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Malabanan-Cabebe CGP, Santos-Gonzales MA, Te AVR, Tan RJD, Gonzales-Sy J. Retinoblastoma in the Southern Philippines: Clinical Outcomes of Retinoblastoma Patients in a Davao Tertiary Hospital. ACTA MEDICA PHILIPPINA 2024; 58:45-51. [PMID: 38846169 PMCID: PMC11151136 DOI: 10.47895/amp.vi0.6754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
Background Retinoblastoma is the most common intraocular cancer in childhood in the Philippines. Most data though on demographics, clinical profile, treatment options, and outcomes in the country are from the National Capital Region. Objectives This study aimed to describe the demographics, clinical profile, treatment done, and outcomes of retinoblastoma patients seen in a public tertiary referral center in Davao from 2011-2020 to make available literature more representative of the status of retinoblastoma in the Philippines. Methods An analytical cross-sectional study was conducted using the records of retinoblastoma patients seen in a tertiary government hospital located in Davao Region from January 2011 to December 2020. Results There were 157 patients included in the analysis. Seventy-three (46%) were female with 44% coming from the Davao Region. One hundred seven (69%) patients had unilateral disease. Median age at initial consultation for patients with unilateral disease was significantly older than those with bilateral disease (p<0.003). Tumors were extraocular in 82 (40%) eyes. In the intraocular group, 36% of the eyes belonged to International Classification of Retinoblastoma (ICRB) Groups D and E. Enucleation was the most commonly performed treatment. Survival rate was 28%.This is the first report to provide epidemiologic and clinical data on retinoblastoma in the literature, including survival data, from Mindanao. Advanced stages and extraocular cases of retinoblastoma remain high. Delay of consultation contributed to the prognosis and clinical outcome of the disease. Conclusion Advanced stages and extraocular cases of retinoblastoma remain significantly high in the country, even in Mindanao.
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Affiliation(s)
| | - Melissa Anne Santos-Gonzales
- Section of Pediatric Ophthalmology and Strabismus, Department of Ophthalmology, Southern Philippines Medical Center, Davao City, Philippines
- St. Elizabeth Hospital, Inc., General Santos City, Philippines
- General Santos Doctor's Hospital, General Santos City, Philippines
| | | | - Roland Joseph D. Tan
- Department of Ophthalmology and Visual Sciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Jocelyne Gonzales-Sy
- Southern Philippines Medical Center, Davao City, Philippines
- Metro Davao Medical and Research Institute, Davao City, Philippines
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Tan RJD, Mercado GJV, Cabrera PE, Astudillo PPP, Domingo RED, Poblete JMS, Cabebe CGM, Te AVR, Gonzales MAS, Sy JG, Aclan BAA, So JT, Regala FG, Comia KAK, Castro JM, Galang MAS, Cabanlas ADC, Aguilar BJE, Evangelista GS, Maniwan JM, Martin AP, Martinez CY, Lim JAH, Bascuna RI, Ng RM, Agsaoay KB, Acluba-Arao KZA, Apostol ERV, Prieto BM. Philippine retinoblastoma initiative multi-eye center study 2010-2020. Int J Ophthalmol 2024; 17:144-156. [PMID: 38239949 PMCID: PMC10754670 DOI: 10.18240/ijo.2024.01.20] [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: 07/01/2023] [Accepted: 10/19/2023] [Indexed: 01/22/2024] Open
Abstract
AIM To provide a comprehensive and more representative national data on the disease, especially on treatment options and outcomes, and to determine access of retinoblastoma patients from Luzon, Visayas and Mindanao to eye care, and determine if access is associated with delay in consultation, staging and outcomes. METHODS Cohort study of retinoblastoma patients seen in eleven institutions located in the three major areas of the Philippines namely Luzon, Vizayas and Mindanao from 2010-2020. RESULTS Totally 636 patients, involving 821 eyes, were included. Majority (57%) were from Luzon and were seen in institutions in Luzon (72%). Annually, 58±10 new cases were seen with 71% having unilateral disease. Median delay of consultation remained long at 9 (3, 17)mo, longest in patients with unilateral disease (P<0.02) and those from the Visayas (P<0.003). Based on the International Retinoblastoma Staging System, only 35% of patients had Stage 1 while 47% already had extraocular disease. Enucleation was the most common treatment received by 484 patients while intravenous chemotherapy was received by 469. There were 250 (39%) patients alive, 195 (31%) dead, 85 (13%) abandoned, 17 (3%) refused and 89 (14%) with no data. CONCLUSION This study presents the largest cohort of retinoblastoma patients in the Philippines in terms of patients' and participating institutions' number and geographical location and type of institution (private and public). It also presents more comprehensive data on the treatments used and outcomes (survival, globe salvage, and vision retention rates). Delay in consultation was still long among patients leading to advanced disease stage and lower survival rate. Despite increasing capacity to diagnose and manage retinoblastoma in the country, the delay of consultation remains long primarily due to accessibility issues to eye care institutions especially in the Visayas and financial concerns. The delay was still significant that overall survival rate remain low.
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Affiliation(s)
- Roland Joseph D. Tan
- Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila 1000, Philippines
- Department of Ophthalmology, Baguio General Hospital and Medical Center, Baguio City 2600, Philippines
| | - Gary John V. Mercado
- Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila 1000, Philippines
- Department of Ophthalmology, Manila Doctors Hospital, Manila 1000, Philippines
| | - Patricia E. Cabrera
- Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila 1000, Philippines
- Department of Ophthalmology, Rizal Medical Center, Pasig City 1600, Philippines
| | - Paulita Pamela P. Astudillo
- Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila 1000, Philippines
- Department of Ophthalmology, Jose B. Lingad Memorial Regional Hospital, Pampanga 2000, Philippines
| | | | - Josept Mari S. Poblete
- Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila 1000, Philippines
| | | | - Adriel Vincent R. Te
- Department of Ophthalmology, Southern Philippines Medical Center, Davao City 8000, Philippines
| | | | - Jocelyn G. Sy
- Department of Ophthalmology, Southern Philippines Medical Center, Davao City 8000, Philippines
| | | | - Jayson T. So
- Department of Ophthalmology, East Avenue Medical Center, Quezon City 1100, Philippines
| | - Fatima G. Regala
- Department of Ophthalmology, East Avenue Medical Center, Quezon City 1100, Philippines
| | | | - Josemaria M. Castro
- Department of Ophthalmology, Manila Doctors Hospital, Manila 1000, Philippines
| | | | | | - Benedicto Juan E. Aguilar
- Department of Ophthalmology, Northern Mindanao Medical Center, Cagayan de Oro City 9000, Philippines
| | - Gabrielle S. Evangelista
- Department of Ophthalmology, Northern Mindanao Medical Center, Cagayan de Oro City 9000, Philippines
| | - Jo Michael Maniwan
- Department of Ophthalmology, Rizal Medical Center, Pasig City 1600, Philippines
| | - Andrei P. Martin
- Department of Ophthalmology, Rizal Medical Center, Pasig City 1600, Philippines
| | - Calvin Y. Martinez
- Department of Ophthalmology, Cebu Velez General Hospital, Cebu City 6000, Philippines
| | - John Alfred H. Lim
- Department of Ophthalmology, Cebu Velez General Hospital, Cebu City 6000, Philippines
| | | | - Rachel M. Ng
- Legazpi Eye Center, Legazpi City 4500, Philippines
| | - Kevin B. Agsaoay
- Department of Ophthalmology, Cagayan Valley Medical Center, Tuguegarao City 3500, Philippines
| | | | | | - Beatriz M. Prieto
- Department of Ophthalmology, East Avenue Medical Center, Quezon City 1100, Philippines
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Lukamba RM, Budiongo AN, Monga BB, Yao A, Bey P, Chenge GB, Desjardins L, Doz F, Mwembo AT, Kabesha TA, Luboya ON. Treatment adherence in retinoblastoma: A retro-prospective cohort study in Ivory Coast and the Democratic Republic of Congo. Cancer Rep (Hoboken) 2023; 7:e1949. [PMID: 38146612 PMCID: PMC10849925 DOI: 10.1002/cnr2.1949] [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: 06/28/2023] [Revised: 10/11/2023] [Accepted: 11/12/2023] [Indexed: 12/27/2023] Open
Abstract
BACKGROUND In high-income countries, retinoblastoma is curable in more than 95% of cases, whereas in low-income countries, mortality remains high, especially when the diagnosis is made late or the treatment is discontinued. AIMS To determine the factors associated with adherence to the treatment of retinoblastoma in the Ivory Coast and the Democratic Republic of Congo (DRC). METHODS AND RESULTS A retro-prospective cohort study was carried out. Data were collected from patient folders and follow-up records of parents. RESULTS A total of 175 children with retinoblastoma were registered from January 2013 to December 2015. Seventy-six children (43%) were 5 years old and above. Care costs were covered by families in 86.9% of cases. Chemotherapy refusal was recorded in 39 cases (22.3%), and enucleation refusal was recorded in 79 cases (45.1%). After 36 months of follow-up, we recorded 16.6% deaths, 27.4% treatment dropouts, and 18.3% loss to follow-up after treatment. The commonest cause for enucleation refusal was fear of infirmity, while chemotherapy refusal and absconding treatment were due to financial constraints. CONCLUSION Poor adherence to retinoblastoma management was due to financial constraints, and a lack of knowledge of the disease and its treatment. Family psychosocial support is needed to improve this condition.
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Affiliation(s)
- Robert Mbuli Lukamba
- Department of Pediatrics (Pediatric Oncology Unit)University of LubumbashiLubumbashiDemocratic Republic of the Congo (DRC)
| | - Aléine Nzazi Budiongo
- Department of Pediatrics (Pediatric Oncology Unit)University of KinshasaKinshasaDemocratic Republic of the Congo (DRC)
| | - Ben Bondo Monga
- Faculty of Medicine and School of Public HealthUniversity of LubumbashiLubumbashiDemocratic Republic of the Congo (DRC)
| | - Atteby Yao
- Pediatric Oncology UnitUniversity Teaching Hospital of TreichvilleAbidjanIvory Coast
| | - Pierre Bey
- Advisor to the President of Institut CurieUniversity of Lorraine and AMCCParisFrance
| | | | | | - François Doz
- SIREDO Oncology Center (Care, Innovation, Research in Child Oncology, Adolescent and Young Adult) Institut Curie and University Paris CitéParisFrance
| | - Albert Tambwe Mwembo
- Faculty of Medicine and School of Public HealthUniversity of LubumbashiLubumbashiDemocratic Republic of the Congo (DRC)
| | | | - Oscar Numbi Luboya
- Department of Pediatrics and School of Public HealthUniversity of LubumbashiLubumbashiDemocratic Republic of the Congo (DRC)
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Gibbs D, Reynolds L, Shea Yates T. Understanding the Experiences of Living With an Artificial Eye in Children With Retinoblastoma-Perspectives of Children and Their Parents. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:250-263. [PMID: 35791854 DOI: 10.1177/27527530211073688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Background: Retinoblastoma is a rare form of pediatric eye cancer for which enucleation is a common treatment modality. There is an increasing focus upon the impact of enucleation on children and families. This study aimed to explore the experiences of children and their families following enucleation to consider the barriers that may be encountered when adjusting to living with an artificial eye and identifying the support services and strategies used to address these barriers. Methods: Using a descriptive qualitative approach, interviews were conducted with 12 parents and seven children and thematic analysis was used to identify four themes representing the perspective of parents and children. Results: Parent themes identified were (a) entry into the world of retinoblastoma; (b) the importance of specialist support; (c) a family learning to cope; and (d) navigating school. The perspectives of children were (a) the importance of preparation and play; (b) positive reinforcement and hospital support; (c) support and openness at home; and (d) the importance of good school planning. Two overarching themes related to parent and child adaptation were also identified. Discussion: The study findings reveal that the process of adapting to living with an artificial eye extended to influencing decisions around parenting, learning to advocate for their child, and supporting children through school and peer relationships. For children, the importance of ongoing support and information was vital to enhance understanding, adaptation, and development of independence. Overall, the study suggests that children and families undergoing enucleation need continuing, individualized, and specialist support.
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Affiliation(s)
- Deanna Gibbs
- Barts Health NHS Trust, London, UK
- Blizard Institute, 4617Queen Mary University of London, London, UK
| | | | - Tara Shea Yates
- Barts Health NHS Trust, London, UK
- Blizard Institute, 4617Queen Mary University of London, London, UK
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Handayani K, Indraswari BW, Sitaresmi MN, Mulatsih S, Widjajanto PH, Kors WA, Kaspers GJ, Mostert S. Treatment Outcome of Children with Retinoblastoma in a Tertiary Care Referral Hospital in Indonesia. Asian Pac J Cancer Prev 2021; 22:1613-1621. [PMID: 34048193 PMCID: PMC8408394 DOI: 10.31557/apjcp.2021.22.5.1613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Although survival rates for retinoblastoma (RB) are over 95% in high-income countries, its high mortality rate in low and middle-income countries remains a great concern. Few studies investigated treatment outcome and factors contributing to RB survival in these latter settings. Aims of this study are to determine treatment outcome of Indonesian children diagnosed with RB and to explore factors predictive of treatment outcome. Methods: This study was a retrospective medical records review combined with an illustrative case report. Children newly diagnosed with RB between January 2011 and December 2016 at a tertiary care referral hospital in Indonesia were included. A home visit was conducted to perform an in-depth interview with a mother of two children affected by RB. Results: Of all 61 children with RB, 39% abandoned treatment, 21% died, 20% had progressive or relapsed disease and 20% event-free survival. Progressive or relapsed disease was more common in older (≥ 2 years at diagnosis, 29%) than young (<2 years at diagnosis, 0%) children (P=0.012). Event-free survival estimate at 5 years was higher in young (42%) than older (6%) children (P=0.045). Odds-ratio for event-free survival was 6.9 (95% CI: 1.747 – 27.328, P=0.006) for young versus older children. Other clinical and socio-demographic characteristics had no significant correlation with treatment outcome or event-free survival. The case report elucidated conditions and obstacles that Indonesian families face when their children are diagnosed with RB. Conclusion: Survival of children with RB in Indonesia is much lower compared to high-income and many other low and middle-income countries. Abandonment of treatment is the most common cause of treatment failure. Older age at diagnosis is associated with more progressive or relapsed disease and worse survival. Interventions to improve general public and health-care providers’ awareness, early detection and treatment adherence are required.
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Affiliation(s)
- Krisna Handayani
- Emma's Children's Hospital, Amsterdam UMC, Vrije Universiteit, Cancer Center Amsterdam, the Netherlands
| | - Braghmandita W Indraswari
- Pediatrics, Faculty Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr Sardjito Hospital, Yogyakarta, Indonesia
| | - Mei N Sitaresmi
- Pediatrics, Faculty Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr Sardjito Hospital, Yogyakarta, Indonesia
| | - Sri Mulatsih
- Pediatrics, Faculty Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr Sardjito Hospital, Yogyakarta, Indonesia
| | - Pudjo H Widjajanto
- Pediatrics, Faculty Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr Sardjito Hospital, Yogyakarta, Indonesia
| | - Wijnanda A Kors
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Gertjan Jl Kaspers
- Emma's Children's Hospital, Amsterdam UMC, Vrije Universiteit, Cancer Center Amsterdam, the Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Saskia Mostert
- Emma's Children's Hospital, Amsterdam UMC, Vrije Universiteit, Cancer Center Amsterdam, the Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
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Gupta SK, Meshram M, Kumar A, Verma N, Agrawal S, Kumar A. Survival and outcome of retinoblastoma treated by neo‐adjuvant chemotherapy in India. Cancer Rep (Hoboken) 2019. [DOI: 10.1002/cnr2.1137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Sanjiv Kumar Gupta
- King George's Medical University, Ophthalmology Lucknow Uttar Pradesh India
| | - Madhuri Meshram
- King George's Medical University, Ophthalmology Lucknow Uttar Pradesh India
| | - Ajai Kumar
- Jan Kalyan Eye hospital, Retina Unit Lucknow Uttar Pradesh India
| | - Nishant Verma
- King George's Medical University, Pediatric Oncology Lucknow Uttar Pradesh India
| | - Siddharth Agrawal
- King George's Medical University, Ophthalmology Lucknow Uttar Pradesh India
| | - Archana Kumar
- King George's Medical University, Pediatric Oncology Lucknow Uttar Pradesh India
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