title: Evaluation of high-risk features of primary enucleation of patients with retinoblastoma in a tertiary center of a developing country in the era of intra-arterial chemotherapy.
abstract: OBJECTIVE
  To evaluate the frequency of high-risk histopathologic factors in Turkish children enucleated for retinoblastoma and to analyze the association between growth pattern, rosetta formation, tumor thickness, presence of necrosis, calcification, neovascularization, rate of mitosis, and high-risk histopathologic factors.
  
  
  METHODS
  Pathology reports of 59 eyes who had received enucleation for retinoblastoma were reviewed retrospectively. The histopathologic data included presence of choroidal invasion, optic nerve invasion, scleral extension, tumor thickness, presence of necrosis, calcification, neovascularization, rosetta formation and lymphocyte infiltration, rate of mitosis, and growth pattern.
  
  
  RESULTS
  This study included 59 eyes from 30 (50.8%) male and 29 (49.2%) female patients. The mean age was 22.87 ± 18.99 months. There were 30 (50.8%) eyes with choroidal invasion, 30 (50.8%) eyes with optic nerve invasion, and 5 (8.5%) eyes with scleral invasion. Endophytic growth pattern was seen in 27 (45.8%) eyes, exophytic growth pattern was seen in 2 (3.4%) eyes, and combined growth pattern was seen in 30 (50.8%) eyes. Exophytic growth pattern was found statistically related to choroidal invasion (p = 0.00). Although tumor with greater thickness tended to have more choroidal invasion (p = 0.02), there was no relation between tumor thickness and optic nerve invasion (p = 0.09).
  
  
  CONCLUSIONS
  Incidences of choroidal and optic nerve invasion showed similarity with other developing countries. Because of higher incidence of high-risk factors, intra-arterial chemotherapy with its targeted effect should be preferred carefully.
authors.affiliation: Department of Ophthalmology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey.
authors.forename: Funda
authors.initials: F
authors.lastname: Dikkaya
authors.affiliation: Department of Ophthalmology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey. ahmetsarici@gmail.com.
authors.forename: Ahmet Murat
authors.initials: AM
authors.lastname: Sarıcı
authors.affiliation: Department of Pediatrics, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Firuze
authors.initials: F
authors.lastname: Erbek
authors.affiliation: Department of Pediatrics, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Tiraje
authors.initials: T
authors.lastname: Celkan
authors.affiliation: Department of Ophthalmology, Okmeydanı Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mehmet Serhat
authors.initials: MS
authors.lastname: Mangan
authors.affiliation: Department of Pathology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Övgü
authors.initials: Ö
authors.lastname: Aydın
authors.affiliation: Department of Pathology, School of Medicine, Acıbadem University, Istanbul, Turkey.
authors.forename: Cuyan
authors.initials: C
authors.lastname: Demirkesen
authors.affiliation: Department of Ophthalmology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Halit
authors.initials: H
authors.lastname: Pazarlı
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002114:Calcinosis / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D002829:Choroid / Q000473:pathology; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D007223:Infant; D007261:Infusions, Intra-Arterial; D008297:Male; D009361:Neoplasm Invasiveness / Q000473:pathology; D009389:Neovascularization, Pathologic / Q000473:pathology; D009900:Optic Nerve / Q000473:pathology; D019572:Retinal Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D012175:Retinoblastoma / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D014421:Turkey
chemical_list: D000970:Antineoplastic Agents
keywords: Choroidal invasion; High-risk histopathologic factors; Optic nerve invasion; Retinoblastoma