An international survey of classification and treatment choices for group D retinoblastoma Journal Article


Authors: Scelfo, C.; Francis, J. H.; Khetan, V.; Jenkins, T.; Marr, B.; Abramson, D. H.; Shields, C. L.; Pe’er, J.; Munier, F.; Berry, J.; Harbour, J. W.; Yarovoy, A.; Lucena, E.; Murray, T. G.; Bhagia, P.; Paysse, E.; Tuncer, S.; Chantada, G. L.; Moll, A. C.; Ushakova, T.; Plager, D. A.; Ziyovuddin, I.; Leal, C. A.; Materin, M. A.; Ji, X. D.; Cursino, J. W.; Polania, R.; Kiratli, H.; All-Ericsson, C.; Kebudi, R.; Honavar, S. G.; Vishnevskia-Dai, V.; Epelman, S.; Daniels, A. B.; Ling, J. D.; Traore, F.; Ramirez-Ortiz, M. A.
Article Title: An international survey of classification and treatment choices for group D retinoblastoma
Abstract: • AIM: To determine which IIRC scheme was used by retinoblastoma centers worldwide and the percentage of D eyes treated primarily with enucleation versus globe salvaging therapies as well as to correlate trends in treatment choice to IIRC version used and geographic region. • METHODS: An anonymized electronic survey was offered to 115 physicians at 39 retinoblastoma centers worldwide asking about IIRC classification schemes and treatment patterns used between 2008 and 2012. Participants were asked to record which version of the IIRC was used for classification, how many group D eyes were diagnosed, and how many eyes were treated with enucleation versus globe salvaging therapies. Averages of eyes per treatment modality were calculated and stratified by both IIRC version and geographic region. Statistical significance was determined by Chi-square, ANOVA and Kruskal-Wallis tests using Prism. • RESULTS: The survey was completed by 29% of physicians invited to participate. Totally 1807 D eyes were diagnosed. Regarding IIRC system, 27% of centers used the Childrenfs Hospital of Los Angeles (CHLA) version, 33% used the Childrenfs Oncology Group (COG) version, 23% used the Philadelphia version, and 17% were unsure. The rate for primary enucleation varied between 0 and 100% and the mean was 29%. By IIRC version, primary enucleation rates were: Philadelphia, 8%; COG, 34%; and CHLA, 37%. By geographic region, primary enucleation rates were: Latin America, 57%; Asia, 40%; Europe, 36%; Africa, 10%, US, 8%; and Middle East, 8%. However, systemic chemoreduction was used more often than enucleation in all regions except Latin America with a mean of 57% per center (P<0.0001). • CONCLUSION: Worldwide there is no consensus on which IIRC version is used, systemic chemoreduction was the most frequently used initial treatment during the study period followed by enucleation and primary treatment modality, especially enucleation, varied greatly with regards to IIRC version used and geographic region. © 2017, International Journal of Ophthalmology (c/o Editorial Office). All rights reserved.
Keywords: chemotherapy; retinoblastoma; oncology; enucleation; retina; intra-arterial chemotherapy; ophthalmic artery chemosurgery; cancer
Journal Title: International Journal of Ophthalmology
Volume: 10
Issue: 6
ISSN: 2222-3959
Publisher: International Council of Ophthalmology  
Date Published: 2017-06-18
Start Page: 961
End Page: 967
Language: English
DOI: 10.18240/ijo.2017.06.20
PROVIDER: scopus
PMCID: PMC5515152
PUBMED: 28730089
DOI/URL:
Notes: Article -- Export Date: 2 August 2017 -- Source: Scopus
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  1. Brian Marr
    112 Marr
  2. Jasmine Helen Francis
    256 Francis
  3. David H Abramson
    389 Abramson
  4. Christina Scelfo
    2 Scelfo