原发性眼球摘除术后视网膜母细胞瘤的高危组织病理学特征：一项对来自五大洲1426例患者的全球研究。
HIGH-RISK HISTOPATHOLOGICAL FEATURES OF RETINOBLASTOMA FOLLOWING PRIMARY ENUCLEATION: A Global Study Of 1,426 Patients From 5 Continents.
作者信息
Kaliki Swathi, Vempuluru Vijitha S, Bakal Komal Rajendra, Dorji Samten, Tanna Vishakha, Shields Charlotte N, Fallon Samuel J, Raval Vishal, Ahmad Alia, Mushtaq Asma, Hussain Mahvish, Yousef Yacoub A, Mohammad Mona, Roy Soma Rani, Huque Fahmida, Tatiana Ushakova, Yuri Serov, Vladimir Polyakov, Zambrano Sandro Casavilca, Alarcón-León Sandra, Valdiviezo-Zapata Cinthya, Vargas-Martorellet Maria, Gutierrez-Chira Cynthia, Buitrago Mario, Ortiz Joana Sánchez, Diaz-Coronado Rosdali, Tripathy Devjyoti, Rath Suryasnata, Patil Gaurav, Berry Jesse L, Pike Sarah, Brown Brianne, Tanabe Mika, Frenkel Shahar, Eiger-Moscovich Maya, Pe'er Jacob, Shields Carol L, Eagle Ralph C, Laiton Andrea, Velasco Ana Maria, Vega Katherine, DeSimone Joseph, Bejjanki Kavya Madhuri, Kapoor Anasua Ganguly, Venkataraman Anusha, Bryant Victoria, Reddy M Ashwin, Sagoo Mandeep S, Hubbard G Baker, Azarcon Corrina P, Olson Thomas A, Grossniklaus Hans, Rolfe Olivia, Staffieri Sandra E, O'Day Roderick, Mathew Anu A, Elder James E, McKenzie John D, Fabian Ido Didi, Shemesh Rachel, Vishnevskia-Dai Vicktoria, Ali Mohammed Hasnat, Jakati Saumya, Mishra Dilip K, Palkonda Vijay Anand Reddy
机构信息
The Operation Eyesight Institute for Eye Cancer, LV Prasad Eye Institute, Hyderabad, India.
Children Hospital, Lahore, Pakistan.
出版信息
Retina. 2024 Dec 1;44(12):2105-2115. doi: 10.1097/IAE.0000000000004250. Epub 2024 Nov 12.
PURPOSE
To evaluate high-risk histopathological features following primary enucleation of eyes with retinoblastoma and assess the patient outcomes across continents.
METHODS
A retrospective study of 1,426 primarily enucleated retinoblastoma eyes from five continents.
RESULTS
Of all, 923 (65%) were from Asia (AS), 27 (2%) from Australia (AUS), 120 (8%) from Europe (EUR), 162 (11%) from North America (NA), and 194 (14%) from South America (SA). Based on the continent (AS vs. AUS vs. EUR vs. NA vs. SA), the histopathological features included massive choroidal invasion (31% vs. 7% vs. 13% vs. 19% vs. 27%, P = 0.001), postlaminar optic nerve invasion (27% vs. 0% vs. 16% vs. 21% vs. 19%, P = 0.0006), scleral infiltration (5% vs. 0% vs. 4% vs. 2% vs. 7%, P = 0.13), and microscopic extrascleral infiltration (4% vs. 0% vs. <1% vs. <1% vs. 4%, P = 0.68). Adjuvant chemotherapy with/without orbital radiotherapy was given to 761 (53%) patients. Based on Kaplan-Meier estimates in different continents (AS vs. AUS vs. EUR vs. NA vs. SA), the 6-year risk of orbital tumor recurrence was 5% versus 2% versus 0% versus 0% versus 12% ( P < 0.001), systemic metastasis was reported in 8% versus 5% versus 2% versus 0% versus 13% ( P = 0.001), and death in 10% versus 3% versus 2% versus 0% versus 11% ( P < 0.001) patients.
CONCLUSION
There is a wide variation in the infiltrative histopathological features of retinoblastoma across continents, resulting in variable outcomes. SA and AS had a higher risk of orbital tumor recurrence, systemic metastasis, and death compared to AUS, EUR, and NA.
目的
评估视网膜母细胞瘤患者眼球初次摘除术后的高风险组织病理学特征，并评估各大洲患者的预后情况。
方法
对来自五大洲的1426例初次接受眼球摘除术的视网膜母细胞瘤患者进行回顾性研究。
结果
其中，923例（65%）来自亚洲（AS），27例（2%）来自澳大利亚（AUS），120例（8%）来自欧洲（EUR），162例（11%）来自北美洲（NA），194例（14%）来自南美洲（SA）。基于各大洲（亚洲 vs. 澳大利亚 vs. 欧洲 vs. 北美洲 vs. 南美洲）分析，组织病理学特征包括广泛脉络膜浸润（31% vs. 7% vs. 13% vs. 19% vs. 27%，P = 0.001）、筛板后视神经浸润（27% vs. 0% vs. 16% vs. 21% vs. 19%，P = 0.0006）、巩膜浸润（5% vs. 0% vs. 4% vs. 2% vs. 7%，P = 0.13）以及微小巩膜外浸润（4% vs. 0% vs. <1% vs. <1% vs. 4%，P = 0.68）。761例（53%）患者接受了辅助化疗及/或眼眶放疗。基于不同大洲（亚洲 vs. 澳大利亚 vs. 欧洲 vs. 北美洲 vs. 南美洲）的Kaplan-Meier估计，眼眶肿瘤复发的6年风险分别为5%、2%、0%、0%、12%（P < 0.001），发生全身转移的比例分别为8%、5%、2%、0%、13%（P = 0.001），死亡比例分别为10%、3%、2%、0%、11%（P < 0.001）。
结论
各大洲视网膜母细胞瘤的浸润性组织病理学特征差异很大，导致预后各不相同。与澳大利亚、欧洲和北美洲相比，南美洲和亚洲眼眶肿瘤复发、全身转移及死亡的风险更高。
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