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Global Retinoblastoma Presentation and Analysis by National Income Level.
Fabian, Ido Didi; Abdallah, Elhassan; Abdullahi, Shehu U; Abdulqader, Rula A; Adamou Boubacar, Sahadatou; Ademola-Popoola, Dupe S; Adio, Adedayo; Afshar, Armin R; Aggarwal, Priyanka; Aghaji, Ada E; Ahmad, Alia; Akib, Marliyanti N R; Al Harby, Lamis; Al Ani, Mouroge H; Alakbarova, Aygun; Portabella, Silvia Alarcón; Al-Badri, Safaa A F; Alcasabas, Ana Patricia A; Al-Dahmash, Saad A; Alejos, Amanda; Alemany-Rubio, Ernesto; Alfa Bio, Amadou I; Alfonso Carreras, Yvania; Al-Haddad, Christiane; Al-Hussaini, Hamoud H Y; Ali, Amany M; Alia, Donjeta B; Al-Jadiry, Mazin F; Al-Jumaily, Usama; Alkatan, Hind M; All-Eriksson, Charlotta; Al-Mafrachi, Ali A R M; Almeida, Argentino A; Alsawidi, Khalifa M; Al-Shaheen, Athar A S M; Al-Shammary, Entissar H; Amiruddin, Primawita O; Antonino, Romanzo; Astbury, Nicholas J; Atalay, Hatice T; Atchaneeyasakul, La-Ongsri; Atsiaya, Rose; Attaseth, Taweevat; Aung, Than H; Ayala, Silvia; Baizakova, Baglan; Balaguer, Julia; Balayeva, Ruhengiz; Balwierz, Walentyna; Barranco, Honorio.
Afiliación
  • Fabian ID; International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
  • Abdallah E; The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel.
  • Abdullahi SU; Ophthalmology Department of Rabat, Mohammed V University, Rabat, Morocco.
  • Abdulqader RA; Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria.
  • Adamou Boubacar S; Basra Children's Specialty Hospital, Basra, Iraq.
  • Ademola-Popoola DS; National Hospital of Niamey, Niamey, Niger.
  • Adio A; University of Ilorin Teaching Hospital, University of Ilorin, Ilorin, Nigeria.
  • Afshar AR; Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
  • Aggarwal P; University of California, San Francisco.
  • Aghaji AE; Department of Pediatrics, Banaras Hindu University, Varanasi, India.
  • Ahmad A; Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria.
  • Akib MNR; The Children's Hospital and the Institute of Child Health, Lahore, Pakistan.
  • Al Harby L; RS Dr Wahidin Sudirohusodo, Makassar, Indonesia.
  • Al Ani MH; The Royal London Hospital, Barts Health NHS Trust, and Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.
  • Alakbarova A; Hawler Medical University, Erbil, Iraq.
  • Portabella SA; Zarifa Aliyeva National Center of Ophthalmology, Baku, Azerbaijan.
  • Al-Badri SAF; Department of Pediatric Ophthalmology, Hospital Vall d'Hebron, Barcelona, Spain.
  • Alcasabas APA; Pediatric Oncology Unit, Children Welfare Teaching Hospital, College of Medicine, University of Baghdad, Baghdad, Iraq.
  • Al-Dahmash SA; Philippine General Hospital, University of the Philippines, Manila, Philippines.
  • Alejos A; College of Medicine, King Saud University, Riyadh, Saudi Arabia.
  • Alemany-Rubio E; Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala.
  • Alfa Bio AI; Instituto Cubano de Oftalmología Ramón Pando Ferrer, Marianao, Havana, Cuba.
  • Alfonso Carreras Y; University of Parakou, Parakou, Benin.
  • Al-Haddad C; St Damien Pediatric Hospital, Port-au-Prince, Haiti.
  • Al-Hussaini HHY; Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon.
  • Ali AM; Pediatric Oncology Department, National Oncology Center, Sana'a, Yemen.
  • Alia DB; Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
  • Al-Jadiry MF; University Hospital Center Mother Theresa, Tirana, Albania.
  • Al-Jumaily U; Pediatric Oncology Unit, Children Welfare Teaching Hospital, College of Medicine, University of Baghdad, Baghdad, Iraq.
  • Alkatan HM; Imam Hussein Cancer Center, Karbala, Iraq.
  • All-Eriksson C; College of Medicine, King Saud University, Riyadh, Saudi Arabia.
  • Al-Mafrachi AARM; St Erik Eye Hospital, Stockholn, Sweden.
  • Almeida AA; Ibn Al Haitham Teaching Eye Hospital, Baghdad, Iraq.
  • Alsawidi KM; Beira Central Hospital, Beira, Mozambique.
  • Al-Shaheen AASM; Tripoli Eye Hospital, University of Tripoli, Tripoli, Libya.
  • Al-Shammary EH; Basra Children's Specialty Hospital, Basra, Iraq.
  • Amiruddin PO; Oncology Unit, Child's Central Teaching Hospital, Baghdad, Iraq.
  • Antonino R; National Eye Center, Cicendo Eye Hospital, Bandung, Indonesia.
  • Astbury NJ; Bambino Gesù IRCCS Children's Hospital, Rome, Italy.
  • Atalay HT; International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
  • Atchaneeyasakul LO; Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey.
  • Atsiaya R; Siriraj Hospital, Mahidol University, Bangkok, Thailand.
  • Attaseth T; Lighthouse For Christ Eye Centre, Mombasa, Kenya.
  • Aung TH; Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
  • Ayala S; Yangon Eye Hospital, University of Medicine 1, Yangon, Myanmar.
  • Baizakova B; Retina Consultants of Houston, Houston, Texas.
  • Balaguer J; Scientific Center of Pediatrics and Pediatric Surgery, Almaty, Kazakhstan.
  • Balayeva R; Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
  • Balwierz W; Zarifa Aliyeva National Center of Ophthalmology, Baku, Azerbaijan.
  • Barranco H; Institute of Pediatrics, Jagiellonian University Medical College, Children's University Hospital of Krakow, Krakow, Poland.
JAMA Oncol ; 6(5): 685-695, 2020 05 01.
Article en En | MEDLINE | ID: mdl-32105305
Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Retinoblastoma Tipo de estudio: Risk_factors_studies / Screening_studies Límite: Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: JAMA Oncol Año: 2020 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Retinoblastoma Tipo de estudio: Risk_factors_studies / Screening_studies Límite: Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: JAMA Oncol Año: 2020 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Estados Unidos