High-risk Pathologic Features Based on Presenting Findings in Advanced Intraocular Retinoblastoma: A Multicenter, International Data-Sharing American Joint Committee on Cancer Study.
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Tomar Ankit Singh, Finger Paul T, Gallie Brenda, Kivelä Tero T, Mallipatna Ashwin, Zhang Chengyue, Zhao Junyang, Wilson Matthew W, Brennan Rachel C, Burges Michala, Kim Jonathan, Berry Jesse L, Jubran Rima, Khetan Vikas, Ganesan Suganeswari, Yarovoy Andrey, Yarovaya Vera, Kotova Elena, Volodin Denis, Yousef Yacoub A, Nummi Kalle, Ushakova Tatiana L, Yugay Olga V, Polyakov Vladimir G, Ramirez-Ortiz Marco A, Esparza-Aguiar Elizabeth, Chantada Guillermo, Schaiquevich Paula, Fandino Adriana, Yam Jason C, Lau Winnie W, Lam Carol P, Sharwood Phillipa, Moorthy Sonia, Long Quah Boon, Essuman Vera Adobea, Renner Lorna A, Semenova Ekaterina, Català-Mora Jaume, Correa-Llano Genoveva, Carreras Elisa, American Joint Committee on Cancer Ophthalmic Oncology Task Force
Аннотация
DESIGN: International, multicenter, registry-based retrospective case series.
PARTICIPANTS: Eighteen ophthalmic oncology centers from 13 countries over 6 continents shared evaluations of 942 eyes enucleated as primary treatment for AJCC cT3 and, for comparison, cT2 retinoblastoma.
METHODS: International, multicenter, registry-based data were pooled from patients enrolled between 2001 and 2013. High-risk pathologic features were defined as AJCC categories pT3 and pT4. In addition, AJCC OOTF Size Groups were defined as follows: (1) less than half, (2) more than half but less than two thirds, (3) more than two thirds of globe volume involved, and (4) diffuse infiltrating retinoblastoma.
MAIN OUTCOME MEASURES: Statistical risk of high-risk pathologic features corresponding to AJCC cT3 subcategories and AJCC OOTF Size Groups.
RESULTS: Of 942 retinoblastoma eyes treated by primary enucleation, 282 (30%) showed high-risk pathologic features. Both cT subcategories and AJCC OOTF Size Groups (P < 0.001 for both) were associated with high-risk pathologic features. On logistic regression analysis, cT3c (iris neovascularization with glaucoma), cT3d (intraocular hemorrhage), and cT3e (aseptic orbital cellulitis) were predictive factors for high-risk pathologic features when compared with cT2a with an odds ratio of 2.3 (P = 0.002), 2.5 (P = 0.002), and 3.3 (P = 0.019), respectively. Size Group 3 (more than two-thirds globe volume) and 4 (diffuse infiltrative retinoblastoma) were the best predictive factors with an odds ratio of 3.3 and 4.1 (P < 0.001 for both), respectively, for high-risk pathologic features when compared with Size Groups 1 (i.e., < 50% of globe volume).
CONCLUSIONS: The AJCC retinoblastoma staging clinical cT3c-e subcategories (glaucoma, intraocular hemorrhage, and aseptic orbital cellulitis, respectively) as well as the AJCC OOTF Size Groups 3 (tumor more than two thirds of globe volume) and 4 (diffuse infiltrative retinoblastoma) both allowed stratification of clinical risk factors that can be used to predict the presence of high-risk pathologic features and thus facilitate treatment decisions.