Risk factors for extraocular relapse following enucleation after failure of

CHANTADA GL, DUNKEL IJ, ANTONELI CB, DE DÁVILA MT, ARIAS V, BEAVERSON K, FANDIÑO

MEDICAL AND PEDIATRIC ONCOLOGY

Año: 2007 p. 256 - 260

0098-1532

OBJECTIVE: To assess the outcome and determine risk factors for extraocularrelapse in patients with retinoblastoma who had been enucleated after failure of chemoreduction. METHODS: Retrospective study (1995-2002) at three institutions.Pathological risk factors (PRF) were defined as invasion of the anterior segment,choroid, post-laminar optic nerve, subarachnoid space, or sclera according to thelocal pathology report. Extraocular relapse was defined as an event. RESULTS: Onehundred twenty-two patients were included (17 had bilateral enucleation).Chemoreduction included vincristine, carboplatin, and etoposide (n=80, 65.6%),vincristine, and carboplatin (n=17, 13.9%), or carboplatin (n=25, 20.5%).Thirty-five also received external beam radiotherapy (28.7%). PRF included: 39with choroidal involvement, 9 with anterior segment, 9 with scleral, and 2 withpost-laminar optic nerve with subarachnoid invasion. Adjuvant chemotherapy wasgiven to eight patients (6.5%) because of scleral invasion. Four patients had an extraocular relapse after enucleation, two of whom survive after intensivetreatment including stem cell rescue. Five-year probability of event-freesurvival is 0.96. Only scleral invasion and bilateral enucleation weresignificantly associated with extraocular relapse. CONCLUSIONS: The risk ofextraocular relapse is low after enucleation following failure of chemoreduction.Patients who underwent bilateral enucleation and those with scleral invasion are at higher risk of extraocular relapse.