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Updated: Sep 3, 2026
Grossing of Non-neoplastic Globes, Including Fetal Eyes
Published on: May 30, 2025
Evaluation of globe-preserving therapies in unilateral cT2/cT3 retinoblastoma: a multicentre study of 1566 eyes
Yiran Yao1, Mingpeng Xu2, Jie Yang1,3
1State Key Laboratory of Eye Health, Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Aims:
To evaluate survival, globe salvage and visual outcomes of globe-preserving treatment approaches in unilateral cT2 and cT3 retinoblastoma, with a focus on cT3 disease.
Methods:
This multicentre, retrospective cohort study enrolled 1566 treatment-naïve unilateral retinoblastoma eyes (870 clinical (c)T2, 696 cT3 by eighth American Joint Committee on Cancer clinical tumour, node, metastases staging) from 11 Chinese tertiary centres. Patients underwent intra-arterial chemotherapy, intravenous chemotherapy or primary enucleation. Outcomes were globe salvage, overall survival, metastasis-free survival, high-risk histopathological feature prevalence and vision-preserving rate (≥light perception (LP)).
Results:
In this multicentre cohort of 1566 eyes, the globe-salvage rate across cT2 and cT3 retinoblastoma was higher with intra-arterial chemotherapy than with intravenous chemotherapy. When stratified by cT3 subcategories, intra-arterial chemotherapy achieved significantly higher globe-salvage rates than intravenous chemotherapy in cT3b eyes (HR 3.65; 95% CI 1.91 to 6.98) and cT3c eyes (HR 4.02; 95% CI 2.79 to 5.80). In contrast, globe salvage did not differ between intra-arterial chemotherapy and intravenous chemotherapy in cT3d eyes. Overall survival and metastasis-free survival did not differ between intra-arterial chemotherapy and primary enucleation. Among eyes with cT3b or cT3c disease, 79.4% of eyes salvaged with intra-arterial chemotherapy and 65.0% of eyes salvaged with intravenous chemotherapy retained at least LP. Detected high-risk pathological features were not significantly different between eyes treated with intra-arterial chemotherapy and those undergoing primary enucleation in cT3b or cT3c disease. Among secondary enucleated eyes with cT3d disease, intra-arterial chemotherapy was associated with lower rates of choroidal invasion.
Conclusion:
Intra-arterial chemotherapy may enable globe salvage in cT3b/c retinoblastoma, whereas cT3d eyes continue to warrant prompt enucleation.