Microscopic Scleral Invasion in Retinoblastoma
| Autor: | Guillermo L. Chantada, Adriana Fandiño, Daisy Castro, María T. G. de Dávila, Adriana Cuenca, Myriam Guitter, Flor Giron |
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| Rok vydání: | 2009 |
| Předmět: |
Male
Surgical margin medicine.medical_specialty genetic structures Retinal Neoplasms medicine.medical_treatment Eye disease Eye Enucleation Metastasis Central nervous system disease medicine Humans Neoplasm Invasiveness Prospective Studies Child business.industry Eye Neoplasms Retinoblastoma Infant Cancer medicine.disease Chemotherapy regimen eye diseases Scleral Diseases Surgery Survival Rate Radiation therapy Ophthalmology Regimen Chemotherapy Adjuvant Child Preschool Female sense organs Neoplasm Recurrence Local business Follow-Up Studies |
| Zdroj: | Archives of Ophthalmology. 127:1006 |
| ISSN: | 0003-9950 |
| DOI: | 10.1001/archophthalmol.2009.174 |
| Popis: | Objective To describe the clinical and pathological features of patients with retinoblastoma and microscopic scleral invasion. Methods We reviewed all pathology slides of patients with microscopic scleral invasion who were included in 3 prospective treatment protocols (1988-2007). All patients received adjuvant chemotherapy (moderately intensive chemotherapy in the first 2 protocols or a more intensive combination in the third one). Only patients with cut-end invasion received orbital radiotherapy. Results Thirty-two of 386 patients had enucleated eyes with intrascleral (21 cases) and transscleral (11 cases) invasion. Of these cases, 20 had tumor invading the optic nerve beyond the lamina cribrosa, with 6 of these having tumor at the surgical margin. Sixteen were treated with moderately intensive chemotherapy and 16 received a higher-intensity regimen. Five-year overall survival was 0.77. Seven patients had an extraocular relapse (central nervous system metastasis, n = 4; systemic metastasis, n = 2; and involving the orbit, n = 3, isolated in 1 and combined with central nervous system disease in 2). All patients who had a relapse died. Patients receiving the intensive regimen had a significantly better outcome ( P = .007). Conclusions Microscopic scleral invasion might be a risk factor for extraocular relapse, and more intensive chemotherapy results in improved survival for these patients. |
| Databáze: | OpenAIRE |
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