Modes of presentation, management and short term outcome of retinoblastoma at the University Teaching Hospital(UTH),Lusaka
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Date
2016
Authors
Mutale, Nyaywa
Journal Title
Journal ISSN
Volume Title
Publisher
The University of Zambia
Abstract
Objectives: To establish the presentation, management and short-term outcomes of
retinoblastoma at UTH from January 2006- December 2012
Method: This was a retrospective case series study of the modes of presentation,
management of retinoblastoma and treatment outcomes 6 months after initiation of
treatment at UTH from January 2006 – December 2012. The data was collected from
registers for the eye unit inpatient and outpatient, histopathology laboratory, pediatric
oncology department as well as patients’ files. The data collected included demographics,
clinical presentation, histopathology reports, treatment modalities, and treatment outcome at
6 months after initiation of treatment. The statistical analyses were performed using the
statistical package SPSS version 20.
Results: There were 57 African participants in the study of which 26 (45.6%) were males
and 31 (54.4%) were females. The youngest was 0.75 months old while the oldest was 132
month old. The average age of the participants was 31.1 months old (with a standard
deviation of 21.96). The average time lag from the onset of symptoms to treatment at UTH
was 9.27 months with a minimum of one month and a maximum of 36 months. 71.2% had
unilateral retinoblastoma, 28.8% had bilateral retinoblastoma however no trilateral
retinoblastoma was observed. The most common presentations were proptosis (47.3%),
leukocoria (36.8%), phthisis bulbi (4%), hyphema (2%), orbital cellulitis (1%) and uveitis
(1%). The common treatment regimens were enucleation and chemotherapy (28.8%),
exenteration and chemotherapy (15%), enucleation, chemotherapy and radiotherapy (3.4%).
Moreover, 8.5% had enucleation only whilst 3.4% had exenteration, chemotherapy and
radiotherapy treatment regimen. In the study, the treatment outcomes 6 months post
initiation of treatment were abandoned treatment 17.7%, while 49.1% died and 33.2% were
alive.
Conclusion: The common presentation was proptosis (47.3%) and leukocoria (36.8%). The
most common treatment outcome was death, alive followed by abandonment of treatment.
Treatment was completed in 22% of the participants. Delay in diagnosis of retinoblastoma
remains a challenge as seen in the study by the high mean lag time and late presentation.
The diagnosis of retinoblastoma from the referral centers was accurate in 50 % of the
patients. Awareness of retinoblastoma to primary health care givers and parents will help to
improve early referrals. Further, we recommend the integration of knowledge of
retinoblastoma into the curriculum of primary health care giver to facilitate quick referral of
patient.
Description
Keywords
Retinoblastoma , Retinoblastoma-Treatment , Retinoblastoma-Diagnosis , Retinoblastoma-Therapy