The Impact of Tumor Laterality (Unilateral vs. Bilateral) on Presentation and Management Outcome in Patients with Retinoblastoma
<b>Background:</b> This study compares the outcomes of managing retinoblastoma between patients with unilateral and bilateral presentations. <b>Methods:</b> The study, conducted at the King Hussein Cancer Center in Amman, Jordan, retrospectively analyzed cases of retinoblasto...
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MDPI AG
2024-04-01
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| Online Access: | https://www.mdpi.com/2077-0383/13/7/2146 |
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| author | Mona Mohammad Mustafa Mehyar Hadeel Halalsheh Reham Shehada Omar Al Adawi Jakub Khzouz Imad Jaradat Maysa Al-Hussaini Iyad Sultan Ibrahim Alnawaiseh Yacoub A. Yousef |
| author_facet | Mona Mohammad Mustafa Mehyar Hadeel Halalsheh Reham Shehada Omar Al Adawi Jakub Khzouz Imad Jaradat Maysa Al-Hussaini Iyad Sultan Ibrahim Alnawaiseh Yacoub A. Yousef |
| author_sort | Mona Mohammad |
| collection | DOAJ |
| description | <b>Background:</b> This study compares the outcomes of managing retinoblastoma between patients with unilateral and bilateral presentations. <b>Methods:</b> The study, conducted at the King Hussein Cancer Center in Amman, Jordan, retrospectively analyzed cases of retinoblastoma treated between March 2003 and December 2019. Evaluation criteria included clinical features, disease stage, treatment methods, and overall management outcomes. <b>Results:</b> The study comprised 697 eyes from 478 patients with retinoblastoma, with 52% being males. Bilateral disease was observed in 70% of patients, and a family history of retinoblastoma was more prevalent in cases with bilateral disease (20%) compared to those with unilateral disease (4%). Unilateral cases had a median age at diagnosis of 28 months, whereas bilateral cases were diagnosed at a median age of 6 months. Extra-ocular retinoblastoma was detected in 1% of eyes. According to the International Intraocular Retinoblastoma Classification (IIRC), 88% of unilateral cases presented with advanced disease (IIRC group D/E), compared to 46% in bilateral cases. Primary enucleation was performed in 29% of unilateral cases and 16% of bilateral cases (<i>p</i>-value 0.0007). Eye salvage rates were 31% in unilateral cases and 68% in bilateral cases (<i>p</i>-value < 0.0001). At 120 months of follow-up, 5% of patients died from secondary neoplasms or metastases, 81% were alive, and 14% were lost to follow-up. There was no significant difference in metastasis, secondary neoplasms, or mortality between patients with unilateral and bilateral retinoblastoma. <b>Conclusions:</b> This study highlights the nuanced differences in clinical characteristics and outcomes between unilateral and bilateral retinoblastoma, emphasizing the necessity of customized management and early detection strategies. It demonstrates that while bilateral retinoblastoma benefits from earlier detection and has a higher rate of eye salvage, there is no significant difference in metastasis or mortality rates when compared to unilateral cases. The critical roles of primary enucleation in advanced cases, along with effective communication and patient education, are also underscored to improve treatment adherence. Overall, these findings point to the importance of tailored approaches in optimizing outcomes for the diverse patient population affected by retinoblastoma. |
| first_indexed | 2024-04-24T10:40:55Z |
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| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-04-24T10:40:55Z |
| publishDate | 2024-04-01 |
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| spelling | doaj.art-298d2a1a4653463bb0b949e9c7e073952024-04-12T13:21:40ZengMDPI AGJournal of Clinical Medicine2077-03832024-04-01137214610.3390/jcm13072146The Impact of Tumor Laterality (Unilateral vs. Bilateral) on Presentation and Management Outcome in Patients with RetinoblastomaMona Mohammad0Mustafa Mehyar1Hadeel Halalsheh2Reham Shehada3Omar Al Adawi4Jakub Khzouz5Imad Jaradat6Maysa Al-Hussaini7Iyad Sultan8Ibrahim Alnawaiseh9Yacoub A. Yousef10Departments of Ophthalmology, King Hussein Cancer Centre (KHCC), Amman 11941, JordanDepartments of Ophthalmology, King Hussein Cancer Centre (KHCC), Amman 11941, JordanPediatric Oncology, King Hussein Cancer Centre (KHCC), Amman 11941, JordanDepartments of Ophthalmology, King Hussein Cancer Centre (KHCC), Amman 11941, JordanDepartments of Ophthalmology, King Hussein Cancer Centre (KHCC), Amman 11941, JordanPathology, King Hussein Cancer Centre (KHCC), Amman 11941, JordanRadiation Oncology, King Hussein Cancer Centre (KHCC), Amman 11941, JordanPathology, King Hussein Cancer Centre (KHCC), Amman 11941, JordanPediatric Oncology, King Hussein Cancer Centre (KHCC), Amman 11941, JordanDepartments of Ophthalmology, King Hussein Cancer Centre (KHCC), Amman 11941, JordanDepartments of Ophthalmology, King Hussein Cancer Centre (KHCC), Amman 11941, Jordan<b>Background:</b> This study compares the outcomes of managing retinoblastoma between patients with unilateral and bilateral presentations. <b>Methods:</b> The study, conducted at the King Hussein Cancer Center in Amman, Jordan, retrospectively analyzed cases of retinoblastoma treated between March 2003 and December 2019. Evaluation criteria included clinical features, disease stage, treatment methods, and overall management outcomes. <b>Results:</b> The study comprised 697 eyes from 478 patients with retinoblastoma, with 52% being males. Bilateral disease was observed in 70% of patients, and a family history of retinoblastoma was more prevalent in cases with bilateral disease (20%) compared to those with unilateral disease (4%). Unilateral cases had a median age at diagnosis of 28 months, whereas bilateral cases were diagnosed at a median age of 6 months. Extra-ocular retinoblastoma was detected in 1% of eyes. According to the International Intraocular Retinoblastoma Classification (IIRC), 88% of unilateral cases presented with advanced disease (IIRC group D/E), compared to 46% in bilateral cases. Primary enucleation was performed in 29% of unilateral cases and 16% of bilateral cases (<i>p</i>-value 0.0007). Eye salvage rates were 31% in unilateral cases and 68% in bilateral cases (<i>p</i>-value < 0.0001). At 120 months of follow-up, 5% of patients died from secondary neoplasms or metastases, 81% were alive, and 14% were lost to follow-up. There was no significant difference in metastasis, secondary neoplasms, or mortality between patients with unilateral and bilateral retinoblastoma. <b>Conclusions:</b> This study highlights the nuanced differences in clinical characteristics and outcomes between unilateral and bilateral retinoblastoma, emphasizing the necessity of customized management and early detection strategies. It demonstrates that while bilateral retinoblastoma benefits from earlier detection and has a higher rate of eye salvage, there is no significant difference in metastasis or mortality rates when compared to unilateral cases. The critical roles of primary enucleation in advanced cases, along with effective communication and patient education, are also underscored to improve treatment adherence. Overall, these findings point to the importance of tailored approaches in optimizing outcomes for the diverse patient population affected by retinoblastoma.https://www.mdpi.com/2077-0383/13/7/2146retinoblastomaunilateralbilateralenucleation |
| spellingShingle | Mona Mohammad Mustafa Mehyar Hadeel Halalsheh Reham Shehada Omar Al Adawi Jakub Khzouz Imad Jaradat Maysa Al-Hussaini Iyad Sultan Ibrahim Alnawaiseh Yacoub A. Yousef The Impact of Tumor Laterality (Unilateral vs. Bilateral) on Presentation and Management Outcome in Patients with Retinoblastoma Journal of Clinical Medicine retinoblastoma unilateral bilateral enucleation |
| title | The Impact of Tumor Laterality (Unilateral vs. Bilateral) on Presentation and Management Outcome in Patients with Retinoblastoma |
| title_full | The Impact of Tumor Laterality (Unilateral vs. Bilateral) on Presentation and Management Outcome in Patients with Retinoblastoma |
| title_fullStr | The Impact of Tumor Laterality (Unilateral vs. Bilateral) on Presentation and Management Outcome in Patients with Retinoblastoma |
| title_full_unstemmed | The Impact of Tumor Laterality (Unilateral vs. Bilateral) on Presentation and Management Outcome in Patients with Retinoblastoma |
| title_short | The Impact of Tumor Laterality (Unilateral vs. Bilateral) on Presentation and Management Outcome in Patients with Retinoblastoma |
| title_sort | impact of tumor laterality unilateral vs bilateral on presentation and management outcome in patients with retinoblastoma |
| topic | retinoblastoma unilateral bilateral enucleation |
| url | https://www.mdpi.com/2077-0383/13/7/2146 |
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