Recurrence and new tumor development after frontline intravenous chemotherapy for retinoblastoma: Risk factors and treatment results

Author:

Gündüz Ahmet Kaan12ORCID,Mirzayev Ibadulla13ORCID,Dinçaslan Handan4,Özalp Ateş Funda Seher5

Affiliation:

1. Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey

2. Private Eye Clinic, Ankara, Turkey

3. Department of Ophthalmology, Dünyagöz Hospital, Ankara, Turkey

4. Departmant of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey

5. Department of Biostatistics, Ankara University Faculty of Medicine, Ankara, Turkey

Abstract

Purpose: To evaluate the risk factors leading to recurrence and new tumor (NT) development in patients with retinoblastoma after intravenous chemotherapy (IVC) and to review the treatment outcomes. Materials and methods: The records of 166 retinoblastoma cases (having 246 affected eyes) who underwent six-cycle IVC (vincristine, etoposide, and carboplatin) as primary treatment between October 1999 and August 2020 were reviewed retrospectively. Results: The mean ages at presentation were 9.0 (median: 8.0) and 9.2 (median: 8.5) months in cases with recurrence and NTs respectively. Recurrence was detected in 40 (16.3%) eyes, NTs in 29 (11.8%), and both recurrence/NTs in 24 (9.8%). The mean time elapsed till recurrence and NT was 10.7 months. Multivariable analysis showed that the factors predictive of recurrence were largest tumor base diameter (LTBD) >12 mm ( p = 0.039) and presence of subretinal seeds at diagnosis ( p = 0.043). Multivariable risk factors for the development of NTs were bilateral familial retinoblastoma ( p = 0.001) and presence of subretinal seeds at diagnosis ( p = 0.010). Mean follow-up was 80.1 (median: 72.5) months. By Kaplan-Meier analysis, the 1-, 3-, and 6-year recurrence and NT rates were 21.2%, 28.1%, and 28.7% and 14.9%, 22.6%, and 23.9% respectively. The most common treatment methods used for recurrent and/or NTs included cryotherapy, transpupillary thermotherapy, and intra-arterial chemotherapy. Enucleation was eventually required in 24/93 (25.8%) eyes. No patient developed metastasis. Discussion: Development of recurrence and/or NT after IVC was noted in 38% of all retinoblastoma eyes. Bilateral familial disease, LTBD >12 mm, and presence of subretinal seeds at baseline were risk factors for recurrence and NTs in this study.

Publisher

SAGE Publications

Subject

Ophthalmology,General Medicine

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