Pattern of ocular tumors in the eastern region of Nepal

Histopathological profile of orbito-ocular cancers at a tertiary hospital in Northern Malawi: a retrospective cross-sectional study

Objective

Orbito-ocular cancers are a common cause of morbidity and mortality in our population, yet these cancers have not been adequately described in Malawi. This study sought to describe the burden and histopathological profile of orbito-ocular cancers in Northern Malawi.

Methods and Analysis

A retrospective review of pathology reports was done. Descriptive analyses were performed to summarise patients' demographic and clinical characteristics, and histopathological results. A binary logistic regression was used to explore the association between demographic variables, site of lesion and cancer.

Results

210 pathology reports of orbito-ocular biopsies were reviewed. 60.0% of patients were female. The majority (39.5%) of patients were in the 31 to 40 age group but overall mean age (±SD) was 34.81±15.9 years. Cancer was diagnosed in 84 (40.0%) patients. Squamous cell carcinoma constituted the majority (82.1%) of cancers followed by retinoblastoma at 7.1%. Orbito-ocular cancers were associated with HIV infection (OR5.9, 95% CI 2.0 to 17.2) and intraocular tumours were 8.3 times (OR 8.3, 95% CI 2.0 to 33.8) more likely to be malignant. However, squamous cell carcinoma was the only type of cancer found in patients with HIV infection and mostly affected the conjunctiva, constituting 94.4% of cancers affecting this site. Retinoblastoma on the other hand only affected children less than 10 years of age.

Conclusion

Cancer constituted a substantial proportion of orbito-ocular lesions in our study population, with conjunctiva being the common site. This calls for improved capacity to prevent, diagnose and manage orbito-oracular cancers in Northern Malawi and similar settings.

Predicted Trends in the Incidence of Retinoblastoma in the Asia-Pacific Region

PURPOSE

The aim of this study is to predict the incidence trends of retinoblastoma in the Asia-Pacific region.

DESIGN

Statistical prediction is based on the assumption of uniform incidence among live-born children.

METHODS

The number of live births was projected from population sizes and birth rates, corrected for infant mortality, and taken from the 2012 Revision of the World Population Prospects by the United Nations. The uniform incidence of 1:16,642 was derived from an earlier birth cohort analysis. Western Asia was excluded from calculations.

RESULTS

Six of 15 countries with over 100 retinoblastomas annually and responsible for 43% of 8099 retinoblastomas predicted for 2013 are Asia-Pacific nations. The predicted incidence of retinoblastoma in the Asia-Pacific peaked in 1988 at 4772 children and is 4167 and 3859, respectively, in 2012 and 2023. The 10 countries that account for 90% of retinoblastomas in the Asia-Pacific are India (1486 and 1435 children in 2013 and 2023, respectively), China (1103 and 911), Indonesia (277 and 265), Pakistan (260 and 261), Bangladesh (184 and 172), the Philippines (142 and 152), Iran (87 and 74), Vietnam (85 and 72), Japan (64 and 58), and Afghanistan (59 and 59). Largest relative decreases are predicted for China (-17%), Vietnam and Iran (-15%), and Sri Lanka (-13%).

CONCLUSIONS

Reported retinoblastomas during the last decade in the Asia-Pacific account for less than half of predicted numbers, which can be used as surrogates for evaluating completeness of registration and for advocacy toward reducing deaths and blindness from retinoblastoma.