Anesthesia exposure in unilateral retinoblastoma-comparison of enucleation and intraarterial chemotherapy.

BACKGROUND

Retinoblastoma treatment requires prolonged and repeated exposure to general anesthesia. In 2016, the FDA issued a warning that repeated or lengthy anesthesia exposures in children under 3 years of age may cause neurodevelopmental abnormalities. The purpose of this study was to compare the mean anesthesia exposure time associated with enucleation compared with intraarterial chemotherapy (IAC) in patients treated for advanced unilateral retinoblastoma.

METHODS

This retrospective study evaluated demographics, tumor features, and treatment details of unilateral intraocular retinoblastoma cases newly diagnosed at a single tertiary care children's hospital between August 2011 and March 2021. Anesthesia time was stratified by clinical characteristics and procedure type.

RESULTS

A total of 25 patients (mean age at diagnosis, 26.4 months) met inclusion criteria (13 primary enucleation and 12 primary IAC), undergoing 212 tumor-directed procedures under general anesthesia. Within the first year of diagnosis, the mean total anesthesia time was 273 minutes in the enucleation group compared with 2,572 minutes in the IAC group. No anesthetic complications were noted in either group.

CONCLUSIONS

In our small patient cohort, the mean total anesthesia exposure for unilateral retinoblastoma was shorter with enucleation than with IAC.