A Multicenter, International Collaborative Study for American Joint Committee on Cancer Staging of Retinoblastoma Part II : Treatment Success and Globe Salvage

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Amer Joint Comm Canc Ophthalmic On , Tomar , A S , Finger , P T , Gallie , B , Kivelä , T T & Carreras , E 2020 , ' A Multicenter, International Collaborative Study for American Joint Committee on Cancer Staging of Retinoblastoma Part II : Treatment Success and Globe Salvage ' , Ophthalmology , vol. 127 , no. 12 , pp. 1733-1746 . https://doi.org/10.1016/j.ophtha.2020.05.051

Title: A Multicenter, International Collaborative Study for American Joint Committee on Cancer Staging of Retinoblastoma Part II : Treatment Success and Globe Salvage
Author: Amer Joint Comm Canc Ophthalmic On; Tomar, Ankit Singh; Finger, Paul T.; Gallie, Brenda; Kivelä, Tero T.; Carreras, Elisa
Contributor organization: HUS Head and Neck Center
Silmäklinikka
Department of Ophthalmology and Otorhinolaryngology
Helsinki University Hospital Area
Date: 2020-12
Language: eng
Number of pages: 14
Belongs to series: Ophthalmology
ISSN: 0161-6420
DOI: https://doi.org/10.1016/j.ophtha.2020.05.051
URI: http://hdl.handle.net/10138/324937
Abstract: Purpose: To evaluate the ability of the American Joint Committee on Cancer (AJCC) 8th edition to predict local tumor control and globe salvage for children with retinoblastoma (RB). Design: International, multicenter, registry-based retrospective case series. Participants: A total of 2854 eyes of 2097 patients from 18 ophthalmic oncology centers from 13 countries over 6 continents. Methods: International, multicenter, registry-based data were pooled from patients enrolled between January 2001 and December 2013. All RB eyes with adequate records to allow tumor staging by the AJCC 8th edition criteria and follow-up to ascertain treatment outcomes were included. Main Outcome Measures: Globe-salvage rates were estimated by AJCC clinical (cTNMH) categories and tumor laterality. Local treatment failure was defined as use of enucleation or external beam radiation therapy (EBRT), with or without plaque brachytherapy or intra-arterial chemotherapy (IAC). Results: Unilateral RB occurred in 1340 eyes (47%). Among the 2854 eyes, tumor categories were cT1 to cT4 in 696 eyes (24%), 1334 eyes (47%), 802 eyes (28%), and 22 eyes (1%), respectively. Of these, 1275 eyes (45%) were salvaged, and 1179 eyes (41%) and 400 eyes (14%) underwent primary and secondary enucleation, respectively. The 2- and 5-year KaplaneMeier cumulative globe-salvage rates without the use of EBRT by cTNMH categories were 97% and 96% for category cT1a tumors, 94% and 88% for cT1b tumors, 68% and 60% for cT2a tumors, 66% and 57% for cT2b tumors, and 32% and 25% for cT3 tumors, respectively. Risk of local treatment failure increased with increasing cT category (P <0.001). Cox proportional hazards regression analysis confirmed a higher risk of local treatment failure in categories cT1b (hazard ratio [HR], 3.5; P = 0.004), cT2a (HR, 15.1; P <0.001), cT2b (HR, 16.4; P <0.001), and cT3 (HR, 45.0; P <0.001) compared with category cT1a. Use of plaque brachytherapy and IAC improved local tumor control in categories cT1a (P = 0.031) and cT1b (P <0.001). Conclusions: Multicenter, international, internet-based data sharing validated the 8th edition AJCC RB staging to predict globe-salvage in a large, heterogeneous, real-world patient population with RB. (C) 2020 by the American Academy of Ophthalmology. This is an open access article under the CC BY-NC-ND license
Subject: INTRAOCULAR RETINOBLASTOMA
INTRAARTERIAL CHEMOTHERAPY
FOCAL THERAPY
CLASSIFICATION
CHEMOREDUCTION
3125 Otorhinolaryngology, ophthalmology
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: publishedVersion


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