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JA Epstein, CL Shields, JA Shields; Trends in Enucleation of Unilateral Retinoblastoma Over Three Decades in 461 Cases . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2588.
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Purpose: To evaluate trends in the management of unilateral retinoblastoma over the past 12 years [1989-2001] and compare with the previous two decades [1974-1988]. Methods: Data from 282 consecutive patients with unilateral retinoblastoma from 1989-2001 were gathered in a retrospective, noncomparative fashion and compared with 179 consecutive patients with unilateral retinoblastoma from 1974-1988. The patients were evaluated with regard to tumor characteristics and primary tumor treatment including enucleation, chemoreduction, external beam radiotherapy, and focal treatments (cryotherapy, laser photocoagulation, plaque radiotherapy). Results: Between 1989 and 2001, there were 282 patients with unilateral retinoblastoma. Primary treatment included enucleation (65%), chemoreduction (16%), external beam radiotherapy (7%), and focal treatments (12%). With regard to Reese Ellsworth classification, enucleation was performed in 0% of group I, 6% of group II, 20% of group III, 38% of group IV, and 84%of group V. Eyes with vitreous seeding only were commonly enucleated (76%) while those with subretinal seeding only were commonly enucleated (49%) or treated with chemoreduction (36%). Over the past three decades, the enucleation rate for unilateral retinoblastoma has stabilized at approximately 73%. Conclusion: The management of unilateral retinoblastoma varies depending on many factors including the extent of disease (Reese-Ellsworth classification) and available treatment options. The decrease in enucleation rates seen between 1974 and 1988 have stabilized over the past 12 years at approximately 73%.
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