Clinical Pathologic Study of a Cohort of Patients With Retinoblastoma From a Developing Country

Orellana, María Eugenia; Fernandes, Bruno F.; Areán, Carolina; Pifano, Imelda de; Al-Kandari, Abdullah; Burnier, Miguel N.

doi:10.3928/01913913-20090903-07

Cited by 13 publications

(18 citation statements)

References 18 publications

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“…The overall reported incidence of optic nerve involvement beyond the lamina cribrosa and at the resection margin ranged from 6.5% to 40%, while the overall reported incidence of massive choroid invasion ranged from 12% to 41%. In our series, 18% of eyes had massive choroid invasion and 14% had post laminar optic nerve invasion, which is comparable to the results reported from the developed world, and is less than the results reported from the developing world (Table V) (10,11,15,18,19,24,(28)(29)(30). The higher incidence of these risk factor in developing world might be related to later presentation (more advanced stage) in relation to the lower socioeconomic status and the delay in getting the needed treatment.…”

Section: Discussionsupporting

confidence: 57%

“…Most of these reported higher incidences compared with studies reported from the developed world (15)(16)(17)(18)(19)(20)(21).…”

Section: Introductioncontrasting

confidence: 51%

“…The reported incidence of the various histopathologic features in eyes enucleated for retinoblastoma is highly variable, and generally the incidence of choroid and optic nerve invasion in the developing world was higher than in the developed world (Table IV) (10,11,15,18,19,24,(28)(29)(30). The overall reported incidence of optic nerve involvement beyond the lamina cribrosa and at the resection margin ranged from 6.5% to 40%, while the overall reported incidence of massive choroid invasion ranged from 12% to 41%.…”

Section: Discussionmentioning

confidence: 99%

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A histopathologic analysis of 50 eyes primarily enucleated for retinoblastoma in a tertiary cancer center in jordan

Yousef¹,

Hajja²,

Nawaiseh³

et al. 2013

TJPATH

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Objective: To analyze the histopathologic features of the eyes with intraocular retinoblastoma primarily treated by enucleation in a tertiary cancer center in Jordan. Material and Method:A retrospective case series of 50 eyes for 49 patients who had pathologically confirmed retinoblastoma after enucleation as primary therapy. The main outcome measures included demographics, laterality, international classification of intraocular retinoblastoma, choroid invasion, optic nerve invasion, anterior chamber invasion, and tumor differentiation. Results:The median age at enucleation was 30 months. Twenty-seven (55%) patients were males, and 19 (39%) patients had bilateral retinoblastoma. High risk pathological features were seen as massive choroid invasion in 9 (18%) eyes, post-laminar optic nerve invasion in 7 (14%) eyes, and anterior chamber, iris or ciliary body invasion in 7 (14%) eyes. Thirty-seven (74%) tumors were well/moderately differentiated, and 13 (26%) were poorly differentiated. Poorly differentiated tumors presented later (median 31 months) than well/ moderately differentiated tumors (26 months) and were associated with a higher incidence of high-risk pathological features. No single ICRB group C eye had high-risk pathological features, while 17% and 4% of group D eyes and 28% and 33% of group E eyes had massive choroid invasion and post-laminar optic nerve invasion, respectively. Eighteen (36%) patients received adjuvant chemotherapy for high risk pathological features, and at median follow up of 40 months, no single case had metastasis or was dead. Conclusion:Our pathologic findings were similar to the developed world. They were supportive of the predictive power of the international classification of retinoblastoma staging system for the likelihood of high risk pathological features. Poorly differentiated tumors were associated with a higher incidence of high risk pathological features than well/moderately differentiated tumors.Key Words: Choroid, Optic nerve, Retinoblastoma, Eye ÖZ Amaç: Ürdün' de üçüncü basamak kanser merkezinde primer olarak enükleasyon ile tedavi edilen intraoküler retinoblastomalı gözlerin histopatolojik özelliklerinin araştırılması. Gereç ve Yöntem:Primer tedavi olarak enükleasyon uygulandıktan sonra patolojiyle retinoblastoma tanısı alan 49 hastaya ait 50 gözden oluşan retrospektif olgu serisi. Demografik bulgular, lateralite, Uluslararası Retinoblastoma Sınıflaması, koroid invazyon, optik sinir invazyonu, ön kamera invazyonu ve tümör farklılaşması ana sonuç verileri olarak dahil edildi. Bulgular:Enükleasyon sırasında ortalama yaş 30 aydı. Yirmi yedi (%55) hasta erkekti ve 19 (%39) hastanın bilateral retinoblastoması vardı. Yüksek riskli patolojik özellikler; 9 (%18) gözde massif koroid invazyonu, 7'sinde (%14) post-laminar optik sinir invazyonu ve 7'sinde (%14) ön kamera, iris veya silier cisimcik invazyonu şeklindeydi. Otuz yedi (%74) tümör iyi/orta derecede diferansiye ve 13 (%26) az diferansiye idi. Az diferansiye tümörler (ortalama 31 ay), iyi/orta derecedeki tümörle...

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Section: Discussionsupporting

confidence: 57%

“…Most of these reported higher incidences compared with studies reported from the developed world (15)(16)(17)(18)(19)(20)(21).…”

Section: Introductioncontrasting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A histopathologic analysis of 50 eyes primarily enucleated for retinoblastoma in a tertiary cancer center in jordan

Yousef¹,

Hajja²,

Nawaiseh³

et al. 2013

TJPATH

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“…Previously published studies from developing countries have shown a higher incidence of histopathological high risk factors (HRF) in eyes enucleated for retinoblastoma [7,8]. Some clinical features have shown to be associated with the presence of high risk factors [3,4,9,10].…”

Section: Introductionmentioning

confidence: 99%

Clinical predictors of high risk histopathology in retinoblastoma

Kashyap

Meel²,

Sen

et al. 2011

Pediatric Blood & Cancer

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BackgroundPrevious studies show that clinical features at presentation, in retinoblastoma patients, like glaucoma and neovascularization of iris are associated with a higher incidence of high risk histopathology findings (HRF) in enucleated eyes. Herein, we analyze association between clinical features at time of enucleation and occurrence of HRF including invasion of anterior chamber, iris, ciliary body, choroid (massive), sclera, extrascleral tissue, optic nerve beyond lamina cribrosa, and optic nerve cut end, in a large series of eyes enucleated for retinoblastoma.ProcedureWe retrospectively studied demographic, clinical, and histopathology findings in all retinoblastoma patients who underwent primary enucleation at our center, over a 5 years duration. Statistical analysis was done to find any association between clinical features at presentation and the presence of HRF.ResultsThree hundred twenty‐six eyes were studied. Median age of presentation was 2 years. Glaucoma was the most common clinical finding at presentation apart from leucocoria. Out of 326 enucleated eyes, 28 (8.6%) had extrascleral and/or optic nerve transection invasion. Among remaining 298 eyes, with completely resected tumor, 115 (38.6%) had massive choroidal invasion, 54 (17%) had retrolaminar optic nerve invasion, and 24 (7%), 29 (9%), and 23(7%) had anterior chamber, iris, and ciliary body invasion, respectively. Age more than 2 years, lag period more than 3 months, hyphema, pseudohypopyon, staphyloma, and orbital cellulitis were associated with occurrence of three or more HRF on univariate analysis.ConclusionsClinical variables including older age, longer lag period, hyphema, pseudohypopyon, staphyloma, and orbital cellulitis were strongly associated with occurrence of HRF in this study. Pediatr Blood Cancer 2012; 58: 356–361. © 2011 Wiley Periodicals, Inc.

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“…[2][3][4][5] This has been attributed to delay in presentation and diagnosis, lack of specialized centers, and/or differences in biologic behavior of the tumors.…”

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confidence: 99%

A Histopathologic Analysis of Eyes Primarily Enucleated for Advanced Intraocular Retinoblastoma From a Developing Country

Kashyap¹,

Sethi²,

Meel³

et al. 2012

Archives of Pathology & Laboratory Medicine

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N Context.-In eyes enucleated for retinoblastoma, presence of histopathologic high-risk factors is associated with a higher risk of local recurrence and systemic metastasis.Objective.-To evaluate histopathologic features in children with retinoblastoma in our population and establish relationship between age, tumor differentiation, and high-risk features.Design.-Retrospective histopathologic analysis of 609 consecutively enucleated eyes for advanced intraocular retinoblastoma during a 10-year period. A nonparametric test was used to establish relationship between age, differentiation, and high-risk features.Results.-Poorly differentiated retinoblastoma presented in 80.3% and well-differentiated in 19.7% of eyes. Welldifferentiated tumors presented earlier (median 1.2 years) than poorly differentiated tumors (median 2.5 years) (P , .001). One hundred fourteen eyes (18.7%) had 1 and 138 (22.7%) had at least 2 high-risk histopathologic factors. Invasion of anterior chamber was found in 10.0%, iris in 10.7%, ciliary body in 6.7%, sclera in 13.7%, massive choroid in 24.6%, postlaminar optic nerve in 16.1%, resected margin of the optic nerve in 7.4%, and extrascleral tissue in 4.1% of eyes. Extensive necrosis was seen in 31.0% of eyes. Poorly differentiated tumors were significantly associated with presence of more than 1 highrisk histopathologic feature (P , .001) and extensive necrosis (P , .001).Conclusion.-Poorly differentiated tumors present at a later age and are associated with presence of multiple high-risk factors and extensive necrosis. In our population, high-risk histopathologic factors are present in a significant number of eyes. Because we have included only primarily enucleated eyes, this could truly represent the distribution of high-risk histopathologic factors in children with retinoblastoma. (Arch Pathol Lab Med. 2012;136:190-193; doi: 10.5858/ arpa.2010-0759-OA) R etinoblastoma is the most frequent primary malignant intraocular tumor in children and has an estimated annual incidence of 1 in 16 000 to 1 in 18 000 live births. 1With the present-day multidisciplinary therapeutic approach, ocular salvage is possible in group A through D intraocular tumors (International Retinoblastoma Classification). However, in group E tumors (and group D in unilateral cases), enucleation remains the modality of choice. Some histopathologic findings in enucleated eyes, designated as high-risk factors (HRFs), are associated with a greater risk of orbital recurrence and distant metastasis and need adjuvant therapy.There are few studies that have evaluated HRFs in eyes enucleated for advanced intraocular retinoblastoma from developing countries, and most of them have reported higher incidences compared with studies reported in the Western literature. [2][3][4][5] This has been attributed to delay in presentation and diagnosis, lack of specialized centers, and/or differences in biologic behavior of the tumors. 6-8Herein, we report the results of a retrospective histopathologic analysis conducted on a large series of ...

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Clinical Pathologic Study of a Cohort of Patients With Retinoblastoma From a Developing Country

Cited by 13 publications

References 18 publications

A histopathologic analysis of 50 eyes primarily enucleated for retinoblastoma in a tertiary cancer center in jordan

A histopathologic analysis of 50 eyes primarily enucleated for retinoblastoma in a tertiary cancer center in jordan

Clinical predictors of high risk histopathology in retinoblastoma

A Histopathologic Analysis of Eyes Primarily Enucleated for Advanced Intraocular Retinoblastoma From a Developing Country

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