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Li N, Wang YZ, Zhang Y, Zhang WL, Huang DS. Characteristics of patients with recurrent retinoblastoma: a survival analysis. BMC Cancer 2024; 24:287. [PMID: 38438837 PMCID: PMC10910724 DOI: 10.1186/s12885-024-12058-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 02/26/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Management guidelines and corresponding survival data for patients with recurrent retinoblastoma (RB) are lacking. This study aimed to summarize the clinical characteristics of patients with recurrent RB and analyze their survival outcomes. METHODS We retrospectively analyzed 68 patients with recurrent RB who underwent treatment in our institution from January 2016 to December 2020. Patients were grouped according to location of recurrence: intraocular, orbital, and distant metastasis. RESULTS The male:female ratio was 1.3:1 and the median age at recurrence was 37.5 months (range, 30.3-62.8). The number of patients in the intraocular recurrence, orbital recurrence, and metastasis groups was 13 (19.1%), 23 (33.8%), and 32 (47.1%), respectively. Thirty patients died, 36 were alive at last follow-up, and two were lost to follow-up. Eye enucleation was performed in 94.1% of patients. Five-year overall survival in patients with intraocular recurrence, orbital recurrence, and metastasis was 84.6%, 69.6%, and 31.3%, respectively (P = 0.001). Most deaths occurred within 2 years of recurrence. Presence of high-risk pathological factors, central nervous system invasion, and absence of combination therapy were independent predictors of worse 5-year overall survival. CONCLUSION The rate of eye preservation in survivors of recurrent RB was very low. Although 5-year overall survival in patients who underwent treatment for intraocular and orbital recurrence was high, it was low in those with metastasis. RB patients may need lifelong follow-up for recurrence and secondary malignancy.
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Affiliation(s)
- Nan Li
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Yizhuang Economic and Technological Development Zone, No. 2, Xihuan South Road, Beijing, 100176, China
| | - Yi-Zhuo Wang
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Yizhuang Economic and Technological Development Zone, No. 2, Xihuan South Road, Beijing, 100176, China
| | - Yi Zhang
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Yizhuang Economic and Technological Development Zone, No. 2, Xihuan South Road, Beijing, 100176, China
| | - Wei-Ling Zhang
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Yizhuang Economic and Technological Development Zone, No. 2, Xihuan South Road, Beijing, 100176, China
| | - Dong-Sheng Huang
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Yizhuang Economic and Technological Development Zone, No. 2, Xihuan South Road, Beijing, 100176, China.
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Yadav G, Singh A, Kushwaha R, Verma N, Srivastava RM, Singh US. Utility of bone marrow examination in retinoblastoma and their correlation with hematological features. J Med Life 2023; 16:1245-1250. [PMID: 38024824 PMCID: PMC10652682 DOI: 10.25122/jml-2023-0156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/24/2023] [Indexed: 12/01/2023] Open
Abstract
Retinoblastoma makes up about 3% of all childhood malignancies. The frequency of metastatic retinoblastoma ranges from 4.8 to 11%. Assessing the bone marrow status of newly diagnosed patients is crucial because of the advantages of autologous bone marrow transplants for high-risk patients. This study aimed to determine the utility of bone marrow examination in cases of retinoblastoma and its correlation with hematological findings. This retrospective study was conducted at the Department of Pathology, King George's Medical University, Lucknow, India. A total of 34 cases of retinoblastoma with bone marrow examination were included in the study. Bone marrow infiltration was present in 17.65% (6/34) cases of retinoblastoma. Bone marrow aspirate myelogram showed that marrow metastasis in retinoblastoma was significantly linked with a reduced percentage of total myeloid cells (p=0.001) and segmented cells (p=0.006). The present study demonstrated that 15% (3/20) of retinoblastoma patients previously classified as nonmetastatic before bone marrow examination (stages I to III based on histology, imaging, and bone scan) had bone marrow metastases following bone marrow examination and were upgraded to stage IV. To conclude, a diligent and exhaustive search for metastatic cells in bone marrow is advised if the myelogram shows a reduced percentage of total myeloid and segmented cells. All stage II and stage III cases of retinoblastoma must undergo bone marrow examination for early metastasis detection, as it may result in an upgrade to stage IV disease, impacting the prognosis and necessitating distinct treatment modalities.
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Affiliation(s)
- Geeta Yadav
- Department of Pathology, King George’s Medical University Lucknow, India
| | - Anurag Singh
- Department of Pathology, King George’s Medical University Lucknow, India
| | - Rashmi Kushwaha
- Department of Pathology, King George’s Medical University Lucknow, India
| | - Nishant Verma
- Department of Pediatrics, King George’s Medical University, Lucknow, India
| | | | - Uma Shankar Singh
- Department of Pathology, King George’s Medical University Lucknow, India
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Li N, Wang YZ, Huang DS, Zhang Y, Zhang WL, Ma JM, Zhou Y, Liu TT. Clinical Analysis of 16 Distant Metastatic Retinoblastoma Cases with Event-Free Survival. Cancer Manag Res 2022; 14:367-375. [PMID: 35115833 PMCID: PMC8805837 DOI: 10.2147/cmar.s349035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/17/2022] [Indexed: 12/11/2022] Open
Abstract
Aim This study aimed to summarize the clinical characteristics, treatment, and outcomes of distant metastatic retinoblastoma with event-free survival. Design Retrospective interventional case series. Methods We screened patients with retinoblastoma who survived without events after the comprehensive treatment of distant metastases from June 2015 to February 2021 and collected information regarding their basic characteristics, diagnosis, and treatment. All patients received systemic intravenous chemotherapy. Other treatments included surgical treatment, radiotherapy, intrathecal chemotherapy, and autologous stem cell transplantation. Results Among 780 hospitalized patients with retinoblastoma in the pediatric ward, a total of 94 patients with retinoblastoma were diagnosed with distant metastases, and 16 patients with distant metastatic retinoblastoma who survived more than 6 months without events were screened, including eight male and eight female patients. The median age of onset was 29 (range, 11–120) months. Among the 16 patients, central nervous system metastasis (8/16), bone metastasis (8/16), bone marrow infiltration (4/16), lymph node metastasis (4/16), and parotid gland metastasis (3/16) were presented. All patients received treatment for more than 6 months, completed their regimen by February 2021, and survived without events. The median survival time after the onset of retinoblastoma was 50.5 (range, 23–102) months, the median survival time after metastasis was 43.5 (range, 16–71) months, and the median event-free survival was 29.0 (range, 6–59) months. Conclusion Metastatic retinoblastoma may benefit from comprehensive treatments including systemic intravenous chemotherapy and hematopoietic stem cell transplantation. However, recurrence after treatment still needs attention, and patients in complete remission still need long-term follow-up.
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Affiliation(s)
- Nan Li
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, 100176, People’s Republic of China
| | - Yi-Zhuo Wang
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, 100176, People’s Republic of China
| | - Dong-Sheng Huang
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, 100176, People’s Republic of China
- Correspondence: Dong-Sheng Huang, Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, No. 2, Xihuan South Road, Yizhuang Economic and Technological Development Zone, Beijing, 100176, People’s Republic of China, Email
| | - Yi Zhang
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, 100176, People’s Republic of China
| | - Wei-Ling Zhang
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, 100176, People’s Republic of China
| | - Jian-Min Ma
- Department of Ophthalmic Oncology, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Yan Zhou
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, 100176, People’s Republic of China
| | - Ting-Ting Liu
- Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, 100176, People’s Republic of China
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Boddu D, Thankamony P, Prakasam R, Sugath S, Kumar A, Nair S. Successful Treatment of Late Isolated Bone Metastasis in a Patient with Bilateral Retinoblastoma Using an Unconventional Method. Ocul Oncol Pathol 2021; 7:262-266. [PMID: 34604198 PMCID: PMC8443926 DOI: 10.1159/000514620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 01/20/2021] [Indexed: 11/19/2022] Open
Abstract
Though survival in bilateral retinoblastoma (RB) has improved due to advancement in diagnostics and treatment modalities, children require long-term follow-ups for recurrence and second malignancies. We report a case of bilateral RB in a 7-month-old baby who was treated with chemotherapy, transpupillary thermotherapy, and periocular carboplatin for both eyes following which there was complete regression of tumour. Six and a half years after treatment, the child presented with metastatic recurrence of tumour in the left ulna. He was treated successfully with chemotherapy, extracorporeal radiation and reimplantation therapy. A less aggressive treatment approach for isolated bone relapse may be considered in selected cases.
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Affiliation(s)
- Deepthi Boddu
- Department of Paediatric Oncology, Regional Cancer Centre, Thiruvananthapuram, India
| | | | - Reshma Prakasam
- Department of Radiodiagnosis, Regional Cancer Centre, Thiruvananthapuram, India
| | - Subin Sugath
- Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, India
| | - Aswin Kumar
- Department of Radiation Oncology, Regional Cancer Centre, Thiruvananthapuram, India
| | - Sindhu Nair
- Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, India
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Clarissa A, Sutandi N, Fath AA. Stem-Cell Therapy Following High-Dose Chemotherapy in Advanced Retinoblastoma: A Systematic Review. Asia Pac J Ophthalmol (Phila) 2021; 10:397-407. [PMID: 33481395 DOI: 10.1097/apo.0000000000000372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
PURPOSE To analyze the risk and benefit of high-dose chemotherapy followed by stem cell transplantation (HDCT-SCT) treatment in patients with advanced retinoblastoma. DESIGN Systematic review. METHODS A comprehensive literature search from 4 online databases, including PubMed, Scopus, EBSCO, and Cochrane was done for original studies evaluating the use of HDCT followed by SCT in the treatment of patients with advanced retinoblastoma. The last search was performed on April 15, 2020. RESULTS A total of 35 studies consisting of 160 patients were considered suitable for inclusion. After HDCT-SCT treatment, 108/160 (67.5%) patients were alive with no evidence of disease at the last follow-up. The incidence of secondary malignancy in our data was also relatively low, which was 16/160 (10%) patients. The side effects were mainly hematological and gastrointestinal toxicities. The prognosis for metastatic cases especially the one to the central nervous system (CNS) remains poor, as shown in our data that 22 of 44 (50%) patients died due to the evidence of disease, and 12 of 44 (27%) patients acquired CNS relapse and died. CONCLUSIONS HDCT-SCT is a promising treatment option in patients with advanced retinoblastoma. The use of HDCT-SCT in CNS metastases needs to be carefully considered, possibly by adding thiotepa or topotecan to improve tumor control. Further randomized clinical trials are needed to draw firm conclusion regarding its safety and efficacy.
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Affiliation(s)
- Audrey Clarissa
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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