Comparison of high-risk histopathological features in eyes with primary or secondary enucleation for retinoblastoma

Rachel C. Brennan, Ibrahim Qaddoumi, Catherine A Billups, Tammy L. Free, Barrett G. Haik, Carlos Rodriguez-Galindo, Matthew Wilson

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Aims: To compare high-risk histopathology of eyes with primary versus secondary enucleation from patients with retinoblastoma. Patients and Methods: A retrospective histopathology review identified 207 eyes enucleated from 202 patients between March 1997 and August 2013. Our review considered high-risk histopathological features to include extraocular disease or invasion of the anterior chamber, iris, ciliary body, choroid (massive), postlaminar optic nerve or sclera. Results: Most eyes (144, 70%) were primarily enucleated; 63 (30%) were secondarily enucleated after neoadjuvant therapy. The primary enucleation group had more advanced disease (Reese-Ellsworth group V: 95% vs 59%; International Classification Group D/E: 97% vs 59%; p<0.001). The incidence of high-risk histopathology features was similar between groups (32% vs 21%, n=59; p=0.132). The type of prior therapy was not associated with high-risk histopathology features. Time to enucleation was longer for secondarily enucleated eyes with high-risk features. Choroid and postlaminar optic nerve invasion were more frequent in eyes primarily enucleated (p<0.001). Forty-six of the 59 (78%) patients with high-risk features received adjuvant chemotherapy and/or external beam radiation therapy. Three patients who received primary enucleation and adjuvant therapy died of metastatic recurrence. Conclusions: Despite the more favourable classification of eyes treated with neoadjuvant therapy, the risk of high-risk histopathology features at enucleation was comparable with eyes undergoing primary enucleation. Delayed enucleation was associated with these features, and the majority of patients required further adjuvant therapy. Caution must be exercised in treating recalcitrant intraocular retinoblastoma to promptly pursue definitive enucleation in an effort to minimise further treatment exposures and metastases.

Original languageEnglish (US)
Pages (from-to)1366-1371
Number of pages6
JournalBritish Journal of Ophthalmology
Volume99
Issue number10
DOIs
StatePublished - Oct 1 2015

Fingerprint

Retinoblastoma
Neoadjuvant Therapy
Choroid
Optic Nerve
Ciliary Body
Sclera
Anterior Chamber
Iris
Therapeutics
Adjuvant Chemotherapy
Radiotherapy
Neoplasm Metastasis
Recurrence
Incidence

All Science Journal Classification (ASJC) codes

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

Comparison of high-risk histopathological features in eyes with primary or secondary enucleation for retinoblastoma. / Brennan, Rachel C.; Qaddoumi, Ibrahim; A Billups, Catherine; Free, Tammy L.; Haik, Barrett G.; Rodriguez-Galindo, Carlos; Wilson, Matthew.

In: British Journal of Ophthalmology, Vol. 99, No. 10, 01.10.2015, p. 1366-1371.

Research output: Contribution to journalArticle

Brennan, Rachel C. ; Qaddoumi, Ibrahim ; A Billups, Catherine ; Free, Tammy L. ; Haik, Barrett G. ; Rodriguez-Galindo, Carlos ; Wilson, Matthew. / Comparison of high-risk histopathological features in eyes with primary or secondary enucleation for retinoblastoma. In: British Journal of Ophthalmology. 2015 ; Vol. 99, No. 10. pp. 1366-1371.
@article{c841cf7fa9974a289f8deb50f94ceb3d,
title = "Comparison of high-risk histopathological features in eyes with primary or secondary enucleation for retinoblastoma",
abstract = "Aims: To compare high-risk histopathology of eyes with primary versus secondary enucleation from patients with retinoblastoma. Patients and Methods: A retrospective histopathology review identified 207 eyes enucleated from 202 patients between March 1997 and August 2013. Our review considered high-risk histopathological features to include extraocular disease or invasion of the anterior chamber, iris, ciliary body, choroid (massive), postlaminar optic nerve or sclera. Results: Most eyes (144, 70{\%}) were primarily enucleated; 63 (30{\%}) were secondarily enucleated after neoadjuvant therapy. The primary enucleation group had more advanced disease (Reese-Ellsworth group V: 95{\%} vs 59{\%}; International Classification Group D/E: 97{\%} vs 59{\%}; p<0.001). The incidence of high-risk histopathology features was similar between groups (32{\%} vs 21{\%}, n=59; p=0.132). The type of prior therapy was not associated with high-risk histopathology features. Time to enucleation was longer for secondarily enucleated eyes with high-risk features. Choroid and postlaminar optic nerve invasion were more frequent in eyes primarily enucleated (p<0.001). Forty-six of the 59 (78{\%}) patients with high-risk features received adjuvant chemotherapy and/or external beam radiation therapy. Three patients who received primary enucleation and adjuvant therapy died of metastatic recurrence. Conclusions: Despite the more favourable classification of eyes treated with neoadjuvant therapy, the risk of high-risk histopathology features at enucleation was comparable with eyes undergoing primary enucleation. Delayed enucleation was associated with these features, and the majority of patients required further adjuvant therapy. Caution must be exercised in treating recalcitrant intraocular retinoblastoma to promptly pursue definitive enucleation in an effort to minimise further treatment exposures and metastases.",
author = "Brennan, {Rachel C.} and Ibrahim Qaddoumi and {A Billups}, Catherine and Free, {Tammy L.} and Haik, {Barrett G.} and Carlos Rodriguez-Galindo and Matthew Wilson",
year = "2015",
month = "10",
day = "1",
doi = "10.1136/bjophthalmol-2014-306364",
language = "English (US)",
volume = "99",
pages = "1366--1371",
journal = "British Journal of Ophthalmology",
issn = "0007-1161",
publisher = "BMJ Publishing Group",
number = "10",

}

TY - JOUR

T1 - Comparison of high-risk histopathological features in eyes with primary or secondary enucleation for retinoblastoma

AU - Brennan, Rachel C.

AU - Qaddoumi, Ibrahim

AU - A Billups, Catherine

AU - Free, Tammy L.

AU - Haik, Barrett G.

AU - Rodriguez-Galindo, Carlos

AU - Wilson, Matthew

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Aims: To compare high-risk histopathology of eyes with primary versus secondary enucleation from patients with retinoblastoma. Patients and Methods: A retrospective histopathology review identified 207 eyes enucleated from 202 patients between March 1997 and August 2013. Our review considered high-risk histopathological features to include extraocular disease or invasion of the anterior chamber, iris, ciliary body, choroid (massive), postlaminar optic nerve or sclera. Results: Most eyes (144, 70%) were primarily enucleated; 63 (30%) were secondarily enucleated after neoadjuvant therapy. The primary enucleation group had more advanced disease (Reese-Ellsworth group V: 95% vs 59%; International Classification Group D/E: 97% vs 59%; p<0.001). The incidence of high-risk histopathology features was similar between groups (32% vs 21%, n=59; p=0.132). The type of prior therapy was not associated with high-risk histopathology features. Time to enucleation was longer for secondarily enucleated eyes with high-risk features. Choroid and postlaminar optic nerve invasion were more frequent in eyes primarily enucleated (p<0.001). Forty-six of the 59 (78%) patients with high-risk features received adjuvant chemotherapy and/or external beam radiation therapy. Three patients who received primary enucleation and adjuvant therapy died of metastatic recurrence. Conclusions: Despite the more favourable classification of eyes treated with neoadjuvant therapy, the risk of high-risk histopathology features at enucleation was comparable with eyes undergoing primary enucleation. Delayed enucleation was associated with these features, and the majority of patients required further adjuvant therapy. Caution must be exercised in treating recalcitrant intraocular retinoblastoma to promptly pursue definitive enucleation in an effort to minimise further treatment exposures and metastases.

AB - Aims: To compare high-risk histopathology of eyes with primary versus secondary enucleation from patients with retinoblastoma. Patients and Methods: A retrospective histopathology review identified 207 eyes enucleated from 202 patients between March 1997 and August 2013. Our review considered high-risk histopathological features to include extraocular disease or invasion of the anterior chamber, iris, ciliary body, choroid (massive), postlaminar optic nerve or sclera. Results: Most eyes (144, 70%) were primarily enucleated; 63 (30%) were secondarily enucleated after neoadjuvant therapy. The primary enucleation group had more advanced disease (Reese-Ellsworth group V: 95% vs 59%; International Classification Group D/E: 97% vs 59%; p<0.001). The incidence of high-risk histopathology features was similar between groups (32% vs 21%, n=59; p=0.132). The type of prior therapy was not associated with high-risk histopathology features. Time to enucleation was longer for secondarily enucleated eyes with high-risk features. Choroid and postlaminar optic nerve invasion were more frequent in eyes primarily enucleated (p<0.001). Forty-six of the 59 (78%) patients with high-risk features received adjuvant chemotherapy and/or external beam radiation therapy. Three patients who received primary enucleation and adjuvant therapy died of metastatic recurrence. Conclusions: Despite the more favourable classification of eyes treated with neoadjuvant therapy, the risk of high-risk histopathology features at enucleation was comparable with eyes undergoing primary enucleation. Delayed enucleation was associated with these features, and the majority of patients required further adjuvant therapy. Caution must be exercised in treating recalcitrant intraocular retinoblastoma to promptly pursue definitive enucleation in an effort to minimise further treatment exposures and metastases.

UR - http://www.scopus.com/inward/record.url?scp=84942370435&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84942370435&partnerID=8YFLogxK

U2 - 10.1136/bjophthalmol-2014-306364

DO - 10.1136/bjophthalmol-2014-306364

M3 - Article

VL - 99

SP - 1366

EP - 1371

JO - British Journal of Ophthalmology

JF - British Journal of Ophthalmology

SN - 0007-1161

IS - 10

ER -