Abstract 2P
Background
Retinoblastoma is a rare intraocular malignancy, occurring in approximately one out of every 18,000 live births in the global population. Due to its scarcity, there is not enough data in the literature regarding the best treatment modality of retinoblastoma, especially eye sparing types. The aim of this study is to evaluate the survival outcome of different treatment strategies and the risk of multiple primary malignancies of retinoblastoma.
Methods
Data of 1490 patients were extracted from a national cancer database diagnosed with retinoblastoma from 2000 to 2020. We subdivided the patients according to the treatment modality into four groups: chemotherapy, transpupillary thermotherapy, enucleation and combined enucleation and chemotherapy. MP-SIR session was used to calculate the Standardized incidence Ratio (SIR) as Observed/Expected (O/E) with significant results if P>0.05 and Excess Absolute Risk (EAR) per 10,000.
Results
Both transpupillary thermotherapy and enucleation had improved relative survival compared to primary chemotherapy and adjuvant chemotherapy after enucleation (100%, 98.8%, 96.0% and 95.4% respectively; P=0.01). Performing COX-regression model for age, race, gender, laterality and stage showed race (HR=1.514, 95% CI: 1.999-1.146; P=0.003) and stage (HR=0.195, 95% CI: 0.471-0.081; P<0.001) were significantly associated with survival outcome while gender (HR=0.788, 95% CI: 1.321x-0.470; P=0.365), age (HR=0.947, 95% CI: 1.407-0.638; P=0.789) and laterality (HR=0.943, 95% CI: 1.319-0.674; P=0.732) had no statistical significance. However, a second primary ocular malignancy was observed in 30 cases along ten years after diagnosis with EAR of 31.26 and (O/E) = 14.69, 95% CI:25.13-7.82; P< 0.05).
Conclusions
The results of this study showed promising survival outcomes of transpupillary thermotherapy for treatment of retinoblastoma, which can discourage both enucleation and chemotherapy. It was also shown that stage and race had increased risk of incidence. A second ocular malignancy had increased incidence with previous history with retinoblastoma. Finally, more studies should evaluate the efficacy of transpupillary thermotherapy treatment.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.