Objective: This study determined the treatment outcomes of patients with retinoblastoma seen at a Philippine tertiary government hospital from January 2000 to January 2020. Method: This is a cohort study. Medical records of patients with histopathologic-proven retinoblastoma were reviewed and pertinent information on clinical profile and presentation, treatment and outcomes were recorded. Results: This study included 118 patients (146 eyes) with mean age at symptom onset of 7.4 + 6.6 months and mean age at consult of 11.5 + 13.7 months. There were 69 (47%) eyes with International Classification of Retinoblastoma (ICRB) stage E. The most common primary treatment was enucleation (n=137, 94%). The most common high-risk histopathologic feature was involvement of the optic nerve at the cut-end section (n=27, 34%). Only 14 patients (11%) completed treatment with median follow-up of 30.5 months (range 4- 122). Conclusion The rate of overall survival of patients with retinoblastoma is low in this study, similar to other developing countries. This can be due to higher proportion of patients with advanced stage at presentation and lower percentage of treatment completion. Early diagnosis and treatment may lead to better survival rate, visual outcome and quality of life. Due to limited data on follow-up, globe preservation could not be determined.
Retinoblastoma ; Survival Rate

OBJECTIVE

This study compared the demographics, clinical profile, treatment, and outcomes of retinoblastoma patients seen at medical institutions in the Philippines between two time periods: 2010 to 2015 and 2016 to 2020.

METHODS

This was a multicenter, analytical, cohort study using review of medical charts and databases of retinoblastoma patients seen in 11 medical institutions from 2010 to 2020.

RESULTS

There were 636 patients (821 eyes) included in this study: 330 patients were seen in 2010 to 2015 while 306 in 2016 to 2020. More cases per annum were seen in the latter timeline. The number of patients with unilateral disease was not significantly different between the two time periods (p=0.51). Age at onset of symptom, age at initial consultation, and delay in consult were also not significantly different between the two time periods (p > 0.05). Patients had significantly different distributions of intraocular grades (p < 0.0001) and systemic staging (p < 0.0001) between the two time periods. Enucleation was the most common surgical treatment performed in both timelines. There was significant difference in the status of patients based on the need for systemic chemotherapy (p < 0.01). There was significant difference in outcome between the two time periods, including the proportions of living and deceased patients.

CONCLUSION

This study compared the most comprehensive data on retinoblastoma patients in the country. There was no improvement in early health seeking behavior based on similar age at initial consult and delay in consult. Enucleation remained the most common treatment mode as opposed to chemotherapy due to similar percentage of patients with unilateral disease, an indication for enucleation rather than chemotherapy.

Human ; Retinoblastoma ; Philippines ; Epidemiology ; Treatment ; Therapeutics