Intraocular retinoblastoma features and treatment outcomes according to patient age at initial presentation

Area of Science:

• Ophthalmology
• Pediatric Oncology
• Genetics

Background:

• Age at presentation significantly impacts intraocular retinoblastoma management.
• Limited data exists on treatment outcomes based on age in developed countries.

Purpose of the Study:

• To analyze clinical features and treatment outcomes of retinoblastoma patients based on age at presentation.
• To evaluate the association between age, family history, tumor stage, and treatment requirements.

Main Methods:

• Retrospective review of 185 retinoblastoma patients treated with intravenous chemotherapy (vincristine, etoposide, carboplatin).
• Patients categorized into age groups: ≤12, >12-≤24, >24-≤36, >36-≤48, and >48 months.
• Analysis of tumor group, vitreous seeds, family history, and treatment modalities (intravitreal chemotherapy, radiotherapy).

Main Results:

• Younger patients (≤12 months) had a higher incidence of positive family history (p=0.016).
• Older patients (>36 months) presented with more advanced tumors (Group D/E, p=0.005) and higher rates of vitreous seeds (>24 months, p=0.001).
• Increasing age correlated with increased need for intravitreal chemotherapy (p=0.001) and radiotherapy (p=0.029). The 6-year globe salvage rate was significantly higher in the ≤12 months group (p<0.001).

Conclusions:

• Family history is associated with earlier retinoblastoma diagnosis.
• Advanced tumor stages (D/E) and vitreous seeding are more prevalent in older children.
• Early treatment initiation improves tumor control and eye preservation rates, with no observed deaths in the study cohort.