Clinical presentation and group classification of newly diagnosed intraocular retinoblastoma in China

Abstract

Aim To describe the clinical presentation and group classification of newly diagnosed retinoblastoma patients in China, and to identify future priorities for improving the medical care of this disease. Methods The retrospective review included all patients who presented with previously untreated intraocular retinoblastoma at Beijing Tongren Hospital between August 2006 and August 2009. The clinical charts were reviewed and fundus images taken for all patients were analysed. The tumours were classified according to the International Intraocular Retinoblastoma Classification. Results The study included 595 eyes (470 patients) with untreated retinoblastoma. The mean age at diagnosis was 23 months, with 84% of the patients being younger than 3 years at the time of diagnosis. Bilateral retinoblastoma was present in 150 (32%) of the patients. Bilateral retinoblastoma as compared with unilateral retinoblastoma was diagnosed at a significantly (p<0.001) younger mean age (15 months vs 27 months). Leucocoria was the most common leading sign (73% of patients). The vast majority of eyes (501/595 or 84%) presented with an advanced stage of the tumour (Group D or E of International Intraocular Retinoblastoma Classification). Conclusion In China, diagnosis of retinoblastoma occurs at a relatively advanced clinical stage of the disease. An intensified programme for earlier detection of retinoblastoma including educating parents and physicians may be warranted to improve clinical outcome with fewer enucleations.

Characteristics of Eye Tumor in Children

“…In Taiwan 6 and China 9 , eye tumors are more commonly found among males. This is due to their culture, in which boys are prioritized over girls by their families.…”

“…Congruent findings were also in China and the US. 3,9 The high frequency of this complaint was due to the high number of retinoblastoma cases, in which the eyes do appear to have a glare like a cat's eyes. 3,5,15 Malignant tumors were more prevalent in this study, which is similar to the finding in a Korean study.…”

“…As such, more boys receive medical attention and the mortality rates are lower among them. 6,9 Referring to the studies mentioned, cultural characteristics of a country can possibly contribute to the results of a study. In Indonesia, a tendency towards a gender has not been found, hence, the similar number of male and female patients was found in this study.…”

“…Chemotherapy can be performed both before surgery to reduce the tumor size, and after surgery to prevent tumor regrowth. 6,9,19 Surgery is frequently performed to prevent tumor 2,6,20 In this study, no subjects underwent radiotherapy. Doctors often decide to only observe when the tumor mass is still very small, seems unthreatening, and has a probability of spontaneous regression.…”

Retinoblastoma and ndash; pattern, presentation and management: a quintessential experience of 5 years

“…Our observation of identifying less advanced disease more often in bilateral RB is consistent with that of reported by Zhao et al, in Chinese children. 30 The principles of management of RB include protection of life, preservation of globe and when possible, salvage of vision. Primary enucleation is considered as an ideal treatment for Group E eyes to save life and prevent metastasis.…”