PREDICTIVE VALUE OF TNM CLASSIFICATION, INTERNATIONAL CLASSIFICATION, AND REESE-ELLSWORTH STAGING OF RETINOBLASTOMA FOR THE LIKELIHOOD OF HIGH-RISK PATHOLOGIC FEATURES.
OBJECTIVE
To evaluate the predictive value of the seventh edition American Joint Committee on Cancer (AJCC/UICC) TNM classification, the International Classification of Retinoblastoma (ICRB), and Reese-Ellsworth staging for retinoblastoma for the likelihood of high-risk pathologic features.


METHODS
A retrospective study of 50 primarily enucleated eyes from 49 retinoblastoma patients. Main outcome measures included demographics, TNM stage, ICRB group, Reese-Ellsworth stage, choroid, optic nerve, and anterior chamber invasion.


RESULTS
The median age at enucleation was 30 months. High-risk pathologic features mandating adjuvant chemotherapy were seen in 5 of T2 eyes (22%), in 15 of T3 eyes (56%) (P = 0.021), in 1 of ICRB Group C eyes (13%), 8 of Group D eyes (33%), and 11 of Group E eyes (61%) (P = 0.035). High-risk pathologic features were 4.61 and 3.68 times more likely to be diagnosed at a more advanced T stage and ICRB group consecutively, whereas 0.133 time less likely to be diagnosed at a more advanced Reese-Ellsworth stage. At median follow-up of 40 months, no single case had metastasis or was dead.


CONCLUSIONS
The higher tumor clinical TNM stage and the more advanced ICRB group at presentation are associated with higher frequency of high-risk pathologic features and may predict which patients should receive adjuvant chemotherapy.
Departments of *Surgery, †Pathology, ‡Pediatrics, and §Radiotherapy, King Hussein Cancer Center, Amman, Jordan.
Yacoub A
YA
Yousef
Maysa
M
Al-Hussaini
Mustafa
M
Mehyar
Iyad
I
Sultan
Imad
I
Jaradat
Khaleel
K
AlRawashdeh
Samer
S
Khurma
Rasha
R
Deebajah
Ibrahim
I
Nawaiseh
D017024:Chemotherapy, Adjuvant; D002675:Child, Preschool; D015353:Eye Enucleation; D005260:Female; D014943:Global Health; D006801:Humans; D007223:Infant; D016013:Likelihood Functions; D008297:Male; D008495:Medical Oncology / Q000458:organization & administration; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D019572:Retinal Neoplasms / Q000145:classification* / Q000473:pathology* / Q000628:therapy; D012175:Retinoblastoma / Q000145:classification* / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States