A multicentre report from the Mexican Retinoblastoma Group

Abstract

Background: Retinoblastoma (RB) is a relatively uncommon tumour in childhood. The incidence of retinoblastoma in Mexico is probably higher than the incidence reported worldwide, however there is not enough information about the characteristics of this illness in Mexico. This report aims to present the results of a multicentre clinical survey of RB in Mexico. Methods: A retrospective study was carried out on all RB cases treated in 16 institutions during the last six years. The variables analysed were age at diagnosis, sex, affected eyes, treatment modalities, and pathological staging. Overall survival was obtained. Results: The authors analysed 500 cases; age range was 0-182 months. There were 364 unilateral cases (72.8%). Enucleation was performed in 84.9% of the patients. The St Jude's staging was: 7.4% stage I, 52.8% stage II, 18.0% stage III, 11.4% stage IV, 7.2% not evaluated, and 3.2% missing data. Chemotherapy was used in 74.4% of the patients. Disease free survival was 89% at 73 months follow up. Conclusions: The paper presents a great number of cases and pioneers multicentre studies in paediatric ophthalmology and oncology in this country. Given the great number of patients in advanced stages and the variability on treatment schemes, it is evident that it is mandatory to work in a cooperative group and develop a national early detection programme as well as a treatment protocol which include all specialists involved in the care of patients with RB.

An extremely rare case of metastatic retinoblastoma of parotids presenting as a massive swelling in a child

“…In the developed world more than 95% of children suffering from Rb survive while only 50% children survive in developing nations (9). This trend can be due to poverty, low socio-economic status, illiteracy, lack of access to tertiary oncology centres thus causing a delay in presentation and, consequently a delay in diagnosis and subsequent treatment.…”

Retinoblastoma: A Sixteen-Year Review of the Presentation, Treatment, and Outcome from a Tertiary Care Institute in Northern India

“…The incidence of retinoblastoma varies across different regions of the world and represents almost 4% of all pediatric malignancies [1,10]. Approximately 250-300 children are newly diagnosed with retinoblastoma each year in the United States, and substantially higher rates occur in developing countries [1,10].…”

Strategies to manage retinoblastoma in developing countries

“…However, as opposed to other childhood malignancies, there are no randomized studies to support the treatment decisions in these cases. Most of these results were generated in large referral centers, where multidisciplinary groups that treat retinoblastoma have been established but national cooperative groups have been recently established in Brazil, Mexico, Central America, and Turkey in an attempt to generalize these successful results [24,25,38]. However, until recently, a consensus staging system, common definitions for invasion of the ocular coats and pathology guidelines for the evaluation of enucleated eyes were not available [47,48].…”

“…Pathologic evaluation of enucleated eyes is seldom done, and relatively intensive chemotherapy is not usually available [19][20][21]. Survival in many middle-income countries (MICs) is over 70%, and some upper MICs that have established multidisciplinary teams and adequate treatment facilities have survival rates near 90% (Table I) [22][23][24][25].…”