Abstract
Purpose :
To compare outcomes of primary intra-arterial chemotherapy (IAC) for exophytic vs. endophytic retinoblastoma
Methods :
Retrospective chart review of 82 eyes of 82 consecutive patients with retinoblastoma treated with IAC
Results :
Of the 82 eyes, the tumor was primarily exophytic (n=51, 62%) or endophytic (n=31, 38%). A comparison (exophytic vs. endophytic retinoblastoma) revealed exophytic with younger mean patient age at first IAC (18 vs. 31 months, p=0.02) but with similar mean initial largest tumor diameter (19 vs. 18 mm, p=0.47) and similar mean initial tumor thickness (10 vs. 10 mm, p=0.33). There was no difference with regards to the International Classification of Retinoblastoma ([Group A] 0% vs. 0%, [B] 6% vs. 0%, [C] 10% vs. 0%, [D] 47% vs. 68%, and [E] 37% vs. 32%; p=0.09) and mean number of IAC sessions (3 vs. 3 sessions, p=0.96). Outcomes at mean follow-up (32 vs. 26 months, p=0.22) revealed successful globe salvage (73% vs. 68%, p=0.64), only 1 case of metastasis in the exophytic group (2% vs. 0%, p=0.43), and no death in either group. There was no difference in mean tumor diameter reduction (40% vs. 40%, p=0.98), mean tumor thickness reduction (48% vs. 39%, p=0.67), solid tumor recurrence (10% vs. 13%, p=0.66), and associated retinal detachment (10% vs. 26%, p=0.05). The exophytic group demonstrated less vitreous seed recurrence (12% vs. 39%, p<0.01), yet greater subretinal seed recurrence (45% vs. 23%, p=0.04).
Conclusions :
A comparison of exophytic vs. endophytic retinoblastoma treated with IAC revealed similar tumor control with globe and life salvage, but greater recurrence of vitreous seeds (endophytic group) and subretinal seeds (exophytic group).
This is a 2020 ARVO Annual Meeting abstract.