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Updated: Sep 13, 2025
Reconstruct Human Retinoblastoma In Vitro
Published on: October 11, 2022
Lag time for diagnosis and treatment in 1120 retinoblastoma children: Analysis from InPOG-RB-19-01
Sima Das1, Rachna Meel2, Amita Mahajan3
1Oculoplasty and Ocular Oncology Services, Dr Shroff's Charity Eye Hospital, New Delhi, India.
Insights
Parental lag time significantly delays retinoblastoma (RB) diagnosis and treatment, impacting outcomes. Community awareness and early screening by healthcare professionals are crucial for timely intervention in RB patients.
Area of Science:
- Ophthalmology
- Pediatric Oncology
- Public Health
Background:
- Delayed diagnosis and treatment in retinoblastoma (RB) are linked to poor patient outcomes.
- Understanding lag time is critical for improving RB management.
Purpose of the Study:
- To analyze lag time in retinoblastoma (RB) diagnosis and treatment.
- To identify factors contributing to delays in RB care.
Main Methods:
- Prospective, multicentric study (INPHOG-RB-19-01) of 1120 newly diagnosed RB patients over 36 months.
- Lag time analyzed as parent-lag time and system-lag time (diagnosis and treatment).
- Multivariate logistic regression used to identify predictive factors for increased lag time.
Main Results:
- Mean lag time from symptom onset to treatment was 4.2 months.
- Parental lag time (44%) was the largest contributor to overall delay.
- Increased lag time correlated with advanced stage, lower socioeconomic status, distance, younger maternal age, family cancer history, and non-specialist initial consultation.
Conclusions:
- Parental lag time is the primary driver of delays in retinoblastoma diagnosis and treatment.
- Interventions should focus on community awareness and routine screening during healthcare interactions.
- Earlier detection strategies are essential to improve outcomes for retinoblastoma patients.
Setting:
Increased lag time for diagnosis and treatment is a key determinant of adverse retinoblastoma (RB) outcomes. Analysis from INPHOG-RB-19-01, a prospective, multicentric study of newly diagnosed RB with regard to lag time and its correlation with various variables, is presented.
Patient Or Study Population:
All newly diagnosed RB patients treated at the participating centers during the study period were enrolled.
Observation Procedure:
Lag time was subdivided into parent-lag time (symptom onset to first consult) and system-lag time (including diagnosis lag time, defined as first consult to diagnosis, and treatment lag time, defined as diagnosis to treatment initiation.). Multivariate logistic regression analysis was used to assess factors predictive of increased lag time.
Main Outcome Measures:
In all, 1120 patients from 20 centers were enrolled over a 36-month period. Extraocular or metastatic disease was present in 25.2% of patients at diagnosis. The mean lag time from symptom onset to treatment initiation was 4.2 months (range 0.5-61.6 months). Parental, diagnosis, and treatment lag time contributed to 44%, 26%, and 31% of the total lag time, respectively. Increased lag time had significant correlation with the stage at presentation (P < 0.05), lower socio-economic status (P = 0.006), increased distance from treating center (P = 0.001), younger maternal age at pregnancy (P < 0.05), family history of cancer (P = 0.031), and first consultation with a non-specialist (P = 0.001), and showed a negative correlation with improved maternal education. Parental lag time is the major contributor to the cascading delay in RB diagnosis and treatment initiation. Efforts for earlier diagnosis, therefore, need to be directed towards community awareness and routine screening during contact with healthcare professionals, such as at immunization.
