Patient-related factors and outcome of retinoblastoma in Calabar, Nigeria: A single-center, retrospective study

Background: Retinoblastoma is associated with mortality in resource-poor nations due to disparities and poor access to treatment. The aim was to determine the relationships between patient-related factors and clinical outcomes of retinoblastoma in a tertiary hospital in Nigeria. Material and methods...

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Main Authors: Elizabeth D. Nkanga (Author), Anthony C. Nlemadim (Author), Mattan Arazi (Author), Dennis G. Nkanga (Author), Roseline E. Duke (Author), Ido D. Fabian (Author), Essemfon D. Nkanga (Author), Friday A. Odey (Author), Martin M. Meremikwu (Author)
Format: Book
Published: Elsevier, 2024-06-01T00:00:00Z.
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Summary:Background: Retinoblastoma is associated with mortality in resource-poor nations due to disparities and poor access to treatment. The aim was to determine the relationships between patient-related factors and clinical outcomes of retinoblastoma in a tertiary hospital in Nigeria. Material and methods: It was a retrospective study of all children diagnosed and treated for retinoblastoma from January 2017 through December 2022. Information obtained from their records included bio-socioeconomic data, symptoms, lag time from initial symptoms, staging, treatment, and survival outcome. Results: Fifty-three patients, aged 6-88 months on first hospital presentation were recruited. There were 29 (54.7%) females. Twenty (37.7%) patients died. The majority were the last child of their parents (62.3%) with a low socioeconomic class (86.8%) and lived in rural areas (50.9%). The median (interquartile) age at diagnosis [24 (18-36) months, p = 0.005] and lag time [13 (6-20) months, p = 0.274] were lower in those who survived than in those who died. The prevalence of bilateral disease (20.8%, p = 0.002), brain metastasis (22.6%, p < 0.001), stage IV disease (18.9%, p = 0.01) and relapse (34%, p < 0.001) was higher among the patients who died. The median (interquartile) overall survival (OS) was 22 (11.8-32.2) months with a 1-year OS of 63%. Treatment with only chemotherapy [HR 4.76 (95% CI: 1.7-13.1)], incomplete chemotherapy [HR 5.61 (95% CI: 1.3-24.7)], relapse [HR 5.98 (95% CI: 1.4-25.9)] and eye surgery delayed after 3 chemotherapy cycles [HR 8.22 (95% CI: 1.1-62.2)] were predictors of mortality. Conclusion: Most patients with retinoblastoma arrived at our treatment center approximately 14 months following the first symptom. Most (84.9%) presented with proptosis. The majority were of a low social class (86.8%), had a secondary level of education only (47.2%), and lived in rural areas (50.9%). The 3-year overall survival was 29%.
Item Description:2468-1245
10.1016/j.phoj.2024.03.007