Study on Clinical Therapeutic Effect Including Symptoms, Eye Preservation Rate, and Follow-up of 684 Children with Retinoblastoma

Abstract

Purpose Retinoblastoma is the most common type of primary malignant intraocular tumor in children. The purpose of this study is to summarize the clinical experience of diagnosis and treatment for retinoblastoma, aiming to provide appropriate knowledge for surveillance and therapy for retinoblastoma. Methods We performed retrospective analysis of 684 children (885 eyes) with advanced retinoblastoma diagnosed in the department of Pediatrics in Tongren Hospital, Beijing, China, between September 2005 and May 2010. Results The average age at first diagnosis was 2.2 ± 1.7 years with overall median age 1.91 years. Leucocoria was the most common sign at the initial diagnosis (70.47%, 482/684). A total of 21 cases (3.06%) had positive family history. According to International Retinoblastoma Classification, 551 cases (80.57%, 723 eyes) were A-E stage and 81.47% (589/723) were D-E stages of retinoblastoma; extraocular stage was present in 101 cases (120 eyes, 14.76%); metastatic stage was present in 32 cases (44 eyes, 4.67%). Pathology diagnosis was performed in 494 cases of unilateral or bilateral enucleation; 91 cases were grade I, 260 cases were grade II, 94 cases were grade III, 49 cases were grade IV. The median follow-up time was 27 months until June 2010. Total survival rate was 95.13%. A total of 34 cases were lost to follow-up and 34 cases were abandoned. Conclusions Children developed retinoblastoma at a young age. Early diagnosis is difficult. Key factors of clinical treatment and long survival rate were diagnosis and treatment at the early stage with multidisciplinary methods.