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Survival of retinoblastoma in less-developed countries impact of socioeconomic and health-related indicators
  1. S Canturk1,
  2. I Qaddoumi2,
  3. V Khetan3,
  4. Z Ma4,
  5. A Furmanchuk5,
  6. C B G Antoneli6,
  7. I Sultan7,
  8. R Kebudi8,
  9. T Sharma3,
  10. C Rodriguez-Galindo2,
  11. D H Abramson9,
  12. G L Chantada10
  1. 1Department of Ophthalmology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
  2. 2Department of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee, USA
  3. 3Medical and Vision Research Foundation, Sankara Nethralaya, Chennai, India
  4. 4Department of Pediatric Oncology, West China Second University Hospital, Chengdu, China
  5. 5Department of Oncology, Belarussian Research Centre for Pediatric Oncology-Hematology, Minsk, Belarus
  6. 6Department of Pediatric Oncology, Hospital AC Camargo, Sao Paulo, Brazil
  7. 7Department of Pediatric Oncology, King Hussein Cancer Center, Amman, Jordan
  8. 8Division of Pediatric Hematology-Oncology, Cerrahpaşa Medical Faculty and Oncology Institute, Istanbul University, Istanbul, Turkey
  9. 9Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
  10. 10Department of Hemato-oncology, Hospital JP Garrahan, Buenos Aires, Argentina
  1. Correspondence to Guillermo L Chantada, Hemato-Oncology Department, Hospital JP Garrahan, Combate de los Pozos 1881, C1245 AAL, Buenos Aires, Argentina; gchantada{at}


Background The survival of retinoblastoma in less-developed countries (LDCs) and the impact of socioeconomic variables on survival are not widely available in the literature.

Methods A systematic review of publications from LDCs was performed. Articles were from multiple databases and written in seven languages. Results were correlated with socioeconomic indicators. Lower-income countries (LICs) and middle-income countries (MICs) were included in our analyses.

Results An analysis of 164 publications including 14 800 patients from 48 LDCs was performed. Twenty-six per cent of the papers were written in languages other than English. Estimated survival in LICs was 40% (range, 23–70%); in lower MICs, 77% (range, 60–92%) and in upper MICs, 79% (range, 54–93%; p=0.001).Significant differences were also found in the occurrence of metastasis: in LICs, 32% (range, 12–45); in lower MICs, 12% (range, 3–31) and in upper MICs, 9.5% (range, 3–24; p=0.04). On multivariate analysis, physician density and human development index were significantly associated with survival and metastasis. Maternal mortality rate and per capita health expenditure were significantly associated with treatment refusal.

Conclusions Important information from LDCs is not always available in English or in major databases. Indicators of socioeconomic development and maternal and infant health were related with outcome.

  • Retinoblastoma
  • survival
  • metastasis
  • risk factors
  • early diagnosis
  • treatment refusal
  • retina
  • public health
  • neoplasia
  • child health (paediatrics)

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  • Funding Drs Guillermo Chantada and Serife Canturk were supported in part by a grant from the Fund for Ophthalmic Knowledge.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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