• Ocular Pathology/Oncology, Pediatric Ophth/Strabismus, Retina/Vitreous

    Review of: Global retinoblastoma treatment outcomes

    Tomar A, Finger P, Gallie B, et al. Ophthalmology, May 2021

    In this paper, researchers compared retinoblastoma treatment outcomes in patients worldwide.

    Study design

    This retrospective, registry-based case series included 2,190 patients with retinoblastoma at 18 centers in 13 countries during a 12-year period. Researchers collected registry information such as staging and treatment, and assessed outcomes based on country. Using the 2017 United Nations World Population Prospects, countries were classified as high-income, upper-middle income, and lower-middle income. The main outcomes were metastasis-related mortality and local treatment failure.

    Outcomes

    Most study participants (60%) lived in upper and lower middle-income countries and tended to have a higher median age at diagnosis than children living in high-income countries. In addition, children in upper and lower middle-income countries had a 9- to 10-fold higher rate of metastasis-related mortality and 2-fold higher rate of local treatment failure.

    Limitations

    This retrospective case series spanned a 13-year period during which there were significant treatment advances in high-income countries, such as intra-arterial chemotherapy. The study did not include countries from the low-income category.

    Clinical significance

    Similar to findings from the Global Retinoblastoma Study Group in 2017, this study found little improvement in retinoblastoma outcomes, especially in upper and lower middle-income countries. In countries with more limited resources, the higher rate of metastasis-related mortality indicated a greater need for curative frontline treatments. Attention to earlier retinoblastoma detection and diagnosis should be emphasized in physician education worldwide.