Department of Surgery (Ophthalmology), King Hussein Cancer Centre, Amman, Jordan.
Department of Pathology, King Hussein Cancer Centre, Amman, Jordan.
Eur J Ophthalmol. 2023 Sep;33(5):2014-2023. doi: 10.1177/11206721231155671. Epub 2023 Feb 9.
To compare the risk and pattern of High-Risk Pathologic Features (HRPF) in retinoblastoma between primary and secondary enucleation.
A retrospective analysis of 121 eyes from 118 patients who underwent enucleation at the King Hussein Cancer Center (KHCC) Amman, Jordan, between November 2009 and January 2020. Demographic information, tumor stage, time from diagnosis-to-enucleation, results of pathology, metastasis, and mortality were retrieved.
Patients in the secondary group (49/121 eyes, 40%) were considerably younger at diagnosis (p = 0.0014), had bilateral disease (p = 0.0001), and had less-progressed disease at presentation (p = 0.016) compared to the primary enucleation. Primarily enucleated eyes were more-likely to have massive choroidal invasion (p = 0.0315) and post-laminar optic nerve invasion (p = 0.027), in spite of the finding that the overall prevalence of HRPF was similar between the two groups (35.5 percent vs. 37.5 percent; p = 0.585). The likelihood of anterior chamber invasion, was considerably higher in secondary enucleated eyes (p = 0.013). We evaluated primary and secondary enucleation for each subgroup (D and E) of the International Intraocular Retinoblastoma Classification (IIRC) and found the prevalence of HRPF was comparable (p = 0.58, 1.0, respectively). The difference in time between diagnosis-to-enucleation in secondary enucleation did not predict HRPF (p = 0.50). There was no discernible difference between primary and secondary enucleated eyes in terms of metastasis or survival (p = 0.156 and 0.44, respectively).
Systemic chemotherapy has the ability to reduce the extent of tumor expansion that has been pathologically identified. Primary and secondary enucleated eyes are comparable in low metastatic risk only when strict examination and management guidelines are followed.
比较原发性和继发性眼球摘除术治疗视网膜母细胞瘤（RB）中高危病理特征（HRPF）的风险和模式。
回顾性分析 2009 年 11 月至 2020 年 1 月在约旦安曼侯赛因国王癌症中心（KHCC）接受眼球摘除术的 118 例 121 只眼患者的资料。检索患者的人口统计学信息、肿瘤分期、从诊断到眼球摘除的时间、病理结果、转移和死亡率。
与原发性眼球摘除组相比，继发性眼球摘除组（49/121 只眼，40%）的患者诊断时年龄明显较小（p=0.0014），双眼发病（p=0.0001），且发病时疾病进展程度较轻（p=0.016）。尽管原发性眼球摘除组的眼内大量脉络膜侵犯（p=0.0315）和后层视神经侵犯（p=0.027）的比例更高，但两组 HRPF 的总体发生率相似（35.5% vs. 37.5%；p=0.585）。继发性眼球摘除组前房侵犯的可能性明显更高（p=0.013）。我们对国际眼内 RB 分类（IIRC）的 D 和 E 亚组的原发性和继发性眼球摘除术进行了评估，发现 HRPF 的发生率相似（p=0.58、1.0）。继发性眼球摘除术的诊断到眼球摘除术的时间差异与 HRPF 无关（p=0.50）。原发性和继发性眼球摘除组在转移或生存方面无明显差异（p=0.156 和 0.44）。
全身化疗能够降低病理确定的肿瘤扩展程度。只有严格遵循检查和管理指南，低转移风险的原发性和继发性眼球摘除眼才具有可比性。
