Skip to main content

Advertisement

Log in

Enucleation for retinoblastoma: the experience of a single center in Jordan

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Abstract

Despite multiple advances in the management of retinoblastoma, enucleation remains an essential therapeutic modality. We studied patients who underwent enucleation at the King Hussein Cancer Center in Jordan. We retrospectively reviewed medical records of children with retinoblastoma who were treated at our center from June 2002 to February 2008. Twenty-eight eyes from 27 patients were enucleated. Median age at diagnosis was 1.1 years (range, 0.3–6.3 years). Twenty-six eyes (93%) had advanced disease (RE groups IV and V). Seventeen patients (61%) had unilateral retinoblastoma, and 11 (39%) had bilateral retinoblastoma. The median time from diagnosis to enucleation was 0.45 months (range, 0–45 months; mean, 4.4 months) and was longer for patients with bilateral retinoblastoma (median, 2.2 vs. 0.2 months; P = 0.034). Twenty enucleated eyes (71%) did not show high-risk pathologic features. Seventeen eyes with advanced intraocular disease were enucleated at the time of presentation, whereas chemoreduction was attempted for the other 19 eyes with advanced intraocular disease. Enucleation was then recommended for nine (47%) of those eyes. Enucleation at the time of diagnosis was feasible for most patients with advanced disease. Attempted salvage of eyes with advanced disease is justified, particularly in patients with bilateral disease. We were able to salvage almost half of these eyes. We hope our study provides new insights for counseling patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Chintagumpala M, Chevez-Barrios P, Paysse EA et al (2007) Retinoblastoma: review of current management. Oncologist 12(10):1237–1246

    Article  PubMed  Google Scholar 

  2. Wilson MW, Haik BG, Rodriguez-Galindo C (2006) Socioeconomic impact of modern multidisciplinary management of retinoblastoma. Pediatrics 118(2):e331–e336

    Article  PubMed  Google Scholar 

  3. Barr R, Ribeiro R, RB A (2002) Pediatric oncology in countries with limited resources. In: Pizzo P, Poplack D (eds) Principles and practice of pediatric oncology. Lippincott Williams and Wilkins, Philadelphia, pp 1541–1552

    Google Scholar 

  4. Kivelä T (2009) The epidemiological challenge of the most frequent eye cancer: retinoblastoma, an issue of birth and death. Br Med J 93(9):1129

    Google Scholar 

  5. Leander C, Fu LC, Pena A et al (2007) Impact of an education program on late diagnosis of retinoblastoma in Honduras. Pediatr Blood Cancer 49(6):817–819

    Article  PubMed  Google Scholar 

  6. Qaddoumi I, Nawaiseh I, Mehyar M et al (2008) Team management, twinning, and telemedicine in retinoblastoma: a 3-tier approach implemented in the first eye salvage program in Jordan. Pediatr Blood Cancer 51:241–244

    Article  PubMed  Google Scholar 

  7. Suzuki S, Kaneko A (2004) Management of intraocular retinoblastoma and ocular prognosis. Int J Clin Oncol 9(1):1–6

    Article  PubMed  Google Scholar 

  8. Al-Qudimat MR, Day S, Almomani T et al (2009) Clinical nurse coordinators: a new generation of highly specialized oncology nursing in Jordan. J Pediatr Hematol Oncol 31(1):38–41

    Article  PubMed  Google Scholar 

  9. Chantada GL, Dunkel IJ, de Davila MT et al (2004) Retinoblastoma patients with high risk ocular pathological features: who needs adjuvant therapy? Br J Ophthalmol 88(8):1069–1073

    Article  CAS  PubMed  Google Scholar 

  10. Sastre X, Chantada GL, Doz F et al (2009) Proceedings of the consensus meetings from the International Retinoblastoma Staging Working Group on the pathology guidelines for the examination of enucleated eyes and evaluation of prognostic risk factors in retinoblastoma. Arch Pathol Lab Med 133(8):1199–1202

    PubMed  Google Scholar 

  11. Shields CL, Honavar SG, Meadows AT et al (2002) Chemoreduction for unilateral retinoblastoma. Arch Ophthalmol 120(12):1653–1658

    PubMed  Google Scholar 

  12. Abramson DH, Gamell LS, Ellsworth RM et al (1994) Unilateral retinoblastoma: new intraocular tumours after treatment. Br J Ophthalmol 78(9):698–701

    Article  CAS  PubMed  Google Scholar 

  13. Chantada G, Doz F, Antoneli CB et al (2006) A proposal for an international retinoblastoma staging system. Pediatr Blood Cancer 47(6):801–805

    Article  PubMed  Google Scholar 

  14. Shields CL, Mashayekhi A, Au AK et al (2006) The International Classification of Retinoblastoma predicts chemoreduction success. Ophthalmology 113(12):2276–2280

    Article  PubMed  Google Scholar 

  15. Chantada GL, Doz F, Orjuela M et al (2008) World disparities in risk definition and management of retinoblastoma: a report from the International Retinoblastoma Staging Working Group. Pediatr Blood Cancer 50(3):692–694

    Article  PubMed  Google Scholar 

  16. Shields CL, Shields JA, Baez KA et al (1993) Choroidal invasion of retinoblastoma: metastatic potential and clinical risk factors. Br J Ophthalmol 77(9):544–548

    Article  CAS  PubMed  Google Scholar 

  17. Eagle RC Jr (2009) High-risk features and tumor differentiation in retinoblastoma: a retrospective histopathologic study. Arch Pathol Lab Med 133(8):1203–1209

    PubMed  Google Scholar 

Download references

Acknowledgment

The authors would like to thank David Galloway for editing this manuscript. This research was financially supported by Research to Prevent Blindness, Inc., New York, New York; St Giles Foundation, New York, New York; American Lebanese Syrian Associated Charities (ALSAC), Memphis, TN; and King Hussein Cancer Foundation (KHCF), Amman, Jordan.

Conflicts of interest statement

The authors have no conflicts of interest to disclose.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Iyad Sultan.

About this article

Cite this article

Sultan, I., Wilson, M.W., Nawaiseh, I. et al. Enucleation for retinoblastoma: the experience of a single center in Jordan. Int Ophthalmol 30, 407–414 (2010). https://doi.org/10.1007/s10792-010-9370-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-010-9370-3

Keywords

Navigation