2016
DOI: 10.3109/08820538.2016.1154177
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Disparities in Retinoblastoma Presentation, Treatment, and Outcomes in Developed and Less-Developed Countries

Abstract: Retinoblastoma (RB) is the most common intraocular malignancy in children. In the past century, RB survival rates in developed countries (DCs) have improved from <5% to as high as 99%. In contrast, in less developed countries (LDCs) where the tumor burden is greatest, survival rates remain poor, with some countries reporting survival rates as low as 0-5%. In addition, there are disparities between DCs and LDCs in RB presentation, treatment modalities, and prognosis. These disparities are due to many underlying… Show more

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Cited by 43 publications
(63 citation statements)
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“…In the United States, 75% of children with retinoblastoma have advanced or refractory disease that cannot be cured with focal treatments alone, and thus require external beam radiotherapy, systemic chemotherapy, or enucleation [17]. In developing countries [18], systemic chemotherapy may have a greater utility in practice for not only preservation but also saving lives because of the delayed diagnosis and lower availability of focal treatments, including IAC. In Japan, systemic preservation chemotherapy has been conducted by pediatric oncologists in collaboration with ophthalmologists.…”
Section: Discussionmentioning
confidence: 99%
“…In the United States, 75% of children with retinoblastoma have advanced or refractory disease that cannot be cured with focal treatments alone, and thus require external beam radiotherapy, systemic chemotherapy, or enucleation [17]. In developing countries [18], systemic chemotherapy may have a greater utility in practice for not only preservation but also saving lives because of the delayed diagnosis and lower availability of focal treatments, including IAC. In Japan, systemic preservation chemotherapy has been conducted by pediatric oncologists in collaboration with ophthalmologists.…”
Section: Discussionmentioning
confidence: 99%
“…On one hand, owing to increased awareness and advancements in RB therapeutics, the overall survival rate in high-income countries has improved from <5% to 99%; significantly poor survival rates in low-income countries still remains a cause of concern [5,81]. Based on the genetic make-up of the individual, there are three major scenarios where an RB Patient would require lifelong follow-up for future family planning or to avoid any risk of secondary cancers: 1) germline RB1 mutations, 2) germline RB1 Mosaicism, or 3) low penetrance RB1 Mutations.…”
Section: Discussionmentioning
confidence: 99%
“…RB is not sensitive to radiotherapy and chemotherapy. Although great efforts has been made to tackle this disease, the survival rate is under 5% in developing countries [2]. Hence, exploring biological mechanisms of RB progression and finding out biomarkers and therapeutic approach are urgent for diagnose and therapy of this disease.…”
Section: Introductionmentioning
confidence: 99%