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Impact of Laterality on Cumulative Survival in Patients Diagnosed with Retinoblastoma: A Retrospective Cohort Analysis of 1925 Cases in the Surveillance, Epidemiology, and End Results (SEER) Program

Authors Hussain Z

Received 19 December 2020

Accepted for publication 29 January 2021

Published 5 March 2021 Volume 2021:15 Pages 991—1001


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Zain Hussain

Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA

Correspondence: Zain Hussain Email [email protected]

Background: Retinoblastoma is an intraocular cancer with potentially severe clinical consequences if left untreated. Diagnostic and clinical management guidelines are strictly dependent on nature of laterality. This analysis aims to characterize the influence of laterality on survival in patients diagnosed with retinoblastoma.
Methods: This retrospective cohort analysis utilized the Surveillance, Epidemiology, and End Results (SEER) program for population-based clinical data from 1975 to 2016, a period of 41 years. Univariable and multivariable Cox regression assessed survival with laterality as the primary independent predictor of mortality. Adjustment for demographical and clinical variables was performed.
Results: N = 1925 patients with a valid cause of death classification. Mean±SD age was 2.35± 2.020 years (range 0– 74). At the time of diagnosis, 819 (42.1%) patients were between 0 and 1 year of age, 469 (24.1%) patients were between 1 and 2 years, 350 (18.0%) patients were between 2 and 3 years, 147 (7.6%) patients were between 3 and 4 years, and 68 (3.5%) patients were between 4 and 5 years of age. The hazard of univariable cause-specific death is 55.6% and 52.9% lower for retinoblastoma patients with left-sided origin and right-sided origin as compared to patients with bilateral origin, respectively (HR = 0.444, CI 0.247– 0.800, p = 0.007; HR = 0.471, CI 0.267– 0.832, p = 0.009). After adjusting for confounding variables, the hazard of other-cause death for retinoblastoma patients is significantly less for left-sided origin (HR = 0.364, CI 0.140– 0.946, p = 0.038) and right-sided origin (HR = 0.190, CI 0.066– 0.549, p = 0.002) as compared to patients with retinoblastomas of bilateral origin.
Conclusion: Prognostication of survival is significantly influenced by the nature of laterality in retinoblastoma. Unilateral retinoblastomas showcase increased promise for long-term cause-specific and other-cause survival compared to cases of retinoblastoma arising from bilateral origin.

Keywords: retinoblastoma, survival, laterality

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