title: Metastatic retinoblastoma: single institution experience over two decades.
abstract: BACKGROUND
  Metastatic spread in retinoblastoma is a rare occurrence in developed countries but still associated with a poor prognosis.
  
  
  METHODS
  Medical records of all metastatic retinoblastoma diagnosed during a 20-year period were retrospectively reviewed.
  
  
  RESULTS
  Six patients out of 104 presented a metastatic disease with an incidence at diagnosis of 2%. Three had a metastatic disease at diagnosis, one patient a trilateral retinoblastoma and two a metastatic spread after enucleation. All but one were sporadic retinoblastoma. Central nervous system (CNS) involvement was reported in five patients, while one patient had an intraorbital lesion, and bone and bone marrow spread. Different treatment strategies were administered based on local treatment plus chemotherapy and radiotherapy with or without high-dose chemotherapy. An ifosfamide/carboplatin/etoposide regimen was administered in three patients resulting in a partial response. Out of six patients, four died, and two patients are alive at 60 and 63 months from diagnosis. Both children with a long follow-up were treated with high-dose chemotherapy. All but one of the patients with CNS involvement died; the survivor was a patient with pineal involvement.
  
  
  CONCLUSIONS
  This retrospective review confirms a curable strategy based on local treatment and conventional plus high-dose chemotherapy. Patients with CNS involvement remain incurable.
authors: Pediatric Oncology Unit, Ospedale Pediatrico Bambino Gesù, Rome, Italy.
authors: R
authors: R
authors: Cozza
authors: M A
authors: MA
authors: De Ioris
authors: I
authors: I
authors: Ilari
authors: R
authors: R
authors: Devito
authors: P
authors: P
authors: Fidani
authors: L
authors: L
authors: De Sio
authors: F
authors: F
authors: Demelas
authors: A
authors: A
authors: Romanzo
authors: A
authors: A
authors: Donfrancesco
mesh_terms: D001859:Bone Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D002675:Child, Preschool; D055088:Early Detection of Cancer; D015353:Eye Enucleation / Q000401:mortality; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011379:Prognosis; D019572:Retinal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D012175:Retinoblastoma / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D012189:Retrospective Studies; D013997:Time Factors