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Presentation pattern and survival rate of retinoblastoma following chemotherapy: a prospective study
Mayor Orezime Atima1, Ugbede Idakwo2, Oyeronke Komolafe2
1ECWA Eye Hospital, Kano, Nigeria. atimamatha@yahoo.com.
Insights
This study on retinoblastoma in Nigeria found a high mortality rate of 80% due to advanced disease. Early detection and chemotherapy are crucial for improving survival in pediatric intraocular cancer patients.
Area of Science:
- Ophthalmology
- Pediatric Oncology
- Global Health
Background:
- Retinoblastoma is the most common pediatric intraocular cancer.
- ECWA Eye Hospital in Kano State, Nigeria, serves as a key center for eye care in the region.
- Understanding the clinical presentation and survival rates is vital for improving management.
Purpose of the Study:
- To document the clinical presentation patterns of retinoblastoma.
- To determine the survival rate of retinoblastoma patients at ECWA Eye Hospital.
- To identify areas for enhancing medical care for pediatric intraocular cancer.
Main Methods:
- A prospective 5-year study (January 2018 - December 2022) of clinically diagnosed retinoblastoma cases.
- Standardized pre-medication and chemotherapy protocols were administered.
- A 5-year follow-up was conducted, with data analyzed for descriptive statistics and survival rate calculation.
Main Results:
- 35 retinoblastoma cases were diagnosed, with a mean age of 3.21 years.
- Common presentations included fungating ocular mass and proptosis; 80% mortality and 20% survival rate were observed.
- All survivors had unilateral retinoblastoma, highlighting the impact of disease laterality.
Conclusions:
- Most cases presented with advanced retinoblastoma, contributing to the high mortality rate.
- Chemotherapy is a viable treatment in low-resource settings with limited alternatives.
- Early presentation and timely chemotherapy administration are critical for improving retinoblastoma survival rates.
Background:
This study presents the clinical pattern of presentation and survival rate of retinoblastoma, which is the most prevalent form of pediatric intraocular cancer. The aim of this study is to provide baseline information about the clinical presentation and management of retinoblastoma at ECWA Eye Hospital. Additionally, the study identifies priority areas for enhancing medical care for children diagnosed with this cancer. ECWA Eye Hospital, situated in Kano State, Nigeria, is a specialized eye center located in the North-Western region of the country.
Methods:
A prospective study spanning five years was conducted at ECWA Eye Hospital to investigate clinically diagnosed cases of retinoblastoma. The study took place from January 2018 to December 2022. The patients received standardized pre-medication and chemotherapy protocols for retinoblastoma. Subsequently, a five-year follow-up was conducted to monitor the patients' progress. The collected data was analyzed, descriptive statistics were generated, and the survival rate was calculated.
Results:
During the five-year study period, a total of 35 cases of retinoblastoma were diagnosed. The patients had an average age of 3.21 ± 1.32 years. The most common presentation patterns observed were fungating ocular mass and proptosis. Among the cases, there were 10 instances of bilateral proptosis and 25 instances of unilateral proptosis. While no patients exhibited bilateral leukocoria, eight cases of unilateral leukocoria with anterior segment seedlings were identified. The additional patterns of presentation are proptosis, leukocoria, fungating orbital mass, redness and loss of vision. The mortality rate was 80% (28 cases), while the survival rate was 20% (7 cases). Notably, all the survivors had unilateral retinoblastoma.
Conclusion:
The majority of cases observed at ECWA Eye Hospital involve advanced retinoblastoma. In low-resource settings where alternative treatment options are limited, chemotherapy is considered a viable treatment option. Early presentation of retinoblastoma in patients may lead to a higher survival rate when chemotherapy is administered.
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