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Finger PT, Tomar AS, Gallie B, Kivelä TT, 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. Reply. Ophthalmology 2023; 130:e12-e13. [PMID: 36443124 DOI: 10.1016/j.ophtha.2022.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Paul T Finger
- The Department of Ocular Tumor, Orbital Disease, and Ophthalmic Radiation Therapy, The New York Eye Cancer Center, New York, New York.
| | - Ankit S Tomar
- The Department of Ocular Tumor, Orbital Disease, and Ophthalmic Radiation Therapy, 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
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Tomar AS, Finger PT, Gallie B, Kivelä T, Mallipatna A, Zhang C, Zhao J, Wilson M, Brennan R, Burges M, Kim J, Berry JL, Jubran R, Khetan V, Ganeshan S, Yarovoy A, Yarovaya V, Kotova E, Volodin D, Yousef Y, Nummi K, Ushakova TL, Yugay OV, Polyakov VG, Ramirez-Ortiz MA, Esparza-Aguiar E, Chantada GL, Schaiquevich P, Fandiño AC, Yam JC, Lau WW, Lam CP, Sharwood P, Moorthy S, Long QB, Essuman VA, Renner LA, Semenova E, Català-Mora J, Correa Llano M, Carreras E. Retinoblastoma seeds: impact on American Joint Committee on Cancer clinical staging. Br J Ophthalmol 2023; 107:127-132. [PMID: 34340974 PMCID: PMC9205754 DOI: 10.1136/bjophthalmol-2021-318892] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 07/10/2021] [Indexed: 11/04/2022]
Abstract
AIM To investigate whether the American Joint Committee on Cancer (AJCC) clinical category cT2b needs to be subclassified by the type and distribution of retinoblastoma (RB) seeding. METHODS Multicentre, international registry-based data were collected from RB centres enrolled between January 2001 and December 2013. 1054 RB eyes with vitreous or subretinal seeds from 18 ophthalmic oncology centres, in 13 countries within six continents were analysed. Local treatment failure was defined as the use of secondary enucleation or external beam radiation therapy (EBRT) and was estimated with the Kaplan-Meier method. RESULTS Clinical category cT2b included 1054 eyes. Median age at presentation was 16.0 months. Of these, 428 (40.6%) eyes were salvaged, and 430 (40.8%) were treated with primary and 196 (18.6%) with secondary enucleation. Of the 592 eyes that had complete data for globe salvage analysis, the distribution of seeds was focal in 143 (24.2%) and diffuse in 449 (75.8%). The 5-year Kaplan-Meier cumulative globe-salvage (without EBRT) was 78% and 49% for eyes with focal and diffuse RB seeding, respectively. Cox proportional hazards regression analysis confirmed a higher local treatment failure risk with diffuse seeds as compared with focal seeds (hazard rate: 2.8; p<0.001). There was insufficient evidence to prove or disprove an association between vitreous seed type and local treatment failure risk(p=0.06). CONCLUSION This international, multicentre, registry-based analysis of RB eyes affirmed that eyes with diffuse intraocular distribution of RB seeds at diagnosis had a higher risk of local treatment failure when compared with focal seeds. Subclassification of AJCC RB category cT2b into focal vs diffuse seeds will improve prognostication for eye salvage.
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Affiliation(s)
- Ankit Singh Tomar
- Department of Ocular Tumor and Orbital Disease, New York Eye Cancer Center, New York, New York, USA
| | - Paul T Finger
- Department of Ocular Tumor and Orbital Disease, New York Eye Cancer Center, New York, New York, USA
| | - Brenda Gallie
- The Eye Cancer Clinic, Princess Margaret Cancer Centre, and Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Tero Kivelä
- Ocular Oncology Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ashwin Mallipatna
- Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, Ontario, Canada,Department of Ophthalmology and Vision Sciences, Narayana Nethralaya, Bangalore, Karnataka, India
| | - Chengyue Zhang
- Pediatric Oncology Center, Beijing Children's Hospital, Beijing, China
| | - Junyang Zhao
- Pediatric Oncology Center, Beijing Children's Hospital, Beijing, China
| | - Matthew Wilson
- Ophthalmic Oncology, Department of Ophthalmology Hamilton Eye Institute, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Rachel Brennan
- Department of Ophthalmology, St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Michala Burges
- Ophthalmic Oncology, Department of Ophthalmology Hamilton Eye Institute, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Jonathan Kim
- USC Roski Eye Institute, Keck Medical School of the University of Southern California, and The Vision Center at Children’s Hospital Los Angeles, Los Angeles, California, USA
| | - Jesse L Berry
- Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Rima Jubran
- Cancer and Blood Diseases, Childrens Hospital Society of Los Angeles, Los Angeles, California, USA
| | - Vikas Khetan
- Vitreo Retinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | | | - Andrey Yarovoy
- Ocular Oncology Department, S Fyodorov Eye Microsurgery Federal State Institution, Moskva, Moskva, Russian Federation
| | - Vera Yarovaya
- Ocular Oncology Department, S Fyodorov Eye Microsurgery Federal State Institution, Moskva, Moskva, Russian Federation
| | - Elena Kotova
- Ocular Oncology Department, S Fyodorov Eye Microsurgery Federal State Institution, Moskva, Moskva, Russian Federation
| | - Denis Volodin
- Ocular Oncology Department, S Fyodorov Eye Microsurgery Federal State Institution, Moskva, Moskva, Russian Federation
| | - Yacoub 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
- Pediatric Oncology and Hematology, N N Blokhin NMRCO, Moskva, Russian Federation,Russian Academy of Postgraduate Medical Education, Moskva, Russian Federation
| | - Olga V Yugay
- Pediatric Oncology and Hematology, N N Blokhin NMRCO, Moskva, Russian Federation
| | - Vladimir G Polyakov
- Pediatric Oncology and Hematology, N N Blokhin NMRCO, Moskva, Russian Federation,Russian Academy of Sciences, Moskva, Russian Federation
| | | | | | - Guillermo L Chantada
- Ophthalmology, Paediatric Hospital Dr Juan Garrahan Library, Buenos Aires, Argentina
| | - Paula Schaiquevich
- Precision Medicine Coordination Hospital J. P. Garrahan, and CONICET (National Scientific and Technical Research Council), Buenos Aires, Argentina
| | - Adriana C Fandiño
- Ophthalmology, Paediatric Hospital Dr Juan Garrahan Library, Buenos Aires, Argentina
| | - Jason C Yam
- Opthamology and Visual Sciences, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, Hong Kong
| | - Winnie W Lau
- Department of Ophthalmology and Visual Sciences, Hong Kong Eye Hospital, Hong Kong, Hong Kong
| | - Carol P Lam
- Department of Ophthalmology and Visual Sciences, Hong Kong Eye Hospital, Hong Kong, Hong Kong
| | - Phillipa Sharwood
- Save Sight Institute, Discipline of Ophthalmology, The University of Sydney Sydney Medical School, Sydney, New South Wales, Australia
| | - Sonia Moorthy
- Retinoblastoma Unit, Department of Oncology, Hospital Sant Joan de Déu. Esplugues de Llobregat, Barcelona, Spain
| | | | | | - Lorna A Renner
- Department of Child Health, University of Ghana Medical School, Accra, Greater Accra, Ghana
| | - Ekaterina Semenova
- Department of Ocular Tumor and Orbital Disease, New York Eye Cancer Center, New York, New York, USA
| | - Jaume Català-Mora
- Ophthalmology, Hospital Sant Joan de Deu, Barcelona, Catalunya, Spain
| | | | - Elisa Carreras
- Ophthalmology, Hospital Sant Joan de Deu, Barcelona, Catalunya, Spain
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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. Metastatic Death Based on Presenting Features and Treatment for Advanced Intraocular Retinoblastoma: A Multicenter Registry-Based Study. Ophthalmology 2022; 129:933-945. [PMID: 35500608 PMCID: PMC9329221 DOI: 10.1016/j.ophtha.2022.04.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/12/2022] [Accepted: 04/25/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To evaluate presenting features, tumor size, and treatment methods for risk of metastatic death due to advanced intraocular retinoblastoma (RB). DESIGN International, multicenter, registry-based retrospective case series. PARTICIPANTS A total of 1841 patients with advanced RB. METHODS Advanced RB was defined by 8th edition American Joint Committee on Cancer (AJCC) categories cT2 and cT3 and new AJCC-Ophthalmic Oncology Task Force (OOTF) Size Groups (1: < 50% of globe volume, 2: > 50% but < 2/3, 3: > 2/3, and 4: diffuse infiltrating RB). Treatments were primary enucleation, systemic chemotherapy with secondary enucleation, and systemic chemotherapy with eye salvage. MAIN OUTCOME MEASURES Metastatic death. RESULTS The 5-year Kaplan-Meier cumulative survival estimates by patient-level AJCC clinical subcategories were 98% for cT2a, 96% for cT2b, 88% for cT3a, 95% for cT3b, 92% for cT3c, 84% for cT3d, and 75% for cT3e RB. Survival estimates by treatment modality were 96% for primary enucleation, 89% for systemic chemotherapy and secondary enucleation, and 90% for systemic chemotherapy with eye salvage. Risk of metastatic mortality increased with increasing cT subcategory (P < 0.001). Cox proportional hazards regression analysis confirmed a higher risk of metastatic mortality in categories cT3c (glaucoma, hazard ratio [HR], 4.9; P = 0.011), cT3d (intraocular hemorrhage, HR, 14.0; P < 0.001), and cT3e (orbital cellulitis, HR, 19.6; P < 0.001) than in category cT2a and with systemic chemotherapy with secondary enucleation (HR, 3.3; P < 0.001) and eye salvage (HR, 4.9; P < 0.001) than with primary enucleation. The 5-year Kaplan-Meier cumulative survival estimates by AJCC-OOTF Size Groups 1 to 4 were 99%, 96%, 94%, and 83%, respectively. Mortality from metastatic RB increased with increasing Size Group (P < 0.001). Cox proportional hazards regression analysis revealed that patients with Size Group 3 (HR, 10.0; P = 0.002) and 4 (HR, 41.1; P < 0.001) had a greater risk of metastatic mortality than Size Group 1. CONCLUSIONS The AJCC-RB cT2 and cT3 subcategories and size-based AJCC-OOTF Groups 3 (> 2/3 globe volume) and 4 (diffuse infiltrating RB) provided a robust stratification of clinical risk for metastatic death in advanced intraocular RB. Primary enucleation offered the highest survival rates for patients with advanced intraocular RB.
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Affiliation(s)
- Ankit Singh Tomar
- Department of Ocular Tumor, Orbital Disease, and Ophthalmic Radiation Therapy, The New York Eye Cancer Center, New York, New York
| | - Paul T Finger
- Department of Ocular Tumor, Orbital Disease, and Ophthalmic Radiation Therapy, 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 of the University of Southern California, Los Angeles, California; The Vision Center at Children's Hospital Los Angeles, Los Angeles, California
| | - Jesse L Berry
- USC Roski Eye Institute, Keck Medical School of the University of Southern California, Los Angeles, California; The Vision Center at Children's Hospital Los Angeles, Los Angeles, California
| | - Rima Jubran
- USC Roski Eye Institute, Keck Medical School of the University of Southern California, Los Angeles, California; 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 of N.N. Blokhin National Medical Research Center Oncology of Russian Federation, Moscow, Russian Federation; Medical Academy of Postgraduate Education, Moscow, Russian Federation
| | - Olga V Yugay
- SRI of Pediatric Oncology and Hematology of N.N. Blokhin National Medical Research Center Oncology of Russian Federation, Moscow, Russian Federation
| | - Vladimir G Polyakov
- SRI of Pediatric Oncology and Hematology of N.N. Blokhin National Medical Research Center Oncology of Russian Federation, Moscow, Russian Federation; Medical Academy of Postgraduate Education, Moscow, Russian Federation
| | - Marco A Ramirez-Ortiz
- Department of Ophthalmology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | | | | | - 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
| | | | | | - 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, Orbital Disease, and Ophthalmic Radiation Therapy, 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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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Tomar AS, Finger PT, Gallie B, Mallipatna A, Kivelä TT, Zhang C, Zhao J, Wilson MW, Kim J, Khetan V, Ganesan S, Yarovoy A, Yarovaya V, Kotova E, 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, Català J, Correa-Llano G. A Multicenter, International Collaborative Study for American Joint Committee on Cancer Staging of Retinoblastoma: Part I: Metastasis-Associated Mortality. Ophthalmology 2020; 127:1719-1732. [PMID: 32512116 DOI: 10.1016/j.ophtha.2020.05.050] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 05/04/2020] [Accepted: 05/29/2020] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To evaluate the ability of the 8th edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual to estimate metastatic and mortality rates for children with retinoblastoma (RB). DESIGN International, multicenter, registry-based retrospective case series. PARTICIPANTS A total of 2190 patients from 18 ophthalmic oncology centers from 13 countries over 6 continents. METHODS Patient-specific data fields for RB were designed and selected by subcommittee. All patients with RB with adequate records to allow tumor staging by the AJCC criteria and follow-up for metastatic disease were studied. MAIN OUTCOME MEASURES Metastasis-related 5- and 10-year survival data after initial tumor staging were estimated with the Kaplan-Meier method depending on AJCC clinical (cTNM) and pathological (pTNM) tumor, node, metastasis category and age, tumor laterality, and presence of heritable trait. RESULTS Of 2190 patients, the records of 2085 patients (95.2%) with 2905 eyes were complete. The median age at diagnosis was 17.0 months. A total of 1260 patients (65.4%) had unilateral RB. Among the 2085 patients, tumor categories were cT1a in 55 (2.6%), cT1b in 168 (8.1%), cT2a in 197 (9.4%), cT2b in 812 (38.9%), cT3 in 835 (40.0%), and cT4 in 18 (0.9%). Of these, 1397 eyes in 1353 patients (48.1%) were treated with enucleation. A total of 109 patients (5.2%) developed metastases and died. The median time (n = 92) from diagnosis to metastasis was 9.50 months. The 5-year Kaplan-Meier cumulative survival estimates by clinical tumor categories were 100% for category cT1a, 98% (95% confidence interval [CI], 97-99) for cT1b and cT2a, 96% (95% CI, 95-97) for cT2b, 89% (95% CI, 88-90) for cT3 tumors, and 45% (95% CI, 31-59) for cT4 tumors. Risk of metastasis increased with increasing cT (and pT) category (P < 0.001). Cox proportional hazards regression analysis confirmed a higher risk of metastasis in category cT3 (hazard rate [HR], 8.09; 95% CI, 2.55-25.70; P < 0.001) and cT4 (HR, 48.55; 95% CI, 12.86-183.27; P < 0.001) compared with category cT1. Age, tumor laterality, and presence of heritable traits did not influence the incidence of metastatic disease. CONCLUSIONS Multicenter, international, internet-based data sharing facilitated analysis of the 8th edition AJCC RB Staging System for metastasis-related mortality and offered a proof of concept yielding quantitative, predictive estimates per category in a large, real-life, heterogeneous patient population with RB.
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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, Toronto, Ontario, Canada
| | - Ashwin Mallipatna
- 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
| | - 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, Memphis, Tennessee; Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Jonathan Kim
- USC Roski Eye Institute, Keck Medical School of the University of Southern California, Los Angeles, California; 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
| | - 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 of N.N. Blokhin National Medical Research Center Oncology of Russian Federation, Moscow, Russian Federation; Medical Academy of Postgraduate Education, Moscow, Russian Federation
| | - Olga V Yugay
- SRI of Pediatric Oncology and Hematology of N.N. Blokhin National Medical Research Center Oncology of Russian Federation, Moscow, Russian Federation
| | - Vladimir G Polyakov
- SRI of Pediatric Oncology and Hematology of N.N. Blokhin National Medical Research Center Oncology of Russian Federation, Moscow, Russian Federation; 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
| | - 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, Kowloon, Hong Kong
| | - Winnie W Lau
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
| | - Carol P Lam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
| | - Phillipa Sharwood
- Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, University of Sydney, Sydney, Australia
| | | | | | - Vera Adobea Essuman
- Ophthalmology Unit, Department of Surgery, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Lorna A Renner
- Department of Child Health, University of Ghana Medical School, Accra, Ghana
| | - Jaume Català
- Retinoblastoma Unit, Department of Ophthalmology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Genoveva Correa-Llano
- Retinoblastoma Unit, Department of Oncology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
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