Neovascular Glaucoma as a Predictor of Retinoblastoma High-Risk Histopathology in an International Multicentre Study

• Autores: Negretti, GS, Ushakova, T, Yuri, S, Vladimir, P, Berry, JL, Pike, S, Shields, CL, Hubbard, GB,, III, Eiger-Moscovich, M, Pe'er, J, Staffieri, SE, Elder, JE, McKenzie, JD, Ahmad, A, Hussain, M, Casavilca-Zambrano, S, Alarcon-Leon, S, Yousef, YA, Mohammad, M, Tanabe, M, Arazi, M, Fabian, ID, Goldstein, S, Kaliki, S, Sagoo, MS, Reddy, MA
• Formato: artículo
• Fecha de Publicación: 2024
• Institución: Instituto Nacional de Enfermedades Neoplásicas
• Repositorio: INEN-Institucional
• Lenguaje: inglés
• OAI Identifier: oai:repositorio.inen.sld.pe:20.500.14703/408
• Enlace del recurso: https: //doi.org/10.1097/IAE.0000000000004340; https://hdl.handle.net/20.500.14703/408
• Nivel de acceso: acceso abierto
• Materia: High-Risk Histopathology; Neovascular Glaucoma; Oncology; Retinoblastoma; https://purl.org/pe-repo/ocde/ford#3.02.21

Purpose: To assess histopathology and outcomes following primary enucleation of eyes with retinoblastoma presenting with neovascular glaucoma (NVG). Methods: This was an international multi-centre case series study across five continents. Retrospective review of patient charts was performed for all patients undergoing primary enucleation for retinoblastoma (n=1420) using a standardised data-collection spreadsheet. Clinical features, pathological grade, and outcomes were compared between NVG patients and those with an American Joint Commission on Cancer (AJCC) 8th edition clinical stage of cT2. High-risk histopathology was defined as AJCC 8th edition pathological stage ≥pT2b. Results: NVG was seen in 224/1420 (16%) patients. Mean age at presentation of those with NVG was 30 months (median 25, range 0-120 months) and 131(58%) patients had high-risk histopathology. The univariate logistic regression odds ratio for NVG predicting high-risk histopathology was 1.73 (95% confidence interval: 1.3 to 2.31) and from multivariate logistic regression was 1.77 (95% confidence interval: 1.23 to 2.56). Patients with a longer duration of symptoms (p=0.03), buphthalmos (p=0.02) and ectropion uveae (p<0.01) were more likely to have high-risk histopathology. Patients with NVG were more likely to develop metastasis than cT2 patients (p=0.04). Conclusions: There is a significant association between NVG at presentation, high-risk histopathology and metastatic risk.