Takada Y, Takahashi K, Kobayashi T, Tomoda T, Uyama M
Department of Ophthalmology, Kansai Medical University, Moriguchi, Japan.
Nippon Ganka Gakkai Zasshi. 1990 Aug;94(8):756-61.
Among 21 cases of retinoblastoma (28 eyes) treated during the past 14 years in our clinic, 14 cases were unilateral, and 7 were bilateral. The average ages at the first visit were 27 months in unilateral cases and 7.2 months in bilateral cases. In all unilateral cases, in all of which the tumors were large (over group III according to Reese's classification), we removed the affected eye, and all patients survived without any evidence of metastasis or recurrence during a 5-year follow-up period. In bilateral cases, we removed the advanced eyes in which the tumors were large (over group III according to Reese's classification) in all cases, and the contralateral eyes underwent conservative treatment by radiotherapy, photocoagulation or chemotherapy. When tumors in contralateral eyes were small (Group I or II in Reese's classification), tumors of the retina subsided and all patients survived without recurrence or metastasis. However, when the tumors were large (group V), tumors of retina did not subside and survival was very poor. Our results show that the prognosis for survival in bilateral cases depends mainly upon the size of the tumor in the remaining eye.
在过去14年里，我们诊所治疗了21例视网膜母细胞瘤患者（共28只眼），其中14例为单侧发病，7例为双侧发病。单侧发病患者首次就诊时的平均年龄为27个月，双侧发病患者为7.2个月。所有单侧发病病例中的肿瘤都很大（根据里斯分类法超过III组），我们摘除了患眼，所有患者在5年随访期内均存活，且无任何转移或复发迹象。在双侧发病病例中，我们在所有病例中都摘除了肿瘤较大（根据里斯分类法超过III组）的病情较重的眼睛，对侧眼睛则通过放疗、光凝或化疗进行保守治疗。当对侧眼睛的肿瘤较小（里斯分类法中的I组或II组）时，视网膜肿瘤消退，所有患者均存活且无复发或转移。然而，当肿瘤较大（V组）时，视网膜肿瘤未消退，存活率很低。我们的结果表明，双侧发病病例的生存预后主要取决于剩余眼睛中肿瘤的大小。
