Patient-related factors and outcome of retinoblastoma in Calabar, Nigeria: A single-center, retrospective study
Background: Retinoblastoma is associated with mortality in resource-poor nations due to disparities and poor access to treatment. The aim was to determine the relationships between patient-related factors and clinical outcomes of retinoblastoma in a tertiary hospital in Nigeria. Material and methods...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-06-01
|
| Series: | Pediatric Hematology Oncology Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468124524000196 |
| _version_ | 1827206989659242496 |
|---|---|
| author | Elizabeth D. Nkanga Anthony C. Nlemadim Mattan Arazi Dennis G. Nkanga Roseline E. Duke Ido D. Fabian Essemfon D. Nkanga Friday A. Odey Martin M. Meremikwu |
| author_facet | Elizabeth D. Nkanga Anthony C. Nlemadim Mattan Arazi Dennis G. Nkanga Roseline E. Duke Ido D. Fabian Essemfon D. Nkanga Friday A. Odey Martin M. Meremikwu |
| author_sort | Elizabeth D. Nkanga |
| collection | DOAJ |
| description | Background: Retinoblastoma is associated with mortality in resource-poor nations due to disparities and poor access to treatment. The aim was to determine the relationships between patient-related factors and clinical outcomes of retinoblastoma in a tertiary hospital in Nigeria. Material and methods: It was a retrospective study of all children diagnosed and treated for retinoblastoma from January 2017 through December 2022. Information obtained from their records included bio-socioeconomic data, symptoms, lag time from initial symptoms, staging, treatment, and survival outcome. Results: Fifty-three patients, aged 6–88 months on first hospital presentation were recruited. There were 29 (54.7%) females. Twenty (37.7%) patients died. The majority were the last child of their parents (62.3%) with a low socioeconomic class (86.8%) and lived in rural areas (50.9%). The median (interquartile) age at diagnosis [24 (18–36) months, p = 0.005] and lag time [13 (6–20) months, p = 0.274] were lower in those who survived than in those who died. The prevalence of bilateral disease (20.8%, p = 0.002), brain metastasis (22.6%, p < 0.001), stage IV disease (18.9%, p = 0.01) and relapse (34%, p < 0.001) was higher among the patients who died. The median (interquartile) overall survival (OS) was 22 (11.8–32.2) months with a 1-year OS of 63%. Treatment with only chemotherapy [HR 4.76 (95% CI: 1.7–13.1)], incomplete chemotherapy [HR 5.61 (95% CI: 1.3–24.7)], relapse [HR 5.98 (95% CI: 1.4–25.9)] and eye surgery delayed after 3 chemotherapy cycles [HR 8.22 (95% CI: 1.1–62.2)] were predictors of mortality. Conclusion: Most patients with retinoblastoma arrived at our treatment center approximately 14 months following the first symptom. Most (84.9%) presented with proptosis. The majority were of a low social class (86.8%), had a secondary level of education only (47.2%), and lived in rural areas (50.9%). The 3-year overall survival was 29%. |
| first_indexed | 2024-04-24T16:26:03Z |
| format | Article |
| id | doaj.art-ab2ec51fa1b54af492a2ee4feb41e610 |
| institution | Directory Open Access Journal |
| issn | 2468-1245 |
| language | English |
| last_indexed | 2025-03-21T12:32:56Z |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatric Hematology Oncology Journal |
| spelling | doaj.art-ab2ec51fa1b54af492a2ee4feb41e6102024-06-28T04:52:13ZengElsevierPediatric Hematology Oncology Journal2468-12452024-06-01928794Patient-related factors and outcome of retinoblastoma in Calabar, Nigeria: A single-center, retrospective studyElizabeth D. Nkanga0Anthony C. Nlemadim1Mattan Arazi2Dennis G. Nkanga3Roseline E. Duke4Ido D. Fabian5Essemfon D. Nkanga6Friday A. Odey7Martin M. Meremikwu8Department of Ophthalmology, University of Calabar, PMB 1115, Calabar, Cross River State, Nigeria; Calabar Children's Eye Centre, Department of Ophthalmology, University of Calabar, Calabar, Cross River State, NigeriaPaediatric Oncology Unit, Department of Paediatrics, University of Calabar Teaching Hospital Calabar, Cross River State, Nigeria; Corresponding author.Goldschleger Eye Institute, Sheba Medical Center, Ramat Gan, IsraelDepartment of Ophthalmology, University of Calabar, PMB 1115, Calabar, Cross River State, Nigeria; Calabar Children's Eye Centre, Department of Ophthalmology, University of Calabar, Calabar, Cross River State, Nigeria; Medical Retina Unit, Department of Ophthalmology, University of Calabar Teaching Hospital, Calabar, NigeriaDepartment of Ophthalmology, University of Calabar, PMB 1115, Calabar, Cross River State, Nigeria; Calabar Children's Eye Centre, Department of Ophthalmology, University of Calabar, Calabar, Cross River State, NigeriaInternational Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UKAll Saints University School of Medicine, Hillsborough Street, Roseau, Dominica West IndiesPaediatric Oncology Unit, Department of Paediatrics, University of Calabar Teaching Hospital Calabar, Cross River State, NigeriaPaediatric Oncology Unit, Department of Paediatrics, University of Calabar Teaching Hospital Calabar, Cross River State, NigeriaBackground: Retinoblastoma is associated with mortality in resource-poor nations due to disparities and poor access to treatment. The aim was to determine the relationships between patient-related factors and clinical outcomes of retinoblastoma in a tertiary hospital in Nigeria. Material and methods: It was a retrospective study of all children diagnosed and treated for retinoblastoma from January 2017 through December 2022. Information obtained from their records included bio-socioeconomic data, symptoms, lag time from initial symptoms, staging, treatment, and survival outcome. Results: Fifty-three patients, aged 6–88 months on first hospital presentation were recruited. There were 29 (54.7%) females. Twenty (37.7%) patients died. The majority were the last child of their parents (62.3%) with a low socioeconomic class (86.8%) and lived in rural areas (50.9%). The median (interquartile) age at diagnosis [24 (18–36) months, p = 0.005] and lag time [13 (6–20) months, p = 0.274] were lower in those who survived than in those who died. The prevalence of bilateral disease (20.8%, p = 0.002), brain metastasis (22.6%, p < 0.001), stage IV disease (18.9%, p = 0.01) and relapse (34%, p < 0.001) was higher among the patients who died. The median (interquartile) overall survival (OS) was 22 (11.8–32.2) months with a 1-year OS of 63%. Treatment with only chemotherapy [HR 4.76 (95% CI: 1.7–13.1)], incomplete chemotherapy [HR 5.61 (95% CI: 1.3–24.7)], relapse [HR 5.98 (95% CI: 1.4–25.9)] and eye surgery delayed after 3 chemotherapy cycles [HR 8.22 (95% CI: 1.1–62.2)] were predictors of mortality. Conclusion: Most patients with retinoblastoma arrived at our treatment center approximately 14 months following the first symptom. Most (84.9%) presented with proptosis. The majority were of a low social class (86.8%), had a secondary level of education only (47.2%), and lived in rural areas (50.9%). The 3-year overall survival was 29%.http://www.sciencedirect.com/science/article/pii/S2468124524000196RetinoblastomaPatient factorsClinical outcomeSurvivalTreatment |
| spellingShingle | Elizabeth D. Nkanga Anthony C. Nlemadim Mattan Arazi Dennis G. Nkanga Roseline E. Duke Ido D. Fabian Essemfon D. Nkanga Friday A. Odey Martin M. Meremikwu Patient-related factors and outcome of retinoblastoma in Calabar, Nigeria: A single-center, retrospective study Pediatric Hematology Oncology Journal Retinoblastoma Patient factors Clinical outcome Survival Treatment |
| title | Patient-related factors and outcome of retinoblastoma in Calabar, Nigeria: A single-center, retrospective study |
| title_full | Patient-related factors and outcome of retinoblastoma in Calabar, Nigeria: A single-center, retrospective study |
| title_fullStr | Patient-related factors and outcome of retinoblastoma in Calabar, Nigeria: A single-center, retrospective study |
| title_full_unstemmed | Patient-related factors and outcome of retinoblastoma in Calabar, Nigeria: A single-center, retrospective study |
| title_short | Patient-related factors and outcome of retinoblastoma in Calabar, Nigeria: A single-center, retrospective study |
| title_sort | patient related factors and outcome of retinoblastoma in calabar nigeria a single center retrospective study |
| topic | Retinoblastoma Patient factors Clinical outcome Survival Treatment |
| url | http://www.sciencedirect.com/science/article/pii/S2468124524000196 |
| work_keys_str_mv | AT elizabethdnkanga patientrelatedfactorsandoutcomeofretinoblastomaincalabarnigeriaasinglecenterretrospectivestudy AT anthonycnlemadim patientrelatedfactorsandoutcomeofretinoblastomaincalabarnigeriaasinglecenterretrospectivestudy AT mattanarazi patientrelatedfactorsandoutcomeofretinoblastomaincalabarnigeriaasinglecenterretrospectivestudy AT dennisgnkanga patientrelatedfactorsandoutcomeofretinoblastomaincalabarnigeriaasinglecenterretrospectivestudy AT roselineeduke patientrelatedfactorsandoutcomeofretinoblastomaincalabarnigeriaasinglecenterretrospectivestudy AT idodfabian patientrelatedfactorsandoutcomeofretinoblastomaincalabarnigeriaasinglecenterretrospectivestudy AT essemfondnkanga patientrelatedfactorsandoutcomeofretinoblastomaincalabarnigeriaasinglecenterretrospectivestudy AT fridayaodey patientrelatedfactorsandoutcomeofretinoblastomaincalabarnigeriaasinglecenterretrospectivestudy AT martinmmeremikwu patientrelatedfactorsandoutcomeofretinoblastomaincalabarnigeriaasinglecenterretrospectivestudy |