Eye-Preserving Therapies for Early cT3c Retinoblastoma
Zhenyu Xu1, Yiran Yao1, Jie Yang1
1Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; State Key Laboratory of Eye Health, Shanghai, China; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
Ophthalmology
|July 24, 2026
Summary
Eye-preserving therapies offer comparable survival to enucleation for early cT3c retinoblastoma, achieving significant globe salvage and reducing high-risk features. However, corneal edema and high intraocular pressure indicate poorer outcomes, requiring individualized treatment strategies.
Area of Science:
- Ophthalmology
- Oncology
- Retinoblastoma Research
Background:
- Retinoblastoma, a pediatric eye cancer, requires timely and effective treatment.
- Advanced stages, like AJCC cT3c, pose challenges for both survival and eye preservation.
- Neovascular glaucoma (NVG) in retinoblastoma complicates treatment and prognosis.
Purpose of the Study:
- To assess the safety and efficacy of eye-preserving treatments for early cT3c retinoblastoma with NVG.
- To compare outcomes between primary enucleation and eye-preserving strategies.
- To identify factors influencing overall survival and globe salvage.
Main Methods:
- Retrospective, single-center cohort study of 132 patients with early cT3c retinoblastoma.
- Patients were divided into primary enucleation (50) and primary eye-preserving (82) groups.
- Outcomes analyzed included overall survival, pathological features, globe salvage, and vision preservation.
Main Results:
- Overall survival was similar between groups (P=0.775).
- Eye-preserving therapies reduced high-risk pathological features (OR=0.21, P=0.003), including choroidal and optic nerve invasion.
- Globe salvage rate was 49.4% in the eye-preserving group; intra-arterial chemotherapy and cryotherapy improved salvage.
- High intraocular pressure (IOP ≥32 mmHg) and corneal edema were risk factors for salvage failure.
Conclusions:
- Eye-preserving therapies are safe and effective for early cT3c retinoblastoma, achieving globe salvage and partial vision without compromising survival.
- Corneal edema and high IOP significantly predict poorer globe salvage outcomes.
- Individualized treatment is crucial for patients with these high-risk factors.
