Contemporary Update of Retinoblastoma in China: Three-Decade Changes in Epidemiology, Clinical Features, Treatments, and Outcomes,American Journal of Ophthalmology

当前位置： X-MOL 学术 › Am. J. Ophthalmol. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Contemporary Update of Retinoblastoma in China: Three-Decade Changes in Epidemiology, Clinical Features, Treatments, and Outcomes
American Journal of Ophthalmology ( IF 4.2 ) Pub Date : 2021-10-06 , DOI: 10.1016/j.ajo.2021.09.026
Yingxiu Luo ₁ , Chuandi Zhou ₁ , Fanglin He ₁ , Jiayan Fan ₁ , Xuyang Wen ₁ , Yi Ding ₁ , Yanping Han ₁ , Jingwen Ding ₂ , Mei Jin ₃ , Zhenyin Liu ₄ , Sha Wang ₅ , Minglei Han ₆ , Hongfeng Yuan ₇ , Hong Sun ₈ , Yishuang Xiao ₉ , Li Wu ₁₀ , Jiancang Wang ₁₁ , Yangjun Li ₁₂ , Huasheng Yang ₁₃ , Jiawei Yu ₁₄ , Jianyang Gong ₁₅ , Yuxin Xu ₁₆ , Yuechun Wen ₁₇ , Ziqing Gao ₁₈ , Lixin Mei ₁₉ , Juan Ye ₂₀ , Hu Liu ₂₁ , Zhijun Chen ₂₂ , Shangcai Xue ₂₃ , Rong Liu ₂₄ , Hong Chen ₂₅ , Wei Lu ₂₆ , Hongfei Liao ₂₇ , Qing Guo ₂₈ , Jizhe Cui ₂₉ , Dan Zhu ₃₀ , Fang Lu ₃₁ , Song Tang ₃₂ , Yu Wu ₃₃ , Tseden Yangkyi ₃₄ , Zhang Guanghong ₃₅ , Miershalijiang Wubuli ₃₆ , Guo Huiyu ₃₇ , Xian Wang ₃₈ , Yanjin He ₃₉ , Xunlun Sheng ₄₀ , Qing Wang ₄₁ , Jia Tan ₅ , Jianhong Liang ₄₂ , Xiantao Sun ₄₃ , Jing Zhang ₄ , Xunda Ji ₄₄ , Liwen Jin ₄₅ , Junyang Zhao ₃ , Xinji Yang ₄₆ , Renbing Jia ₁ , Xianqun Fan ₁

Affiliation

Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, R.J, X.F).
Department of Ophthalmology, Beijing Tongren Hospital (J.D).
Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University (M.J, J.Z).
Department of Ophthalmology, Guangzhou Women and Children's Medical Center (Z.L, J.Z).
Department of Ophthalmology, Central South University Xiangya School of Medicine (S.W, J.T).
Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (Y.L, C.Z, F.H, J.F, X.W, Y.D, Y.H, M.H, R.J, X.F); Department of Ophthalmology, Qilu Children's Hospital of Shandong University (M.H).
Department of Ophthalmology, the First hospital Affiliated with AMU (H.Y).
Department of Ophthalmology, Shandong Provincial Hospital (H.S).
Department of Ophthalmology, Kunming Children's Hospital (Y.X).
Department of Ophthalmology, Wuhan University Renmin Hospital (L.W).
Department of Ophthalmology, Hebei Children's Hospital (J.W).
Department of Ophthalmology, Xi'an Tangdu Hospital of No.4 Military Medical University (Y.L).
Zhongshan Ophthalmic Center, Sun Yat-sen University (H.Y).
Department of Ophthalmology, Harbin Children's Hospital (J.Y).
Ophthalmology of the First Affiliated Hospital Anhui Medical University (J.G).
Department of Ophthalmology, the Second affiliated Hospital of Anhui Medical University (Y.X).
Department of Ophthalmology, the Provincial Hospital Affiliated to Anhui Medical University (Y.W).
Department of Ophthalmology, the First Affiliated Hospital of Bengbu Medical College (Z.G).
Department of Ophthalmogy, Yijishan Hospital, Wannan Medical College (L.M).
Department of Ophthalmology, the Second Affiliated Hospital Zhejiang University School of Medicine (J.Y).
Jiangsu Province Hospital (H.L).
Children's Hospital of Nanjing Medical University (Z.C).
Second Provincial People's Hospital of Gansu (S.X).
Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (R.L).
Department of Ophthalmology, Union Hospital Affiliated with Tongji Medical College, Huazhong University of Science and Technology, Wuhan (H.C).
Department of Ophthalmology, the Second Hospital of Dalian Medical University (W.L).
Department of Ocular Trauma and Orbital Diseases, Affiliated Eye Hospital of Nanchang University (H.L).
The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China (Q.G).
The Second Hospital of Jilin University (J.C).
The Affiliated Hospital of Inner Mongolia Medical University (D.Z).
West China Hospital, Sichuan University (F.L).
Shenzhen Eye Hospital (S.T).
People's Hospital of Guangxi Zhuang Autonomous Region (Y.W).
Tibet Autonomous Region Eye Center (T.Y).
Beijing Road Clinical Department of Xinjiang Military Command General Hospital Urumqi (Z.G).
Kashgar Prefecture Second People's Hospital (M.W).
Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University (G.H).
The Affiliated Hospital of Guizhou Medical University (X.W).
Tianjin medical university eye hospital (Y.H).
Ning Xia Eye Hospital, People's Hospital of Ningxia Hui Autonomous Region (X.S).
Qinghai University Affiliated Hospital (Q.W).
Department of Ophthalmology, Peking University People's Hospital (J.L).
Department of Ophthalmology, Henan Children's Hospital (X.S).
Department of Ophthalmology, Xinhua Hospital affiliated with Shanghai Jiaotong University School of Medicine (L.J).
Department of Ophthalmology, Quanzhou Women's and Children's Hospital (L.J).
Department of Ophthalmology, The General Hospital of Chinese People's Armed Police Forces (X.Y).

PURPOSE

To report three-decade changes of clinical characteristics, progress of treatments, and risk factors associated with mortality and enucleation in patients with retinoblastoma in China.

DESIGN

Retrospective cohort study.

METHODS

This multicenter study included 2552 patients diagnosed with retinoblastoma in 38 medical centers in 31 provinces in China from 1989 to 2017, with follow-up data. Kendall's tau-b value was used to describe correlation coefficients between the three eras (between 1989 and 2008, between 2009 and 2013, and between 2014 and 2017) and clinical or demographic features. Hazard ratios and odds ratios were applied to measure risk factors.

RESULTS

A total of 324 (13%) patients died and 1414 (42%) eyes were removed. The 1-year, 3-year, and 5-year overall survival rates were 95%, 86%, and 83%, respectively. Patients were diagnosed at a better stage by International Classification for Retinoblastoma over time (Kendall's tau-b value = –0.084, P < .001). Pathological risk factors were also observed less in recent eras. New conservative therapies were adopted and used in more patients. The eye removal rate gradually decreased (Kendall's tau-b value = –0.167, P < .001). The overall survival rates were 81%, 83%, and 91% in the three eras. By multivariate Cox regression, bilateral tumors and extraocular extension were identified as risk factors for death. Among intraocular disease, Group E indicated higher risk of mortality. By multivariate logistics regression, unilateral tumors, earlier era of diagnosis, and extraocular extension were risk factors for eye salvage failure. Among intraocular retinoblastoma, Groups D and E had higher risk of eye salvage failure.

CONCLUSIONS

Patients were diagnosed at an earlier stage in recent eras. Conservative therapies, including intra-arterial chemotherapy, were increasingly being used. The above changes may contribute to the decreasing enucleation rate. Although no significant impact was identified on the mortality by the three eras, a decreasing trend was shown.

更新日期：2021-10-06

点击分享查看原文

点击收藏

阅读更多本刊最新论文本刊介绍/投稿指南

全部期刊列表>>