Retinoblastoma Outcomes in the Americas: a prospective analysis of 491 children with retinoblastoma from 23 American countries

医学 视网膜母细胞瘤 危险系数 前瞻性队列研究 比例危险模型 内科学 年轻人 人口学 儿科 置信区间 生物化学 化学 社会学 基因
作者
Jesse L. Berry,Sarah Pike,Archeta Rajagopalan,Mark W. Reid,Ido Didi Fabian,Armin R. Afshar,Amanda Alejos,Ernesto Alemany-Rubio,Yvania Alfonso Carreras,Mattan Arazi,Nick Astbury,Covadonga Bascarán,Elaine M. Binkley,Sharon Blum,H. Culver Boldt,Maria Teresa B.C. Bonanomi,Richard Bowman,Rachel C. Brennan,Matthew Burton,Patricia Calderón-Sotelo,Doris A. Calle Jara,Miriam R. Cano,Luis Castillo,Isabel Cavieres,Daniela Černá,Arthika Chandramohan,Guillermo Chantada,Timothy W. Corson,Kristin E. Cowan-Lyn,Jacquelyn M. Davanzo,Hakan Demirci,Rosdali Yesenia Diaz Coronado,Helen Dimaras,Carla Macedo,Connor Ericksen,Adriana Fandiño,Delia D.P.G. Fernández,Allen Foster,Ligia D. Fu,Soad Fuentes‐Alabi,Juan Luis Garcı́a,Henry N. Garcia Pacheco,Ana V. Girón,Marco A. Goenz,Aaron S. Gold,Nir Gomel,Efren Gonzalez,Graciela González Pérez,Liudmira González-Rodríguez,Jaime Graells,Nathália Grigorovski,Patrick Hamel,Eric Hansen,J. William Harbour,M. Elizabeth Hartnett,Muhammad Hassan,G. Baker Hubbard,Noa Kapelushnik,Jonathan W. Kim,Scott Larson,Kelly D. Laurenti,Amy A. Leverant,Cai-Rui Li,Juan Pablo López,Sandra Luna‐Fineman,George N. Magrath,Ashwin Mallipatna,Clarissa C.D.S. Mattosinho,Marilyn B. Mets,Audra K. Miller,Prithvi Mruthyunjaya,Timothy G. Murray,Scott C. N. Oliver,Joaquín I. Oporto,Miriam Ortega-Hernández,D. Ossandón,Claudia R. Pascual Morales,Katherine Paton,David A. Plager,Rodrigo A. Polania,Jimena Ponce,Karina Quintero D,Aparna Ramasubramanian,Marco A. Ramirez-Ortiz,Jasmeen Randhawa,Livia Romero,Beatriz Salas,Gissela Sanchez,Alma Janeth Sanchez Orozco,Mariana Sgroi,Ankoor S. Shah,Carol L. Shields,Arun D. Singh,Alison H. Skalet,Andrew W. Stacey,Erin D. Stahl,Caron Strahlendorf,Maria Estela Coleoni Suarez,Rosanne Superstein,Fanny F Tarrillo Leiva,Luiz Fernando Teixeira,Ogul E. Uner,Jacqueline Karina Vasquez Anchaya,Leon O Vaughan,Víctor M. Villegas,Matthew W. Wilson,Antonio Yaghy,Roberto I Yee,Arturo Manuel Zapata López,Marcia Zondervan
出处
期刊:American Journal of Ophthalmology [Elsevier BV]
卷期号:260: 91-101
标识
DOI:10.1016/j.ajo.2023.11.004
摘要

Purpose Globally, disparities exist in retinoblastoma treatment outcomes between high- and low-income countries, but independent analysis of American countries is lacking. We report outcomes of American retinoblastoma patients and explore factors associated with survival and globe salvage. Design Subanalysis of prospective cohort study data. Methods Multicenter analysis at 57 American treatment centers in 23 countries of varying economic levels (low income=LIC, lower-middle=LMIC, upper-middle=UMIC, high=HIC) of 491 treatment-naïve retinoblastoma patients diagnosed in 2017 and followed through 2020. Survival and globe salvage rates analyzed with Kaplan-Meier analysis and Cox proportional hazard models. Results Of patients, 8 (1.6%), 58 (11.8%), 235 (47.9%) and 190 (38.7%) were from LIC, LMIC, UMIC and HIC, respectively. Three-year survival rates in LICs were 60.0% (95% CI, 12.6-88.2) compared to 99.2% (94.6-99.9) in HICs. Death was less likely in patients older than four years (vs. four or younger, HR=0.45 [95% CI, 0.27 – 0.78], P=0.048). Patients with more advanced tumors (e.g., cT3 vs. cT1, HR= 4.65 × 109 [95% CI, 1.25 × 109 – 1.72 × 1010], P<0.001) and females (vs. males, HR=1.98 [1.27-3.10], P=0.04) were more likely to die. Three-year globe salvage rates were 13.3% (95% CI, 5.1-25.6) in LMICs and 46.2% (38.8-53.3) in HICs. At three years, 70.1% of cT1 eyes (95% CI, 54.5-81.2) versus 8.9% of cT3 eyes (5.5-13.3) were salvaged. Advanced tumor stage was associated with higher enucleation risk (e.g., cT3 vs. cT1, SHR=4.98 [95% CI, 2.36-10.5), P<0.001). Conclusions Disparities exist in survival and globe salvage in American countries based on economic level and tumor stage demonstrating a need for childhood cancer programs.
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