Factors associated with mortality among retinoblastoma patients in Malaysia: A retrospective cohort study

Retinoblastoma is the most common primary intraocular cancer worldwide. Research into factors associated with mortality in retinoblastoma from the Southeast Asian region is currently limited. The present study aims to identify the associated factors that predict mortality among retinoblastoma patients in Malaysia.

A retrospective cohort study was conducted on retinoblastoma patients diagnosed between January 2004 and April 2023 at hospitals with paediatric ophthalmology services in Malaysia. Data were collected from the Retinoblastoma Registry of the National Eye Database and patients' medical records. The adjusted hazard ratio (AHR) was used in the multivariable Cox regression model to identify the factors associated with mortality among retinoblastoma patients.

A total of 402 retinoblastoma patients were included in the study. Of these, 22 (5.5%) patients died, while 353 (87.8%) were alive and under follow-up at the end of the study, and 27 (6.7%) were lost to follow-up. The univariable Cox regression model identified laterality, lag time, and recurrence as the associated factors. The multivariable Cox regression model confirmed that bilateral (AHR: 3.64; 95% CI: 1.46, 9.02; p=0.004) and longer lag time (AHR: 4.03; 95% CI: 1.57, 10.35; p=0.004) were independent predictors of mortality.

This study found that bilateral and longer lag time were independent prognostic factors associated with higher mortality among retinoblastoma patients in Malaysia. These results highlight the utmost importance of early diagnosis and access to appropriate treatment to improve survival outcomes for retinoblastoma patients.