Download PDF
CC BY-NC-ND 4.0 · South Asian J Cancer 2020; 09(01): 56-58
DOI: 10.4103/sajc.sajc_89_19
ORIGINAL ARTICLE: Pediatric and Adolescent Cancers

Epidemiology and clinical features of retinoblastoma

A tertiary care center’s experience in India
Maneya Padma
Department of Pediatric Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
,
Nuthan Kumar
Department of Pediatric Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
,
Prerana S. Nesargi
Department of Pediatric Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
,
B.S Aruna Kumari
Department of Pediatric Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
,
L. Appaji
Department of Pediatric Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
,
Aarthi Viswanathan
Department of Pediatric Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
› Author Affiliations Financial support and sponsorship: Nil.
› Further Information
Also available at
  PDF Download Permissions and Reprints

Abstract

Introduction: Retinoblastoma (RB) is a prototype of heritable cancers. It is more common in the lower socioeconomic strata. Delayed presentation significantly reduces the overall outcome. We have analyzed the epidemiological and clinical data of children who were diagnosed with RB between the years 2009 and 2014. Aim: RB being a disease of the poor, delayed presentation is common due to lack of awareness. We have analyzed the epidemiological profile of our patients and tried to establish the link between delayed presentation and the presence of high-risk features. High-risk features are associated with higher chance of metastasis and poor rates of vision salvage in RB. Methodology: Data were collected in a retrospective manner from the patient case files retrieved from the Medical Records Department, Kidwai cancer Institute. The data were analyzed using Excel and SPSS software (IBM Corp. released 2016, IBM SPSS statistics software for Mac OS, version 24, IBM Corp., Armonk, NY). Results: A total of 53 patients were diagnosed with RB in the years 2009–2014. There was a male predominance with 1.2:1 incidence. Bilateral RB was present in 21 cases. The mean age of children with bilateral RB was 2.1 years, against 1.5 years in unilateral cases. High-risk features such as optic nerve invasion, choroidal invasion, intracranial extension, and orbital involvement were found in 12, 6, 5, and 5 eyes, respectively. Bone marrow involvement was detected in 5% and lung metastasis in 2%. Intracranial involvement was found in 10.4% and cerebrospinal fluid positivity in 15%. Children with high-risk features had a significant delay in presentation in comparison to those without high-risk features (P = 0.035). Conclusion: Incidence of metastatic disease and delayed presentation is still high in developing countries. Routine eye examination during vaccination visits can ensure early diagnosis and appropriate referral in many of these children.

Key words

Delayed presentation - high-risk featurese - metastasis


Publication History

Article published online:
14 December 2020

© 2020. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Pandey AN. Retinoblastoma: An overview. Saudi J Ophthalmol 2014;28:310-5.
  • 2 Wang P, Li YJ, Zhang SB, Cheng QL, Zhang Q, He LS. Metastatic retinoblastoma of the parotid and submandibular glands: A rare case report. BMC Ophthalmol 2017;17:229.
  • 3 Naik AS, Jyothi S, Shah PK. Retinoblastoma: A comprehensive review. Kerala J Ophthalmol 2016;28:164-70.
  • 4 Shifa JZ, Gezmu AM. Presenting signs of retinoblastoma at a tertiary level teaching hospital in Ethiopia. Pan Afr Med J 2017;28:66.
  • 5 Saiju R, Duwal S. Bilateral retinoblastoma in early infancy. Nepal J Ophthalmol 2013;5:124-8.
  • 6 Chawla B, Hasan F, Azad R, Seth R, Upadhyay AD, Pathy S, et al. Clinical presentation and survival of retinoblastoma in Indian children. Br J Ophthalmol 2016;100:172-8.
  • 7 Goddard AG, Kingston JE, Hungerford JL. Delay in diagnosis of retinoblastoma: Risk factors and treatment outcome. Br J Ophthalmol 1999;83:1320-3.
  • 8 Bhuvaneswari A, Pallavi VR, Jayshree RS, Kumar RV. Maternal transmission of human papillomavirus in retinoblastoma: A possible route of transfer. Indian J Med Paediatr Oncol 2012;33:210-5.
  • 9 Shields CL, Shields JA, Baez KA, Cater J, De Potter PV. Choroidal invasion of retinoblastoma: Metastatic potential and clinical risk factors. Br J Ophthalmol 1993;77:544-8.
  • 10 Seema R, Parul S, Nita K, Kamlesh. High-risk histomorphological features in retinoblastoma and their association with p53 expression: An Indian experience. Indian J Ophthalmol 2014;62:1069-71.
  • 11 Faranoush M, Hedayati Asl AA, Mehrvar A, Mehrvar N, Zangooei R, Abadi E, et al. Consequences of delayed diagnosis in treatment of retinoblastoma. Iran J Pediatr 2014;24:381-6.