Global retinoblastoma treatment outcomes association with national income level

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dc.contributor.authorTomar, Ankit Singh
dc.contributor.authorFinger, Paul T.
dc.contributor.authorGallie, Brenda
dc.date.accessioned2023-06-04T18:59:03Z
dc.date.available2023-06-04T18:59:03Z
dc.date.issued2020
dc.description.abstractPurpose: To compare metastasis-related mortality, local treatment failure, and globe salvage after retinoblastoma in countries with different national income levels. Design: International, multicenter, registry-based retrospective case series. Participants: Two thousand one hundred ninety patients, 18 ophthalmic oncology centers, and 13 countries on 6 continents. Methods: Multicenter registry-based data were pooled from retinoblastoma patients enrolled between January 2001 and December 2013. Adequate data to allow American Joint Committee on Cancer staging, eighth edition, and analysis for the main outcome measures were available for 2085 patients. Each country was classified by national income level, as defined by the 2017 United Nations World Population Prospects, and included high-income countries (HICs), upper middle-income countries (UMICs), and lower middle-income countries (LMICs). Patient survival was estimated with the Kaplan-Meier method. Logistic and Cox proportional hazards regression models were used to determine associations between national income and treatment outcomes. Main Outcome Measures: Metastasis-related mortality and local treatment failure (defined as use of secondary enucleation or external beam radiation therapy). Results: Most (60%) study patients resided in UMICs and LMICs. The global median age at diagnosis was17.0 months and higher in UMICs (20.0 months) and LMICs (20.0 months) than HICs (14.0 months; P < 0.001).Patients in UMICs and LMICs reported higher rates of disease-specific metastasis-related mortality and local treatment failure. As compared with HICs, metastasis-related mortality was 10.3-fold higher for UMICs and 9.3-fold higher for LMICs, and the risk for local treatment failure was 2.2-fold and 1.6-fold higher, respectively (all P <0.001). Conclusions: This international, multicenter, registry-based analysis of retinoblastoma management revealed that lower national income levels were associated with significantly higher rates of metastasis-related mortality, local treatment failure, and lower globe salvageen_US
dc.description.sponsorshipACE: Genetic Medicineen_US
dc.identifier.issn0161-6420/20
dc.identifier.urihttp://hdl.handle.net/123456789/1895
dc.language.isoenen_US
dc.publisherElsevier Inc.en_US
dc.relation.ispartofseriesAmerican Academy of Ophthalmology;Volume 128, Number 5
dc.subjectRetinoblastomaen_US
dc.subjectTero T. Kiveläen_US
dc.subjectAshwin Mallipatnaen_US
dc.subjectACE: Genetic Medicineen_US
dc.subjectWAGMCen_US
dc.subjectUniversity of Ghanaen_US
dc.titleGlobal retinoblastoma treatment outcomes association with national income levelen_US
dc.typeArticleen_US
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