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Best results occur with early diagnosis of retinoblastoma
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PHILADELPHIA — Retinoblastoma in neonates is frequently genetic and bilateral and responds best to early diagnosis and treatment, a speaker said here.
“Early recognition can achieve satisfactory tumor control and globe salvage. Chemoreduction is often successful, and external beam radiotherapy should be used with caution,” Laura J. Heinmiller, MD, said at the Wills Eye Institute Annual Conference.
Laura J. Heinmiller
Investigators analyzed 93 patients with retinoblastoma, including 79 white patients, 10 African-American patients and four patients of other races. Mean age at time of diagnosis was 20 days.
Initially, tumors were bilateral in 62 patients (67%) and unilateral in 31 patients (33%). Tumors were ultimately bilateral in 80% of patients. The average number of tumors at presentation was 2.1.
Sporadic inheritance of disease was identified in 43 patients, and 50 patients had a family history of disease.
Twenty-four patients underwent genetic testing, six of whom tested positive for genetic markers.
Treatments included chemoreduction (39%), plaque radiotherapy (24%), external beam radiotherapy (31%) and enucleation (28%). Globe salvage was achieved in 72% of patients.
Mean follow-up was 69 months.
Metastasis to the brain or bone was identified in three patients at an interval ranging from 4 months to 25 years. Secondary cancers were identified in five patients; four of these patients had undergone external beam radiotherapy.
Five patients died at a mean age of 43 months. Two deaths were related to secondary cancer, and one patient died of metastatic cancer. Two patients died of conditions unrelated to retinoblastoma.
Disclosure: Heinmiller has no relevant financial disclosures.