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Retinoblastoma: Analysis of 235 cases

1978; Elsevier BV; Volume: 4; Issue: 5-6 Linguagem: Inglês

10.1016/0360-3016(78)90063-9

1879-355X

Mario Gaitan-yanguas,

Cancer-related Molecular Pathways

Retinoblastoma is the second most frequent tumor of childhood in Colombia, where cancer has an incidence of 16.4 cases per 100,000 children under 9 years of age. Case histories of 235 patients with retinoblastoma who were seen at the Instituto Nacional de Cancerologia (INC) and in private practice were reviewed to discover clinical behavior and results of treatment. The tumor is most frequent between 2 and 6 years of age and more frequent in males, with a factor of 1.3 x. The tumor locates equally in one or other eye and is bilateral (simultaneously or successively) in 25% of the cases. In 13 of 43 bilateral simultaneous tumors, the second primary was discovered during retinoscopy. Histopathological examination of the cut section of the nerve in 29 of 39 simultaneous bilateral cases was negative in 18; this means that the tumor is bilateral genetically, not because of invasion via optic chiasma. Symptoms were analyzed with special attention given to early diagnosis. The sites for metastasis were studied and in particular the frequency of contralateral metastasis. A close relationship was found between the time of evolution from the first symptom to the time of treatment and the confinement of the tumor within the eye, with a critical lapse of 6 months. The treatment policy is detailed as well as the results of treatment, a 30% survival rate was noted in the followed patients, 21% among those who were treated and 18% of the total cases (66% were Group VI, 16% Group V and 15% Groups II–IV). Since recurrences are unusual after 2 years, cancer-free survival longer than this can be equated with control. The prognostic value of some parameters as extracted from the analysis of those patients who were cured and the importance of early diagnosis are discussed.