- Ophthalmology Unit, Department of Surgery, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Lorna A. Renner
- Department of Child Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Ekaterina Semenova
- Department of Ocular Tumor and Orbital Disease, The New York Eye Cancer Center, New York, New York
| | - Jaume Català-Mora
- Retinoblastoma Unit, Department of Ophthalmology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Genoveva Correa-Llano
- Retinoblastoma Unit, Department of Ophthalmology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Elisa Carreras
- Retinoblastoma Unit, Department of Ophthalmology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
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Wu J, Qian D, Sun X. Long noncoding RNAs as potential biomarkers in retinoblastoma: a systematic review and meta-analysis. Cancer Cell Int 2020; 20:201. [PMID: 32514246 PMCID: PMC7257223 DOI: 10.1186/s12935-020-01281-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 05/18/2020] [Indexed: 12/15/2022] Open
Abstract
Background Retinoblastoma is the most common malignant rare intraocular tumor of childhood. Long noncoding RNAs (lncRNAs) have been reported participating in its progression, but their significance remains inconclusive. We conducted this systematic review and meta-analysis to explore specific lncRNA biomarker in patients with retinoblastoma. Materials and methods Eligible articles were searched from the Pubmed, Web of Science, Embase and the Cochrane library. Hazard ratios (HRs) and odds ratios (ORs) were extracted or calculated to evaluate the relationship between lncRNAs and retinoblastoma. The meta-analysis part was conducted with STATA v.15 software. Results A total of 9 articles with 834 retinoblastoma patients are yielded. Heterogeneity among HRs of overall survival (OS) is notably high (I2 = 91.3%, p < 0.001). Subgroup analysis suggests that elevated expression of lncRNA BDNF-AS and MT1JP are favorable factors in OS (pooled HR = 1.89, 95% CI 1.72-2.07, I2 = 0%). Six articles included optic nerve invasion as a clinicopathological outcome and showed a notable correlation (pooled HR = 2.38, 95% CI 1.26-3.50, I2 = 0.0%). We validate our analysis via the public dataset and also sum up the studies of lncRNA BDNF-AS and MT1JP in other cancers. Conclusion Differential expression of lncRNAs has been reported in retinoblastoma. Some of them showed potential in retinoblastoma prognosis and progression.
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Affiliation(s)
- Jiali Wu
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University, School of Medicine, Shanghai, 200080 China
| | - Dashi Qian
- Department of Translation and Interpreting, Shanghai Jiao Tong University School of Foreign Language, Shanghai, China
| | - Xiaodong Sun
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University, School of Medicine, Shanghai, 200080 China.,Shanghai Key Laboratory of Fundus Diseases, Shanghai, 200080 China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, 200080 China.,National Clinical Research Center for Eye Diseases, Shanghai, 200080 China.,Shanghai engineering center for precise diagnosis and treatment of eye diseases, Shanghai, 200080 China
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AlAli A, Kletke S, Gallie B, Lam WC. Retinoblastoma for Pediatric Ophthalmologists. Asia Pac J Ophthalmol (Phila) 2018; 7:160-168. [PMID: 29737052 DOI: 10.22608/apo.201870] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Retinoblastoma can present in 1 or both eyes and is the most common intraocular malignancy in childhood. It is typically initiated by biallelic mutation of the RB1 tumor suppressor gene, leading to malignant transformation of primitive retinal cells. The most common presentation is leukocoria, followed by strabismus. Heritable retinoblastoma accounts for 45% of all cases, with 80% being bilateral. Treatment and prognosis of retinoblastoma is dictated by the disease stage at initial presentation. The 8th Edition American Joint Committee on Cancer (AJCC) TNMH (tumor, node, metastasis, heritable trait) staging system defines evidence-based clinical and pathological staging for overall prognosis for eye(s) and child. Multiple treatment options are available in 2018 for retinoblastoma management with a multidisciplinary team, including pediatric ocular oncology, medical oncology, radiation oncology, genetics, nursing, and social work. Survival exceeds 95% when disease is diagnosed early and treated in centers specializing in retinoblastoma. However, survival rates are less than 50% with extraocular tumor dissemination. We summarize the epidemiology, genetics, prenatal screening, diagnosis, classification, investigations, and current therapeutic options in the management of retinoblastoma.
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Affiliation(s)
- Alaa AlAli
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Canada
| | - Stephanie Kletke
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Canada
| | - Brenda Gallie
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Canada
- Department of Ophthalmology & Vision Sciences, The Hospital for Sick Children, Toronto, Canada
- Techna Institute, University Health Network, Toronto, Canada
- Departments of Molecular Genetics and Medical Biophysics, University of Toronto, Toronto, Canada
| | - Wai-Ching Lam
- Department of Ophthalmology & Vision Sciences, The Hospital for Sick Children, Toronto, Canada
- Department of Ophthalmology, The University of Hong Kong, Hong Kong
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Berry JL, Zolfaghari E, Chen A, Murphree AL, Jubran R, Kim JW. Optic Nerve Obscuration in Retinoblastoma: A Risk Factor for Optic Nerve Invasion? Ocul Oncol Pathol 2017; 3:283-291. [PMID: 29344482 DOI: 10.1159/000464468] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 02/21/2017] [Indexed: 11/19/2022] Open
Abstract
Background The objective of this study is to evaluate the risk of optic nerve invasion associated with optic nerve obscuration at diagnosis or persisting during treatment. Methods Retrospective review from 2011-2016 of patients with advanced retinoblastoma (Group D/E) with complete obscuration of the nerve at diagnosis and a second group of patients with persistent, complete obscuration throughout treatment. Results Advanced retinoblastoma was diagnosed in 102 eyes of 86 patients. The optic nerve was obscured in 69 eyes (68%) at diagnosis. Of these, 30 (43%) underwent salvage therapy and 39 (57%) primary enucleation. Histopathologic analysis of primarily enucleated eyes showed 41% prelaminar and 15% postlaminar invasion. Four eyes in the salvage group demonstrated persistent nerve obscuration; 2 were subsequently enucleated without evidence of nerve invasion. Average follow-up was 23.5 months (range 1-62 months). Conclusions and Relevance Optic nerve obscuration at diagnosis may be associated with postlaminar optic nerve invasion. While persistent, complete obscuration of the optic nerve by retinoblastoma during treatment is a poor prognostic sign for both globe salvage and vision, it does not appear, in this small cohort, to increase the risk of optic nerve invasion. With appropriate control of the intraocular tumor, these eyes can be salvaged.
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Affiliation(s)
- Jesse L Berry
- USC Roski Eye Institute, Keck Medical School of the University of Southern California, California, USA.,The Vision Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Emily Zolfaghari
- The Vision Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Alexander Chen
- USC Roski Eye Institute, Keck Medical School of the University of Southern California, California, USA.,The Vision Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - A Linn Murphree
- The Vision Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Rima Jubran
- The Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Jonathan W Kim
- USC Roski Eye Institute, Keck Medical School of the University of Southern California, California, USA.,The Vision Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, California, USA
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Dimaras H, Corson TW, Cobrinik D, White A, Zhao J, Munier FL, Abramson DH, Shields CL, Chantada GL, Njuguna F, Gallie BL. Retinoblastoma. Nat Rev Dis Primers 2015; 1:15021. [PMID: 27189421 PMCID: PMC5744255 DOI: 10.1038/nrdp.2015.21] [Citation(s) in RCA: 341] [Impact Index Per Article: 37.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Retinoblastoma is a rare cancer of the infant retina that is diagnosed in approximately 8,000 children each year worldwide. It forms when both retinoblastoma gene (RB1) alleles are mutated in a susceptible retinal cell, probably a cone photoreceptor precursor. Loss of the tumour-suppressive functions of the retinoblastoma protein (pRB) leads to uncontrolled cell division and recurrent genomic changes during tumour progression. Although pRB is expressed in almost all tissues, cone precursors have biochemical and molecular features that may sensitize them to RB1 loss and enable tumorigenesis. Patient survival is >95% in high-income countries but <30% globally. However, outcomes are improving owing to increased disease awareness for earlier diagnosis, application of new guidelines and sharing of expertise. Intra-arterial and intravitreal chemotherapy have emerged as promising methods to salvage eyes that with conventional treatment might have been lost. Ongoing international collaborations will replace the multiple different classifications of eye involvement with standardized definitions to consistently assess the eligibility, efficacy and safety of treatment options. Life-long follow-up is warranted, as survivors of heritable retinoblastoma are at risk for developing second cancers. Defining the molecular consequences of RB1 loss in diverse tissues may open new avenues for treatment and prevention of retinoblastoma, as well as second cancers, in patients with germline RB1 mutations.
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Affiliation(s)
- Helen Dimaras
- Department of Ophthalmology & Vision Sciences, The Hospital for Sick Children & University of Toronto, Toronto, Canada
| | - Timothy W. Corson
- Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - David Cobrinik
- The Vision Center, Children’s Hospital Los Angeles & USC Eye Institute, University of Southern California, Los Angeles, CA USA
| | | | - Junyang Zhao
- Department of Ophthalmology, Beijing Children’s Hospital, Capital Medial University, Beijing, China
| | - Francis L. Munier
- Department of Ophthalmology, Jules-Gonin Eye Hospital, Lausanne, Switzerland
| | - David H. Abramson
- Department of Ophthalmology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Carol L. Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, USA
| | | | - Festus Njuguna
- Department of Department of Child Health and Paediatrics, Moi University, Eldoret, Kenya
| | - Brenda L. Gallie
- Department of Ophthalmology & Vision Sciences, The Hospital for Sick Children & University of Toronto, 555 University Ave, Toronto, Ontario M5G1X8, Canada
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