Elizabeth D. Nkanga , Anthony C. Nlemadim , Mattan Arazi , Dennis G. Nkanga , Roseline E. Duke , Ido D. Fabian , Essemfon D. Nkanga , Friday A. Odey , Martin M. Meremikwu
{"title":"尼日利亚卡拉巴尔视网膜母细胞瘤的患者相关因素和临床治疗效果：单中心回顾性研究","authors":"Elizabeth D. Nkanga , Anthony C. Nlemadim , Mattan Arazi , Dennis G. Nkanga , Roseline E. Duke , Ido D. Fabian , Essemfon D. Nkanga , Friday A. Odey , Martin M. Meremikwu","doi":"10.1016/j.phoj.2024.03.007","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Retinoblastoma is associated with mortality in resource-poor nations due to disparities and poor access to treatment. The aim was to determine the relationships between patient-related factors and clinical outcomes of retinoblastoma in a tertiary hospital in Nigeria.</p></div><div><h3>Material and methods</h3><p>It was a retrospective study of all children diagnosed and treated for retinoblastoma from January 2017 through December 2022. Information obtained from their records included bio-socioeconomic data, symptoms, lag time from initial symptoms, staging, treatment, and survival outcome.</p></div><div><h3>Results</h3><p>Fifty-three patients, aged 6–88 months on first hospital presentation were recruited. There were 29 (54.7%) females. Twenty (37.7%) patients died. The majority were the last child of their parents (62.3%) with a low socioeconomic class (86.8%) and lived in rural areas (50.9%). The median (interquartile) age at diagnosis [24 (18–36) months, <em>p</em> = 0.005] and lag time [13 (6–20) months, <em>p</em> = 0.274] were lower in those who survived than in those who died. The prevalence of bilateral disease (20.8%, <em>p</em> <strong>=</strong> 0.002), brain metastasis (22.6%, <em>p</em> <strong><</strong> 0.001), stage IV disease (18.9%, <em>p</em> <strong>=</strong> 0.01) and relapse (34%, <em>p</em> <strong><</strong> 0.001) was higher among the patients who died. The median (interquartile) overall survival (OS) was 22 (11.8–32.2) months with a 1-year OS of 63%. Treatment with only chemotherapy [HR 4.76 (95% CI: 1.7–13.1)], incomplete chemotherapy [HR 5.61 (95% CI: 1.3–24.7)], relapse [HR 5.98 (95% CI: 1.4–25.9)] and eye surgery delayed after 3 chemotherapy cycles [HR 8.22 (95% CI: 1.1–62.2)] were predictors of mortality.</p></div><div><h3>Conclusion</h3><p>Most patients with retinoblastoma arrived at our treatment center approximately 14 months following the first symptom. Most (84.9%) presented with proptosis. The majority were of a low social class (86.8%), had a secondary level of education only (47.2%), and lived in rural areas (50.9%). The 3-year overall survival was 29%.</p></div>","PeriodicalId":101004,"journal":{"name":"Pediatric Hematology Oncology Journal","volume":"9 2","pages":"Pages 87-94"},"PeriodicalIF":0.0000,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468124524000196/pdfft?md5=e4c830646754795f877ed0907e3dc1e1&pid=1-s2.0-S2468124524000196-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Patient-related factors and outcome of retinoblastoma in Calabar, Nigeria: A single-center, retrospective study\",\"authors\":\"Elizabeth D. Nkanga , Anthony C. Nlemadim , Mattan Arazi , Dennis G. Nkanga , Roseline E. Duke , Ido D. Fabian , Essemfon D. Nkanga , Friday A. Odey , Martin M. Meremikwu\",\"doi\":\"10.1016/j.phoj.2024.03.007\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Retinoblastoma is associated with mortality in resource-poor nations due to disparities and poor access to treatment. The aim was to determine the relationships between patient-related factors and clinical outcomes of retinoblastoma in a tertiary hospital in Nigeria.</p></div><div><h3>Material and methods</h3><p>It was a retrospective study of all children diagnosed and treated for retinoblastoma from January 2017 through December 2022. Information obtained from their records included bio-socioeconomic data, symptoms, lag time from initial symptoms, staging, treatment, and survival outcome.</p></div><div><h3>Results</h3><p>Fifty-three patients, aged 6–88 months on first hospital presentation were recruited. There were 29 (54.7%) females. Twenty (37.7%) patients died. The majority were the last child of their parents (62.3%) with a low socioeconomic class (86.8%) and lived in rural areas (50.9%). The median (interquartile) age at diagnosis [24 (18–36) months, <em>p</em> = 0.005] and lag time [13 (6–20) months, <em>p</em> = 0.274] were lower in those who survived than in those who died. The prevalence of bilateral disease (20.8%, <em>p</em> <strong>=</strong> 0.002), brain metastasis (22.6%, <em>p</em> <strong><</strong> 0.001), stage IV disease (18.9%, <em>p</em> <strong>=</strong> 0.01) and relapse (34%, <em>p</em> <strong><</strong> 0.001) was higher among the patients who died. The median (interquartile) overall survival (OS) was 22 (11.8–32.2) months with a 1-year OS of 63%. Treatment with only chemotherapy [HR 4.76 (95% CI: 1.7–13.1)], incomplete chemotherapy [HR 5.61 (95% CI: 1.3–24.7)], relapse [HR 5.98 (95% CI: 1.4–25.9)] and eye surgery delayed after 3 chemotherapy cycles [HR 8.22 (95% CI: 1.1–62.2)] were predictors of mortality.</p></div><div><h3>Conclusion</h3><p>Most patients with retinoblastoma arrived at our treatment center approximately 14 months following the first symptom. Most (84.9%) presented with proptosis. The majority were of a low social class (86.8%), had a secondary level of education only (47.2%), and lived in rural areas (50.9%). The 3-year overall survival was 29%.</p></div>\",\"PeriodicalId\":101004,\"journal\":{\"name\":\"Pediatric Hematology Oncology Journal\",\"volume\":\"9 2\",\"pages\":\"Pages 87-94\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-03-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2468124524000196/pdfft?md5=e4c830646754795f877ed0907e3dc1e1&pid=1-s2.0-S2468124524000196-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric Hematology Oncology Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2468124524000196\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Hematology Oncology Journal","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2468124524000196","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Patient-related factors and outcome of retinoblastoma in Calabar, Nigeria: A single-center, retrospective study
Background
Retinoblastoma is associated with mortality in resource-poor nations due to disparities and poor access to treatment. The aim was to determine the relationships between patient-related factors and clinical outcomes of retinoblastoma in a tertiary hospital in Nigeria.
Material and methods
It was a retrospective study of all children diagnosed and treated for retinoblastoma from January 2017 through December 2022. Information obtained from their records included bio-socioeconomic data, symptoms, lag time from initial symptoms, staging, treatment, and survival outcome.
Results
Fifty-three patients, aged 6–88 months on first hospital presentation were recruited. There were 29 (54.7%) females. Twenty (37.7%) patients died. The majority were the last child of their parents (62.3%) with a low socioeconomic class (86.8%) and lived in rural areas (50.9%). The median (interquartile) age at diagnosis [24 (18–36) months, p = 0.005] and lag time [13 (6–20) months, p = 0.274] were lower in those who survived than in those who died. The prevalence of bilateral disease (20.8%, p= 0.002), brain metastasis (22.6%, p< 0.001), stage IV disease (18.9%, p= 0.01) and relapse (34%, p< 0.001) was higher among the patients who died. The median (interquartile) overall survival (OS) was 22 (11.8–32.2) months with a 1-year OS of 63%. Treatment with only chemotherapy [HR 4.76 (95% CI: 1.7–13.1)], incomplete chemotherapy [HR 5.61 (95% CI: 1.3–24.7)], relapse [HR 5.98 (95% CI: 1.4–25.9)] and eye surgery delayed after 3 chemotherapy cycles [HR 8.22 (95% CI: 1.1–62.2)] were predictors of mortality.
Conclusion
Most patients with retinoblastoma arrived at our treatment center approximately 14 months following the first symptom. Most (84.9%) presented with proptosis. The majority were of a low social class (86.8%), had a secondary level of education only (47.2%), and lived in rural areas (50.9%). The 3-year overall survival was 29%.
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