Tumour size criteria for Group D and E eyes in the International Classification System for Retinoblastoma: effects on rates of globe salvage and high-risk histopathologic features
Tumour size criteria for Group D and E eyes in the International Classification System for Retinoblastoma: effects on rates of globe salvage and high-risk histopathologic features
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DOI：
10.1111/aos.14222
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发表时间：
2020-02-01
影响因子：
3.4
通讯作者：
Berry, Jesse L.
中科院分区：
文献类型：
--
作者：
Kim, Jonathan W.;Shah, Sona N.;Berry, Jesse L.
目的探讨大肿瘤作为晚期眼内视网膜母细胞瘤分类标准的意义，分析地球仪生存率和高危（HE）组织病理学特征。方法回顾性分析2006年1月1日至2016年12月31日使用洛杉矶（LA）分类系统（E组无肿瘤大小标准）诊断为D组（111只眼）或E组（101只眼）视网膜母细胞瘤的212只眼。111个D组肿瘤然后使用10、12、14、16、18 mm肿瘤大小标准重新分类到E组，如通过超声或磁共振成像尺寸确定的。结果对于原始LA分级的眼睛，接受地球仪保留治疗的D组66.7%和E组10.5%的眼睛避免了眼球摘除或放射治疗（p < 0.0001;中位随访时间为33.0个月）。在LA分类中，8.5%的D组和26.3%的E组摘除眼球具有HE组织病理学特征（p = 0.0065）。当肿瘤符合大小标准的D组眼睛被重新分类到E组时，65.7-74.4%的D组眼睛和16.1-36.7%的E组眼睛避免了摘除或放疗。应用肿瘤大小标准，0-10.9%的D组和20.7-23.8%的E组眼睛具有HE组织病理学特征。结论我们的回顾性分析表明，E组视网膜母细胞瘤的大肿瘤大小标准没有临床依据，因为LA分类系统提供了D组和E组之间地球仪挽救率的最大分离。LA分类系统也能够显示D组和E组眼睛之间HE组织病理学特征的发生率存在统计学显著差异。为了避免文献中的差异，我们建议中心使用一个统一的系统来分类晚期眼内视网膜母细胞瘤。
Purpose To determine the significance of large tumour size as a criteria for classifying advanced intraocular retinoblastoma, analysing rates of globe survival and high-risk (HE) histopathologic features. Methods Retrospective chart review of 212 eyes diagnosed with Group D (111 eyes) or Group E (101 eyes) retinoblastoma in at least one eye from January 1, 2006 to December 31, 2016 using the Los Angeles (LA) Classification System (no tumour size criteria for Group E). The 111 Group D tumours were then reclassified to Group E using 10, 12, 14, 16, 18 mm tumour size criteria, as determined by ultrasound or magnetic resonance imaging dimensions. Results For eyes in the original LA classification, 66.7% of Group D and 10.5% of Group E eyes undergoing globe preservation therapy avoided enucleation or radiotherapy (p < 0.0001; median follow-up of 33.0 months). In the LA classification, 8.5% of Group D and 26.3% of Group E enucleated globes had HE histopathologic features (p = 0.0065). When Group D eyes with tumours meeting the size criteria were reclassified to Group E, 65.7-74.4% of Group D and 16.1-36.7% of Group E eyes avoided enucleation or radiotherapy. Applying the tumour size criteria, 0-10.9% of Group D and 20.7-23.8% of Group E eyes had HE histopathologic features. Conclusion Our retrospective analysis suggests that a large tumour size criteria for Group E retinoblastoma have no clinical basis, given that the LA classification system provided the greatest separation in globe salvage rates between Group D and E eyes. The LA classification system was also able to show a statistically significant difference in the rates of HE histopathologic features between Group D and E eyes. To avoid discrepancies in the literature, we recommend that centres use one uniform system for classifying advanced intraocular retinoblastoma.