Vijitha S. Vempuluru MD , Carol L. Shields MD , Jesse L. Berry MD , Swathi Kaliki MD
{"title":"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。","authors":"Vijitha S. Vempuluru MD , Carol L. Shields MD , Jesse L. Berry MD , Swathi Kaliki MD","doi":"10.1016/j.ophtha.2024.08.037","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the outcomes of retinoblastoma (RB) based on the 8<sup>th</sup> edition of the American Joint Committee on Cancer (AJCC) pathological classification in a global cohort of patients.</div></div><div><h3>Design</h3><div>Retrospective, multicenter, intercontinental, collaborative study.</div></div><div><h3>Participants</h3><div>A total of 1411 patients.</div></div><div><h3>Intervention</h3><div>Primary enucleation with or without adjuvant chemotherapy or radiotherapy.</div></div><div><h3>Main Outcome Measures</h3><div>Orbital tumor recurrence, tumor-related metastasis, and tumor-related death.</div></div><div><h3>Results</h3><div>According to the 8<sup>th</sup> 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 (<em>P <</em> 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 (<em>P <</em> 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 (<em>P <</em> 0.001) categories, respectively. Multivariate Cox proportional hazards analysis of outcomes revealed pT category and adjuvant therapy as independent predictors of outcomes. Categories pT3b (<em>P =</em> 0.005), pT3c (<em>P <</em> 0.001), pT3d (<em>P <</em> 0.001), and pT4 (<em>P <</em> 0.001) had a greater hazard for orbital recurrence; categories pT2a (<em>P =</em> 0.015), pT3a (<em>P <</em> 0.001), pT3b (<em>P <</em> 0.001), pT3c (<em>P <</em> 0.001), pT3d (<em>P <</em> 0.001), and pT4 (<em>P <</em> 0.001) had a greater hazard for tumor-related metastasis; and categories pT2a (<em>P =</em> 0.068), pT2b (<em>P =</em> 0.004), pT3a (<em>P <</em> 0.001), pT3b (<em>P <</em> 0.001), pT3c (<em>P <</em> 0.001), pT3d (<em>P <</em> 0.001), and pT4 (<em>P <</em> 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 (<em>P =</em> 0.005), pT3c (<em>P =</em> 0.003), and pT4 (<em>P =</em> 0.002); greater hazards of tumor-related metastasis in categories pT3a (<em>P =</em> 0.001), pT3b (<em>P =</em> 0.01), pT3c (<em>P =</em> 0.001), and pT4 (<em>P =</em> 0.007); and tumor-related death in categories pT3a (<em>P <</em> 0.001), pT3b (<em>P =</em> 0.009), pT3c (<em>P =</em> 0.018), and pT4 (<em>P <</em> 0.001) when compared with those who received adjuvant therapy.</div></div><div><h3>Conclusions</h3><div>The 8<sup>th</sup> 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.</div></div><div><h3>Financial Disclosure(s)</h3><div>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</div></div>","PeriodicalId":19533,"journal":{"name":"Ophthalmology","volume":"132 3","pages":"Pages 317-326"},"PeriodicalIF":10.9000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Retinoblastoma Outcomes Based on the 8th Edition American Joint Committee on Cancer Pathological Classification in 1411 Patients\",\"authors\":\"Vijitha S. Vempuluru MD , Carol L. Shields MD , Jesse L. Berry MD , Swathi Kaliki MD\",\"doi\":\"10.1016/j.ophtha.2024.08.037\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>To evaluate the outcomes of retinoblastoma (RB) based on the 8<sup>th</sup> edition of the American Joint Committee on Cancer (AJCC) pathological classification in a global cohort of patients.</div></div><div><h3>Design</h3><div>Retrospective, multicenter, intercontinental, collaborative study.</div></div><div><h3>Participants</h3><div>A total of 1411 patients.</div></div><div><h3>Intervention</h3><div>Primary enucleation with or without adjuvant chemotherapy or radiotherapy.</div></div><div><h3>Main Outcome Measures</h3><div>Orbital tumor recurrence, tumor-related metastasis, and tumor-related death.</div></div><div><h3>Results</h3><div>According to the 8<sup>th</sup> 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 (<em>P <</em> 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 (<em>P <</em> 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 (<em>P <</em> 0.001) categories, respectively. Multivariate Cox proportional hazards analysis of outcomes revealed pT category and adjuvant therapy as independent predictors of outcomes. Categories pT3b (<em>P =</em> 0.005), pT3c (<em>P <</em> 0.001), pT3d (<em>P <</em> 0.001), and pT4 (<em>P <</em> 0.001) had a greater hazard for orbital recurrence; categories pT2a (<em>P =</em> 0.015), pT3a (<em>P <</em> 0.001), pT3b (<em>P <</em> 0.001), pT3c (<em>P <</em> 0.001), pT3d (<em>P <</em> 0.001), and pT4 (<em>P <</em> 0.001) had a greater hazard for tumor-related metastasis; and categories pT2a (<em>P =</em> 0.068), pT2b (<em>P =</em> 0.004), pT3a (<em>P <</em> 0.001), pT3b (<em>P <</em> 0.001), pT3c (<em>P <</em> 0.001), pT3d (<em>P <</em> 0.001), and pT4 (<em>P <</em> 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 (<em>P =</em> 0.005), pT3c (<em>P =</em> 0.003), and pT4 (<em>P =</em> 0.002); greater hazards of tumor-related metastasis in categories pT3a (<em>P =</em> 0.001), pT3b (<em>P =</em> 0.01), pT3c (<em>P =</em> 0.001), and pT4 (<em>P =</em> 0.007); and tumor-related death in categories pT3a (<em>P <</em> 0.001), pT3b (<em>P =</em> 0.009), pT3c (<em>P =</em> 0.018), and pT4 (<em>P <</em> 0.001) when compared with those who received adjuvant therapy.</div></div><div><h3>Conclusions</h3><div>The 8<sup>th</sup> 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.</div></div><div><h3>Financial Disclosure(s)</h3><div>The author(s) have no proprietary or commercial interest in any materials discussed in this article.</div></div>\",\"PeriodicalId\":19533,\"journal\":{\"name\":\"Ophthalmology\",\"volume\":\"132 3\",\"pages\":\"Pages 317-326\"},\"PeriodicalIF\":10.9000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ophthalmology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0161642024005384\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/7 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0161642024005384","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/7 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Retinoblastoma Outcomes Based on the 8th Edition American Joint Committee on Cancer Pathological Classification in 1411 Patients
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.
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.
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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