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Updated: May 20, 2026
Reconstruct Human Retinoblastoma In Vitro
Published on: October 11, 2022
Outcome of children with retinoblastoma and isolated choroidal invasion
Andrea Bosaleh1, Claudia Sampor, Verónica Solernou
1Department of Pathology, Hospital JP Garrahan, Buenos Aires, Argentina.
Insights
Children with massive choroidal invasion have a higher relapse rate but excellent survival without adjuvant chemotherapy. Aggressive therapy for extraocular relapse ensures comparable outcomes to focal invasion cases.
Area of Science:
- Ophthalmology
- Pediatric Oncology
- Retinoblastoma Research
Background:
- Choroidal invasion in retinoblastoma is a critical prognostic factor.
- Accurate grading systems for choroidal invasion are essential for treatment planning.
- Understanding predictors of extraocular relapse is vital for improving patient outcomes.
Purpose of the Study:
- Evaluate outcomes in children with varying degrees of choroidal invasion.
- Compare different systems for grading choroidal invasion extent.
- Assess prelaminar optic nerve and anterior segment invasion as predictors of extraocular relapse.
Main Methods:
- Retrospective analysis of 167 children across 4 prospective protocols (1989-2010).
- Exclusion of patients with postlaminar optic nerve/scleral involvement or overt extraocular disease.
- Classification of massive choroidal invasion based on three definitions (size, thickness, percentage).
Main Results:
- Overall survival was excellent (98.7%) with 1 relapse in 167 patients.
- Event-free survival was lower in massive invasion (94.2%) vs. focal invasion (99.2%) (P=.04).
- No significant difference in overall survival between massive and focal invasion groups (P=.29).
Conclusions:
- Excellent survival rates achieved without adjuvant chemotherapy.
- Massive choroidal invasion correlates with a higher relapse rate but not reduced overall survival.
- Aggressive management of extraocular relapse is key to achieving comparable survival outcomes.
Objectives:
To evaluate the outcome of children with different degrees of choroidal invasion, to compare different systems for grading the extent of choroidal invasion, and to assess the role of concomitant prelaminar optic nerve and anterior segment invasion as predictors of extraocular relapse.
Design:
Retrospective analysis of children included in 4 prospective protocols (January 1, 1989, through June 31, 2010). Children with postlaminar optic nerve or scleral involvement and overt extraocular disease were excluded. Adjuvant chemotherapy was not scheduled. All slides were reviewed, and massive involvement was classified according to 3 definitions: (1) extending at least 3 mm in any dimension, (2) through the choroid's whole thickness, and (3) more than 50% of the thickness and/or more than 1 cluster.
Results:
One hundred sixty-seven children (35 with massive invasion) were studied (136 did not receive adjuvant therapy). The probability of 5-year event-free survival was 98.1% and the probability of overall survival was 98.7% because 1 patient relapsed. Children with massive invasion had a significantly lower event-free survival probability (94.2%) compared with those with focal invasion (99.2%) (P = .04). However, no significant difference was found in overall survival probability (98.7% vs 99.2%; P = .29). No significant effect of other risk factors was found.
Conclusions:
Survival was excellent without adjuvant therapy, and no other factors correlated with survival. Children with massive invasion have a higher relapse rate but comparable survival to those with focal invasion provided that aggressive therapy for extraocular relapse is available with adequate safety conditions.
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