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2790例视网膜母细胞瘤患儿的临床分析:中国单中心经验

Clinical analysis of 2790 children with retinoblastoma: a single-center experience in China.

作者信息

Zhang Yi, Wang Yi-Zhuo, Shi Ji-Tong, Ma Jian-Min, Li Bin, Zhang Wei-Ling, Gu Hua-Li, Zhou Yan, Mei Yan-Yan, Li Song, Liu Ting-Ting, Jiang Li-Bin, Zhao Hong-Shu, Ge Xin, Hu Hui-Min, Zhi Tian, Huang Dong-Sheng

机构信息

Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing 100176, China.

Department of Ophthalmic Oncology, Beijing Tongren Hospital, Capital Medical University, Beijing 100176, China.

出版信息

World J Pediatr. 2023 Dec;19(12):1169-1180. doi: 10.1007/s12519-023-00719-5. Epub 2023 Jun 3.

Abstract

BACKGROUND

In this study, we aimed to analyze the clinical characteristics and prognosis of children with retinoblastoma (RB) in a single center in China with a large sample collection spanning 17 years.

METHODS

The clinical data of 2790 children with RB treated in Beijing Tongren Hospital from 2005 to 2021 were collected, and a retrospective analysis was conducted.

RESULTS

The median age of the participants was 28.3 months. There were 3624 affected eyes, 12.4% of which were in groups A-C, 67.1% in groups D-E and 16.2% were not specified. The primary symptom observed in most cases was a white pupil, accounting for 66.5%, followed by strabismus (12.8%). The median follow-up time was 59.7 months. The enucleation rate was 71.3% (703/986) in a single left eye and 72.5% (702/968) in a single right eye. The overall survival (OS) rate was 95.8% (2444/2552) because 237 patients dropped out, and 109 died. Kaplan‒Meier survival analysis showed that the median survival time (MST) was 125.92 months [95% confidence interval (CI) = 124.83-127.01]. Cox multivariate survival analysis showed that trilateral RB (P = 0.017), metastasis site (P = 0.001), and combined distant tissue metastasis (P = 0.001) were independent prognostic factors for RB. The OS of 44 cases of familial RB was 93.2% (41/44), with an MST of 80.62 months (95% CI = 67.70-93.54).

CONCLUSIONS

The timing of eye protection treatment and enucleation should be comprehensively judged to avoid worsening prognosis due to operation time delay. More importantly, the promotion and popularization of diagnosis and treatment technologies are necessary to further improve RB prognosis.

摘要

背景

在本研究中,我们旨在分析中国某单一中心17年间大样本收集的视网膜母细胞瘤(RB)患儿的临床特征和预后。

方法

收集2005年至2021年在北京同仁医院接受治疗的2790例RB患儿的临床资料,并进行回顾性分析。

结果

参与者的中位年龄为28.3个月。共有3624只患眼,其中12.4%属于A - C组,67.1%属于D - E组,16.2%未明确分组。大多数病例观察到的主要症状是白瞳症,占66.5%,其次是斜视(12.8%)。中位随访时间为59.7个月。单眼左眼的眼球摘除率为71.3%(703/986),单眼右眼为72.5%(702/968)。总生存率(OS)为95.8%(2444/2552),因为237例患者失访,109例死亡。Kaplan - Meier生存分析显示,中位生存时间(MST)为125.92个月[95%置信区间(CI)= 124.83 - 127.01]。Cox多因素生存分析显示,三侧RB(P = 0.017)、转移部位(P = 0.001)和合并远处组织转移(P = 0.001)是RB的独立预后因素。44例家族性RB的OS为93.2%(41/44),MST为80.62个月(95% CI = 67.70 - 93.54)。

结论

应综合判断保眼治疗和眼球摘除的时机,避免因手术时间延迟而使预后恶化。更重要的是,有必要推广和普及诊疗技术以进一步改善RB的预后。

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