| Title: |
Primary Enucleation for Intraocular Unilateral Retinoblastoma Can Save Life in Lower-Income Settings. |
| Authors: |
Arazi, Mattan; Kfir, Jonathan; Ahmad, Alia; Foster, Allen; Baum, Alona; Stacey, Andrew W; Yarovoy, Andrey A; López, Arturo Manuel Zapata; Reddy, M Ashwin; Brown, Brianne; Bascaran, Covadonga; Im, Deborah; Huque, Fahmida; Berry, Jesse L; Garcia, Juan; Al Harby, Lamis; Sagoo, Mandeep S; Zondervan, Marcia; Burton, Matthew; Cassoux, Nathalie; John Astbury, Nicholas; Gomel, Nir; Bowman, Richard; Rashid, Riffat; Diaz Coronado, Rosdali; Sultana, Sadia; Sherief, Sadik Taju; Blum, Sharon; Rani Roy, Soma; Kaliki, Swathi; Ushakova, Tatiana; A Yarovaya, Vera; Polyakov, Vladimir G; Ji, Xunda; Didi Fabian, Ido |
| Publisher Information: |
Informa UK Limited |
| Publication Year: |
2024 |
| Collection: |
London School of Hygiene & Tropical Medicine: LSHTM Research Online |
| Description: |
OBJECTIVE: To investigate the outcomes of primary enucleation and adjuvant systemic chemotherapy, when deemed appropriate, on a cohort of children with unilateral intraocular Rb (AJCC 8th edition, cT2 and cT3) from diverse economic groupings. METHODS: A prospective analysis including treatment-naïve Rb patients were presented to 11 centers from 10 countries from January 1 to December 31, 2019, and were followed-up thereafter. Only children with unilateral intraocular Rb that underwent primary enucleation were included in the present analysis. Systemic metastasis and survival were investigated. RESULTS: Of the 692 children with Rb, 191 (27.6%) were included in the study cohort. Among them, 24 (12.6%) were from low-income countries (LICs), 89 (46.6%) from lower-middle-income countries (LMICs), 59 (30.9%) from upper-middle-income countries (UMICs), and 19 (9.9%) from high-income countries (HICs). High-risk histopathological features were observed in 110 eyes (57.6%) following enucleation, and 102 of these children (92.7%) received adjuvant intravenous chemotherapy. The three-year survival rate for the entire cohort was 95.0%. Stratified by economic grouping, survival rates were 87.5% (LIC), 96.6% (LMIC), 93.2% (UMIC), and 100% (HIC). Children from LICs demonstrated a higher prevalence of HRHF compared to HICs. Residing in a lower-income country was associated with a higher risk of systemic metastasis and poorer outcomes. CONCLUSION: In the present multinational cohort of children with unilateral intraocular Rb who underwent upfront enucleation coupled with adjuvant chemotherapy as needed, overall survival was favorable, especially for children from low-income countries. Prompting early diagnosis, while the tumor remains intraocular can be life-saving, particularly in low-resource settings where primary enucleation and adjuvant chemotherapy can cure unilateral Rb. |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| ISSN: |
0882-0538 |
| Relation: |
https://researchonline.lshtm.ac.uk/id/eprint/4676337/1/Arazi-etal-2025-Primary%20Enucleation%20for%20Intraocular.pdf; Arazi, Mattan; Kfir, Jonathan; Ahmad, Alia; Foster, Allen ORCID logo; Baum, Alona; Stacey, Andrew W; Yarovoy, Andrey A; López, Arturo Manuel Zapata; Reddy, M Ashwin; Brown, Brianne; +25 more.Bascaran, Covadonga ORCID logo; Im, Deborah; Huque, Fahmida; Berry, Jesse L; Garcia, Juan; Al Harby, Lamis; Sagoo, Mandeep S; Zondervan, Marcia ORCID logo; Burton, Matthew ORCID logo; Cassoux, Nathalie; John Astbury, Nicholas; Gomel, Nir; Bowman, Richard ORCID logo; Rashid, Riffat; Diaz Coronado, Rosdali; Sultana, Sadia; Sherief, Sadik Taju; Blum, Sharon; Rani Roy, Soma; Kaliki, SwathiORCID logo; Ushakova, Tatiana; A Yarovaya, Vera; Polyakov, Vladimir G; Ji, Xunda; and Didi Fabian, Ido (2024) Primary Enucleation for Intraocular Unilateral Retinoblastoma Can Save Life in Lower-Income Settings. Seminars in ophthalmology, 40 (6). pp. 496-500. ISSN 0882-0538 DOI:10.1080/08820538.2024.2447724 |
| DOI: |
10.1080/08820538.2024.2447724 |
| Availability: |
https://researchonline.lshtm.ac.uk/id/eprint/4676337/; https://doi.org/10.1080/08820538.2024.2447724 |
| Rights: |
cc_by_nc_nd_4 |
| Accession Number: |
edsbas.DBA99451 |
| Database: |
BASE |