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Scleral Invasion Linked to Risk of Relapse in Retinoblastoma

Last Updated: August 20, 2009.

Microscopic scleral invasion is uncommon in patients with retinoblastoma, but these patients are at risk of extraocular relapse and have better outcomes if they receive high-intensity chemotherapy, according to a study in the August issue of the Archives of Ophthalmology.

THURSDAY, Aug. 20 (HealthDay News) -- Microscopic scleral invasion is uncommon in patients with retinoblastoma, but these patients are at risk of extraocular relapse and have better outcomes if they receive high-intensity chemotherapy, according to a study in the August issue of the Archives of Ophthalmology.

Adriana Cuenca, M.D., from the Universidad Nacional de Colombia in Bogota, and colleagues reviewed the pathology slides of 386 patients with retinoblastoma who had received chemotherapy. Of these, 32 had enucleated eyes with microscopic scleral invasion (21 intrascleral, 11 transscleral). Half had received moderately intensive chemotherapy while the other half had received higher-intensity chemotherapy.

The researchers found that the tumor had invaded the optic nerve beyond the lamina cribrosa in 20 patients and was present at the surgical margins in six patients. The five-year probability of event-free survival and overall survival was 0.77. Seven patients had an extraocular relapse and all died. Patients receiving high-intensity chemotherapy had better outcomes.

"Microscopic scleral invasion might be a risk factor for extraocular relapse, and more intensive chemotherapy results in improved survival for these patients," Cuenca and colleagues conclude.

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