PT  - JOURNAL ARTICLE
AU  - Ankit Singh Tomar
AU  - Paul T Finger
AU  - Brenda Gallie
AU  - Tero Kivelä
AU  - Ashwin Mallipatna
AU  - Chengyue Zhang
AU  - Junyang Zhao
AU  - Matthew Wilson
AU  - Rachel Brennan
AU  - Michala Burges
AU  - Jonathan Kim
AU  - Jesse L Berry
AU  - Rima Jubran
AU  - Vikas Khetan
AU  - Suganeswari Ganeshan
AU  - Andrey Yarovoy
AU  - Vera Yarovaya
AU  - Elena Kotova
AU  - Denis Volodin
AU  - Yacoub Yousef
AU  - Kalle Nummi
AU  - Tatiana L Ushakova
AU  - Olga V Yugay
AU  - Vladimir G Polyakov
AU  - Marco Antonio Ramirez-Ortiz
AU  - Elizabeth Esparza-Aguiar
AU  - Guillermo L Chantada
AU  - Paula Schaiquevich
AU  - Adriana C Fandiño
AU  - Jason C Yam
AU  - Winnie W Lau
AU  - Carol P Lam
AU  - Phillipa Sharwood
AU  - Sonia Moorthy
AU  - Quah Boon Long
AU  - Vera Adobea Essuman
AU  - Lorna A Renner
AU  - Ekaterina Semenova
AU  - Jaume Català-Mora
AU  - Maria Correa Llano
AU  - Elisa Carreras
ED  - ,
TI  - Retinoblastoma seeds: impact on American Joint Committee on Cancer clinical staging
AID  - 10.1136/bjophthalmol-2021-318892
DP  - 2023 Jan 01
TA  - British Journal of Ophthalmology
PG  - 127--132
VI  - 107
IP  - 1
4099  - http://bjo.bmj.com/content/107/1/127.short
4100  - http://bjo.bmj.com/content/107/1/127.full
SO  - Br J Ophthalmol2023 Jan 01; 107
AB  - Aim To investigate whether the American Joint Committee on Cancer (AJCC) clinical category cT2b needs to be subclassified by the type and distribution of retinoblastoma (RB) seeding.Methods Multicentre, international registry-based data were collected from RB centres enrolled between January 2001 and December 2013. 1054 RB eyes with vitreous or subretinal seeds from 18 ophthalmic oncology centres, in 13 countries within six continents were analysed. Local treatment failure was defined as the use of secondary enucleation or external beam radiation therapy (EBRT) and was estimated with the Kaplan-Meier method.Results Clinical category cT2b included 1054 eyes. Median age at presentation was 16.0 months. Of these, 428 (40.6%) eyes were salvaged, and 430 (40.8%) were treated with primary and 196 (18.6%) with secondary enucleation. Of the 592 eyes that had complete data for globe salvage analysis, the distribution of seeds was focal in 143 (24.2%) and diffuse in 449 (75.8%). The 5-year Kaplan-Meier cumulative globe-salvage (without EBRT) was 78% and 49% for eyes with focal and diffuse RB seeding, respectively. Cox proportional hazards regression analysis confirmed a higher local treatment failure risk with diffuse seeds as compared with focal seeds (hazard rate: 2.8; p<0.001). There was insufficient evidence to prove or disprove an association between vitreous seed type and local treatment failure risk(p=0.06).Conclusion This international, multicentre, registry-based analysis of RB eyes affirmed that eyes with diffuse intraocular distribution of RB seeds at diagnosis had a higher risk of local treatment failure when compared with focal seeds. Subclassification of AJCC RB category cT2b into focal vs diffuse seeds will improve prognostication for eye salvage.Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as online supplemental information.