Familial retinoblastoma in developing countries.
BACKGROUND
Although screening for familial retinoblastoma has been shown to be beneficial we suspected that such screening programs may be less than optimal in developing countries (DC).


METHODS
Retrospective cohort study comparing patients with familial retinoblastoma from five centers in DC (Argentina, Brazil, Turkey, Jordan, and Venezuela) versus a reference center in the USA.


RESULTS
Ninety-two (32 from the USA and 60 from DC) patients were included. Forty-one (44.6%) patients avoided enucleation, 42 (45.7%) had 1 eye removed, and 9 (9.8%) underwent bilateral enucleation. Eleven (11.9%) had major pathology risk factors at enucleation. There were no cases of metastatic disease at diagnosis. Detection via screening was significantly less common in DC than in the USA (23.3% vs. 71.8%, P < 0.0001). Patients in DC were diagnosed at a significantly later age and with more advanced intraocular disease that led to increased risk of bilateral enucleation. Patients detected by screening in DC were significantly younger at diagnosis, had less advanced intraocular disease, better ocular preservation rates and survival results than those whose retinoblastoma was not detected via early screening. Five-year pEFS was 0.92 for the patients treated in the USA and 0.81 for the patients in DC (P = 0.42). Seven events occurred (extraocular relapse four in patients from DC and second malignancies in three).


CONCLUSIONS
Patients with familial retinoblastoma are less likely to be diagnosed by screening in DC and had higher morbidity and mortality caused by recurrent extraocular retinoblastoma.
Department of Hemato-Oncology, Hospital JP Garrahan, Buenos Aires, Argentina. gchantada@yahoo.com
Guillermo L
GL
Chantada
Ira J
IJ
Dunkel
Ibrahim
I
Qaddoumi
Celia B G
CB
Antoneli
Alegria
A
Totah
Serife
S
Canturk
Ibrahim
I
Nawaiseh
Adriana
A
Fandiño
Imelda
I
Pífano
Gonul
G
Peksayar
Karina Braga
KB
Ribeiro
David H
DH
Abramson
D002675:Child, Preschool; D015331:Cohort Studies; D003906:Developing Countries; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019572:Retinal Neoplasms / Q000453:epidemiology* / Q000401:mortality; D012175:Retinoblastoma / Q000453:epidemiology* / Q000401:mortality; D012189:Retrospective Studies