Abstract
Purpose: :
To compare the severity of clinically-based patient classification with the incidence of high risk histopathology in primarily enucleated eyes of patients with unilateral retinoblastoma. Classification systems of interest were International (ICRB), Reese-Ellsworth (RE), and American Joint Committee on Cancer clinical T(NM) classification (cT)..
Methods: :
Retrospective chart review.
Results: :
205 eyes of 236 patients with unilateral disease were enucleated between 1958 and 2009. For 160 primarily enucleated eyes adequate histologic and clinical information was available. Severity of RE classification had poor correspondence (p > 0.09) with high risk histopathologic features, which were present in 55/146 (37.6%) group V eyes, 2/5 (40%) Group IV, 0/12 Group III, 1/1 (100%) Group II. Better correspondence (p < 0.02) was observed for the ICRB ,where 39/82 (47.5%) Group E eyes, 18/67(26.9%) Group D eyes, 1/7 (14.3%) Group C eyes and 0/4 Group B eyes harbored high risk features. The best correspondence with the high risk pathology (p<0.006) was observed for cT: 3/3 (100%) stage 4 eyes, 7/11 (64%) Stage 3, 47/135 (35%) Stage 2, 1/11 (9%) Stage 1 eyes had at least one of the high risk features.
Conclusions: :
No single clinical classification system for retinoblastoma is absolutely accurate in predicting histologic features in primarily enucleated eyes. ICRB and AJCC clinical T systems had the best correspondence with the presence of high risk histopathologic features in the eyes of patients with unilateral retinoblastoma.
Keywords: retinoblastoma • oncology • pathology: human