Histopathological Risk Features in Primary and Secondary Enucleation for Group D Retinoblastoma: A...

Area of Science:

• Ophthalmology
• Pediatric Oncology
• Pathology

Background:

• Group D retinoblastoma (RB) signifies advanced intraocular disease with high treatment failure risk.
• Globe-sparing therapies improve ocular salvage but histopathological data for enucleated Group D eyes, especially after failed conservative treatment, is limited.

Purpose of the Study:

• To evaluate high-risk histopathological features in Group D RB eyes undergoing primary versus secondary enucleation.
• To compare the histopathological risk profile based on the timing of enucleation.

Main Methods:

• Retrospective analysis of enucleated Group D RB eyes (n=8).
• Eyes were categorized into primary (n=4) or secondary (n=4) enucleation groups.
• Histopathological examination for high-risk features: optic nerve invasion (post-laminar, cut-end), massive choroidal invasion, scleral invasion.

Main Results:

• High-risk features were present in 50% of eyes (4/8).
• Secondary enucleation eyes showed a higher prevalence of high-risk features (75%) compared to primary enucleation eyes (25%).
• No statistically significant association between enucleation timing and high-risk pathology (p=0.49).

Conclusions:

• High-risk histopathological features are more common in Group D RB eyes undergoing secondary enucleation after failed globe-sparing therapy.
• Delayed enucleation may permit microscopic disease progression, emphasizing the need for timely intervention in select advanced cases.
• Findings support careful risk assessment for globe-sparing approaches in Group D RB.