Predictors of enucleation after intra-arterial chemotherapy for retinoblastoma
Joanna Roy1, Victor Gabriel El-Hajj1, Taweevat Attaseth2
1Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Background:
Intra-arterial chemotherapy (IAC) has emerged as a minimally invasive treatment modality for globe salvage in patients with retinoblastoma (Rb). There is limited knowledge of the factors that influence rates of enucleation after IAC.
Objective:
Our study identifies predictors of enucleation among Rb patients receiving IAC.
Methods:
This was a retrospective study of Rb patients who received IAC between January 2010 and December 2024 at a single center in the United States. The primary outcome was enucleation at last follow-up.
Results:
Of 305 patients, 26.89% (n=82) underwent enucleation and 73.11% (n=223) did not. On multivariate analysis, factors associated with increased risk for enucleation were greatest basal diameter (OR 1.07, 95% CI 1.00 to 1.15, p=0.035), bilateral Rb (OR 2.82, 95% CI 1.36 to 5.81, p=0.005), and advanced-stage disease at presentation (OR 7.45, 95% CI 1.92 to 28.9, p=0.004). The use of combination chemotherapy was associated with lower odds for enucleation compared with single-agent chemotherapy (OR 0.29, 95% CI 0.11 to 0.80, p=0.016), whereas double-agent chemotherapy was not significantly associated with enucleation (OR 0.90, 95% CI 0.46 to 1.75, p=0.75).
Conclusions:
Larger tumors, bilateral disease, and advanced-stage disease were linked to higher odds of enucleation, whereas combination chemotherapy was associated with lower odds compared with single-agent chemotherapy. Future studies could help validate these results.
