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Metastatic Death Based on Presenting Features and Treatment for Advanced Intraocular Retinoblastoma: A Multicenter
Ankit Singh Tomar1, Paul T Finger1, Brenda Gallie2
1Department of Ocular Tumor, Orbital Disease, and Ophthalmic Radiation Therapy, The New York Eye Cancer Center, New York, New York.
Ophthalmology
|May 2, 2022
Summary
Advanced intraocular retinoblastoma (RB) risk of metastatic death is stratified by American Joint Committee on Cancer (AJCC) staging and tumor size. Primary enucleation offers the best survival outcomes for patients with advanced RB.
Area of Science:
- Ophthalmology
- Oncology
- Medical Imaging
Background:
- Advanced intraocular retinoblastoma (RB) poses a significant risk of metastatic death.
- Accurate staging and risk stratification are crucial for effective treatment planning.
Purpose of the Study:
- To evaluate presenting features, tumor size, and treatment methods for predicting metastatic death risk in advanced intraocular retinoblastoma (RB).
Main Methods:
- Retrospective analysis of 1841 patients with advanced RB (AJCC cT2 and cT3 categories).
- Utilized AJCC-Ophthalmic Oncology Task Force (OOTF) Size Groups for tumor volume assessment.
- Compared survival outcomes across different treatment modalities: primary enucleation, chemotherapy with secondary enucleation, and chemotherapy with eye salvage.
Main Results:
- AJCC cT2 and cT3 subcategories and AJCC-OOTF Size Groups 3 and 4 demonstrated robust stratification of metastatic death risk.
- Higher risk of metastatic mortality was associated with advanced cT subcategories (cT3c-e) and larger tumor sizes (Size Groups 3-4).
- Primary enucleation yielded the highest 5-year survival rates (96%), followed by chemotherapy with eye salvage (90%) and chemotherapy with secondary enucleation (89%).
Conclusions:
- AJCC-RB clinical staging and size-based OOTF groups effectively stratify risk for metastatic death in advanced intraocular RB.
- Primary enucleation is associated with superior survival rates in advanced intraocular retinoblastoma.
- Risk stratification tools are essential for guiding treatment decisions and improving patient outcomes in advanced RB.
