INVESTIGADORES
CHANTADA Guillermo Luis
artículos
Título:
Outcome of patients with retinoblastoma and postlaminar optic nerve invasion.
Autor/es:
CHANTADA GL1, CASCO F, FANDIÑO AC, GALLI S, MANZITTI J, SCOPINARO M, SCHVARTZMAN E, DE DÁVILA MT.
Revista:
OPHTHALMOLOGY
Editorial:
ELSEVIER SCIENCE INC
Referencias:
Lugar: Amsterdam; Año: 2007 p. 2083 - 2089
ISSN:
0161-6420
Resumen:
PURPOSE:
To evaluate the outcome of patients with retinoblastoma and postlaminar optic nerve invasion (PLONI).
DESIGN:
Retrospective interventional case series.
PARTICIPANTS:
Sixty-one consecutive patients included in 3 successive protocols were analyzed.
METHODS:
Pathologic review was done in each case. Patients were stratified into 2 risk groups: the high-risk group included those with concomitant full choroidal and/or scleral invasion and were given adjuvant chemotherapy. Those without these features were considered low risk and chemotherapy was withheld after 1994.
MAIN OUTCOME MEASURES:
Extraocular relapse and survival according to stratification.
RESULTS:
The probability of event-free survival (pEFS) was 0.91 and the probability of overall survival (pOS) was 0.94 at 5 years. Patients in the high-risk group (n = 22) had pEFS of 0.86. Three had extraocular relapse (involving the central nervous system; all died of disease). Microscopic scleral invasion was associated to extraocular relapse (P = 0.05). Lower risk patients (n = 39) had a pEFS of 0.94 and pOS of 1. Eighteen received postenucleation chemotherapy and none relapsed. Twenty-one received no adjuvant therapy and 2 had a systemic relapse but were successfully retrieved. Relapsing patients had a higher ratio of affected optic nerve (>25% of it overall length; P = 0.02).
CONCLUSIONS:
Patients with PLONI have an excellent outcome with current therapy. Risk stratification according to the presence of concomitant choroidal and/or scleral invasion may help in the decision of giving adjuvant therapy.