High-risk features in primary versus secondary enucleated globes with advanced retinoblastoma: a retrospective histopath
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ORIGINAL PAPER
High-risk features in primary versus secondary enucleated globes with advanced retinoblastoma: a retrospective histopathological study Hind M. Alkatan . Saad A. Al-Dahmash . Saleh A. Almesfer . Faisal S. AlQahtani . Azza M. Y. Maktabi
Received: 30 April 2020 / Accepted: 20 June 2020 Ó Springer Nature B.V. 2020
Abstract Purpose The management of bilateral advanced retinoblastoma (RB) cases is challenging with attempts to use neoadjuvant therapy salvaging of one of the globes. Our aim in this study was to demonstrate the effect of this primary therapy on the histopathological features and risk factors in secondary enucleated compared to primarily enucleated globes with groups D and E RB. Methods We retrospectively reviewed all enucleated globes with advanced RB received in the pathology laboratories over a period of 5 years. Patients were
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10792-020-01472-8) contains supplementary material, which is available to authorized users. H. M. Alkatan (&) S. A. Al-Dahmash F. S. AlQahtani Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia e-mail: [email protected]; [email protected] H. M. Alkatan Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia S. A. Almesfer Pediatric Ophthalmology Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia A. M. Y. Maktabi Pathology and Laboratory Medicine Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
divided into two groups: one with primary enucleations and another with at least one secondary enucleated globe, and their demographic and clinical data were analyzed. The enucleated globes in the two groups were analyzed to compare the general histopathological features including tumor seeding, size, differentiation, growth pattern, mitotic figures, and focality. More importantly, high-risk features: choroidal invasion, optic nerve (ON) invasion, iris/ anterior chamber invasion, ciliary body invasion, and scleral and extra-scleral extension, as well as the pathological classification of the tumor (pT) according to the American Joint Committee on Cancer 7th edition were also compared between the two groups. Results We had a total of 106 enucleated globes (78 primary and 28 secondary enucleations) from 99 patients with advanced RB (73 patients with primarily and 26 with secondarily enucleated globes). Demographic and clinical profiles of patients were similar in both, but the mean interval from presentation to enucleation was significantly longer in the secondary enucleations (P = 0.015). Rare/occasional mitotic figures were observed in secondary enucleations using multivariate analysis (P = 0.003). Primarily enucleated globes had higher risk of tumor seeding (P = 0.020), post-laminar/surgical margin ON invasion (P = 0.001), and massive choroidal invasion (P = 0.028). Half of the secondary enucleated globes had tumors
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