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Eye-preserving therapies for advanced retinoblastoma: a multicenter cohort of 1678 patients in China.

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机构: [1]Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China [2] Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China. [2]Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University. [3]Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University. [4]Department of Ophthalmology, Guangzhou Women and Children's Medical Center. [5]Department of Ophthalmology, Xiangya Hospital, Central South University. [6]Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China [8] Department of Ophthalmology, Qilu Children's Hospital of Shandong University. [7]Department of Ophthalmology, First Affiliated Hospital, Army Medical University. [8]Department of Ophthalmology, Kunming Children's Hospital. [9]Department of Ophthalmology, Renmin Hospital of Wuhan University. [10]Department of Ophthalmology, Hebei Children's Hospital. [11]Department of Ophthalmology, Tangdu Hospital, The Fourth Military Medical University. [12]Department of Ophthalmology, Harbin Children's Hospital. [13]Department of Ophthalmology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), University of Science and Technology of China. [14]Department of Ophthalmology, The Second Affiliated Hospital, Zhejiang University School of Medicine. [15]Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. [16]Department of Ophthalmology, Children's Hospital of Nanjing Medical University. [17]Department of Ophthalmology, Second Provincial People's Hospital of Gansu. [18]Department of Ophthalmology, The second Hospital of Dalian Medical University. [19]Department of Ocular Trauma and Orbital Diseases, Affiliated Eye Hospital of Nanchang University. [20]Department of Ophthalmology, The second Hospital of Jilin University. [21]Department of Ophthalmology, The Affiliated Hospital of Inner Mongolia Medical University. [22]Department of Ophthalmology, West China Hospital, Sichuan University. [23]Department of Ophthalmology, Affiliated Shenzhen Eye Hospital of Ji-nan University. [24]Department of Ophthalmology, The People's Hospital of Guangxi Zhuang Autonomous Region. [25]Department of Ophthalmology, Tibet Autonomous Region Eye Center, Tibetan Medicine Hospital. [26]Department of Ophthalmology, The General Hospital of Xinjiang Military Command of PLA. [27]Department of Ophthalmology, Kashgar Prefecture Second People's Hospital. [28]Department of Ophthalmology, Hainan Eye Hospital and Key laboratory of ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University. [29]Department of Ophthalmology, The Affiliated Hospital of Guizhou Medical University. [30]Department of Ophthalmology, Tianjin Medical University Eye Hospital. [31]Department of Ophthalmology, NingXia Eye Hospital, People's Hospital of Ningxia Hui Autonomous Region. [32]Department of Ophthalmology, Qinghai University Affiliated Hospital. [33]National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. [34]Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, Department of Bioinformatics and Biostatistics, Shanghai Jiao Tong University. [35]Department of Ophthalmology, Peking University People's Hospital. [36]Department of Ophthalmology, Henan Children's Hospital. [37]Department of Ophthalmology, Quanzhou Women's and Children's Hospital. [38]Department of Ophthalmology, The General Hospital of Chinese People's Armed Police Forces. [39]Department of Ophthalmology, Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine. [40]Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China [43] Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China. Electronic address: fanxq@sjtu.edu.cn.
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Multiple eye-preserving treatments have been widely used in China for the last 15 years, however, controversy remains on using eye-preserving therapies for advanced retinoblastoma (The International Intraocular Retinoblastoma Classification: groups D and E). This study attempts to estimate the impact of eye-preserving therapies for the long-term prognosis of advanced retinoblastoma with regard to overall survival and ocular salvage.A retrospective cohort study covering all 31 provinces (38 retinoblastoma treating centers) of Chinese mainland.A total of 1678 patients diagnosed with groups D or E retinoblastoma from January 2006 to May 2016.Medical charts review was performed. The patients were divided into primary enucleation and eye-preserving groups, and they were followed up for survival status. The impact of initial treatment on survival was evaluated by Cox analyses.Overall survival and final eye-preservation rate.After a median follow-up period of 43.9 months, 196 (12%) patients died, and the 5-year overall survival was 86%. In total, the eyeball preservation rate was 48%. In this cohort, 1172 (70%) patients had unilateral retinoblastoma, whereas 506 (30%) were bilateral. For unilateral patients, 570 (49%) eyes had primary enucleation, and 602 (51%) patients had eye-preserving therapies initially. During the follow-up (median: 45.6 months), 59 (10%) patients from primary enucleation group and 56 (9.3%) patients from eye-preserving group died. Multivariate Cox analyses indicated no significant difference in overall survival between the two groups (HR=1.25; 95%CI:0.85-1.84; p=0.250). For bilateral patients, only 95 (19%) eyes had primary enucleation, and 411 (81%) patients had eye-preserving therapies initially. During the follow-up (median: 40.1 months), 12 (13%) patients from primary enucleation group and 69 (17%) patients from eye-preserving group died. For bilateral retinoblastoma with the worse eye of group E, patients had primary enucleation exhibited better overall survival (HR=2.35; 95%CI:1.10-5.01; p=0.027), however, this survival advantage was not evident until passing 22.6 months after initial diagnosis.Eye-preserving therapies have been widely used for advanced retinoblastoma in China. Bilateral patients with the worse eye of group E initially underwent eye-preserving therapies exhibited a worse overall survival. The choice of primary treatment for advanced retinoblastoma should be carefully weighed.Copyright © 2021. Published by Elsevier Inc.

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大类 | 1 区 医学
小类 | 1 区 眼科学
最新[2023]版:
大类 | 1 区 医学
小类 | 1 区 眼科学
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出版当年[2022]版:
Q1 OPHTHALMOLOGY
最新[2023]版:
Q1 OPHTHALMOLOGY

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第一作者机构: [1]Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
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