Retinoblastoma Outcomes Based on the 8th Edition American Joint Committee on Cancer Pathological Classification in 1411 Patients.

IF 13.1 1区 医学 Q1 OPHTHALMOLOGY Ophthalmology Pub Date : 2024-09-07 DOI:10.1016/j.ophtha.2024.08.037
Vijitha S Vempuluru, Carol L Shields, Jesse L Berry, Swathi Kaliki
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Abstract

Purpose: To evaluate the outcomes of retinoblastoma (RB) based on the 8th edition of the American Joint Committee on Cancer (AJCC) pathological classification in a global cohort of patients.

Design: Retrospective, multicenter, intercontinental, collaborative study.

Participants: A total of 1411 patients.

Intervention: Primary enucleation with or without adjuvant chemotherapy or radiotherapy.

Main outcome measures: Orbital tumor recurrence, tumor-related metastasis, and tumor-related death.

Results: According to the 8th edition AJCC pathological classification, 645 eyes (46%) belonged to pathological T (pT)1, 164 (11%) to pT2, 493 (35%) to pT3, and 109 (8%) to pT4 categories. At a mean follow-up of 38 months (median, 35 months; < 1-149 months), orbital tumor recurrence was seen in 8 (1%), 5 (3%), 22 (4%), and 25 (23%) of pT1, pT2, pT3, and pT4 (P < 0.001) categories, respectively; tumor-related metastasis was seen in 7 (1%), 5 (3%), 40 (8%), and 46 (43%) of pT1, pT2, pT3, and pT4 (P < 0.001) categories, respectively; tumor-related death was seen in 12 (2%), 7 (4%), 64 (13%), and 64 (59%) of pT1, pT2, pT3, and pT4 (P < 0.001) categories, respectively. Multivariate Cox proportional hazards analysis of outcomes revealed pT category and adjuvant therapy as independent predictors of outcomes. Categories pT3b (P = 0.005), pT3c (P < 0.001), pT3d (P < 0.001), and pT4 (P < 0.001) had a greater hazard for orbital recurrence; categories pT2a (P = 0.015), pT3a (P < 0.001), pT3b (P < 0.001), pT3c (P < 0.001), pT3d (P < 0.001), and pT4 (P < 0.001) had a greater hazard for tumor-related metastasis; and categories pT2a (P = 0.068), pT2b (P = 0.004), pT3a (P < 0.001), pT3b (P < 0.001), pT3c (P < 0.001), pT3d (P < 0.001), and pT4 (P < 0.001) had a greater hazard for tumor-related death when compared with the pT1 category. Patients who did not receive adjuvant therapy had greater hazards of orbital tumor recurrence in categories pT3b (P = 0.005), pT3c (P = 0.003), and pT4 (P = 0.002); greater hazards of tumor-related metastasis in categories pT3a (P = 0.001), pT3b (P = 0.01), pT3c (P = 0.001), and pT4 (P = 0.007); and tumor-related death in categories pT3a (P < 0.001), pT3b (P = 0.009), pT3c (P = 0.018), and pT4 (P < 0.001) when compared with those who received adjuvant therapy.

Conclusions: The 8th edition AJCC pathological classification predicts outcomes in patients undergoing primary enucleation for RB, and adjuvant therapy is associated with a lower risk of orbital recurrence, tumor-related metastasis, and tumor-related death in the pT3 and pT4 categories.

Financial disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

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基于美国癌症联合委员会第八版病理分类的视网膜母细胞瘤 1411 例患者的治疗结果。
目的:根据美国癌症联合委员会(AJCC)第 8 版病理分类,评估全球患者队列中视网膜母细胞瘤(RB)的预后:设计:回顾性、多中心、洲际合作研究 参与者:1411 名患者 干预:原发性去核术,同时/不进行辅助化疗/放疗 主要结局:眼眶肿瘤复发、肿瘤复发率、肿瘤复发率、肿瘤复发率、肿瘤复发率、肿瘤复发率、肿瘤复发率、肿瘤复发率眼眶肿瘤复发、肿瘤相关转移、肿瘤相关死亡 结果:根据第8版AJCC病理分类,645(46%)只眼属于pT1,164(11%)只眼属于pT2,493(35%)只眼属于pT3,109(8%)只眼属于pT4。平均随访时间为 38 个月(中位数为 35 个月):第8版AJCC病理分类可预测因RB接受原发性去核手术的患者的预后,在pT3和pT4类别中,辅助治疗与较低的眼眶复发、肿瘤相关转移和肿瘤相关死亡风险相关。
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来源期刊
Ophthalmology
Ophthalmology 医学-眼科学
CiteScore
22.30
自引率
3.60%
发文量
412
审稿时长
18 days
期刊介绍: The journal Ophthalmology, from the American Academy of Ophthalmology, contributes to society by publishing research in clinical and basic science related to vision.It upholds excellence through unbiased peer-review, fostering innovation, promoting discovery, and encouraging lifelong learning.
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