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Consequences of delayed diagnosis in treatment of retinoblastoma
Mohammad Faranoush1, Amir Abbas Hedayati Asl2, Azim Mehrvar3
1MAHAK Pediatric Cancer Treatment and Research Center ; Iran University of Medical Sciences.
Insights
Early diagnosis of retinoblastoma is crucial for effective treatment. Delays in diagnosis significantly worsen the disease stage and prognosis, emphasizing the need for prompt medical attention.
Area of Science:
- Ophthalmology
- Pediatric Oncology
- Medical Diagnostics
Background:
- Retinoblastoma management hinges on early detection.
- Understanding the impact of diagnostic delays is vital for improving patient outcomes.
Purpose of the Study:
- To investigate the consequences of delayed diagnosis on retinoblastoma treatment.
- To identify factors associated with delayed diagnosis in retinoblastoma patients.
Main Methods:
- Retrospective review of 157 retinoblastoma patients (April 2007–Dec 2011) at MAHAK hospital.
- Tumor staging using the International Classification of Retinoblastoma (Groups A–E).
- Analysis of diagnostic delay duration and its correlation with tumor characteristics.
Main Results:
- Average diagnostic delay was 3.4 months.
- Significant correlation found between delayed diagnosis and advanced tumor grouping (P=0.05).
- Extraocular retinoblastoma showed longer delays (8.7 months) compared to intraocular tumors (2.9 months).
- Leukocoria and strabismus were the most common presenting symptoms.
Conclusions:
- Early referral of suspected retinoblastoma cases to specialists is recommended.
- Public awareness campaigns highlighting key symptoms like leukocoria and strabismus are essential.
- Timely diagnosis is paramount for better retinoblastoma management and prognosis.
Objective:
One of the primary factors in managing patients with retinoblastoma is early diagnosis. The main idea of this study was to recognize the consequences of delay in diagnosis on therapy of the disease.
Methods:
A retrospective review of all children with proven retinoblastoma, who had presented to MAHAK hospital in Tehran, from April 2007 to Dec 2011, was performed. Grouping of intraocular tumors was applied as A to E according to International Classification of Retinoblastoma. Findings : There were 157 (91 boys) children eligible for study. The mean age was 1.21±0.11 years with average delay in diagnosis of 3.4±0.53 months. Classification of D group in both unilateral (93 patients) and bilateral tumors was the largest category. A significant relation (P=0.05) between delayed diagnosis time and tumor grouping was evident. The most frequent symptoms were leukocoria and strabismus. Age was significantly lower in the subgroup of bilateral tumors than in unilateral retinoblastomas (0.6±0.12 year vs 1.6±0.15 years). The diagnosis was delayed in subgroup of extra ocular retinoblastoma more than in intraocular tumors (8.7±2.9 months vs 2.9±0.52 months).
Conclusion:
The authors recommend early referring of suspected cases to ophthalmologists and pediatric oncologists and to organize educational programs to publisize signs and symptoms of the disease such as leukocoria, strabismus and ocular inflammatory disorders through national media. In conclusion, early diagnosis of retinoblastoma can be the primary factor in managing the patients as the delay in diagnosis accounts for highly advanced disease and poor prognosis.
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