Retinoblastoma programme outcome over a 10-year period in Lebanon: assessment of potential impact of the pandemic and economic crisis.

Abstract

Background/objectives: To evaluate the long-term outcomes of patients enrolled in the retinoblastoma programme at the Children's Cancer Institute of the American University of Beirut Medical Center (AUBMC) and to assess the effects of the Lebanese economic crisis and the COVID-19 pandemic on treatment outcomes.

Subjects/methods: A retrospective review of medical charts was conducted for retinoblastoma patients enrolled in the programme from 2012 to 2022. Parameters included age at diagnosis, gender, nationality, tumour characteristics, treatment modalities, follow-up duration, imaging results, and genetic testing outcomes. Outcomes were reported for the 10-year period and compared before and after 2019 (beginning of pandemic).

Results: The cohort included 94 patients: 49(52%) with unilateral retinoblastoma (RB) and 45(48%) with bilateral tumours. Mean age at diagnosis was 19.96 ± 16.2 months (14.18 ± 13.33 months for the bilateral group and 25.27 ± 16.94 months for the unilateral group) with no difference between the 2 time periods. Eye preservation over the 10-year period was 58.4% for bilateral disease and 20.8% for unilateral disease. Ocular salvage rate tended to increase from 54.9% to 72.2% after 2019 in the bilateral group and from 14.3% to 38.5% in the unilateral group but without statistical significance. For the whole cohort, positive genetic testing for RB mutation increased from 25% to 46%. In those who underwent testing, detection of RB1 mutation was similar in patients before 2019 (58%) and after 2019 (62.5%).

Conclusion: Our retinoblastoma programme demonstrated continued improved outcomes in terms of early detection, treatment, RB mutation detection, and eye preservation, despite the different challenges posed by the economic crisis and pandemic.