美洲视网膜母细胞瘤结果：对来自 23 个美洲国家的 491 名视网膜母细胞瘤儿童进行的前瞻性分析。
Retinoblastoma Outcomes in the Americas: a prospective analysis of 491 children with retinoblastoma from 23 American countries.
发表日期：2023 Nov 08
作者：
, Jesse L Berry, Sarah Pike, Archeta Rajagopalan, Mark W Reid, Ido Didi Fabian, Armin R Afshar, Amanda Alejos, Ernesto Alemany-Rubio, Yvania Alfonso Carreras, Mattan Arazi, Nicholas J Astbury, Covadonga Bascaran, Elaine Binkley, Sharon Blum, H Culver Boldt, Maria Teresa B C Bonanomi, Richard Bowman, Rachel C Brennan, Matthew J Burton, Patricia Calderón-Sotelo, Doris A Calle Jara, Miriam R Cano, Luis Castillo, Isabel Cavieres, Doris Quiroz Cerna, Arthika Chandramohan, Guillermo L Chantada, Timothy W Corson, Kristin E Cowan-Lyn, Jacquelyn M Davanzo, Hakan Demirci, Rosdali Y Diaz Coronado, Helen Dimaras, Carla R Donato Macedo, Connor Ericksen, Adriana C Fandiño, Delia D P G Fernández, Allen Foster, Ligia D Fu, Soad L Fuentes-Alabi, Juan L Garcia, Henry N Garcia Pacheco, Ana V Girón, Marco A Goenz, Aaron S Gold, Nir Gomel, Efren Gonzalez, Graciela Gonzalez Perez, Liudmira González-Rodríguez, Jaime Graells, Nathalia D A K Grigorovski, Patrick Hamel, Eric D Hansen, J William Harbour, M Elizabeth Hartnett, Muhammad Hassan, G Baker Hubbard, Noa Kapelushnik, Jonathan W Kim, Scott A Larson, Kelly D Laurenti, Amy A Leverant, Cairui Li, Juan P López, Sandra Luna-Fineman, George N Magrath, Ashwin Mallipatna, Clarissa C D S Mattosinho, Marilyn B Mets, Audra Miller, Prithvi Mruthyunjaya, Timothy G Murray, Scott C N Oliver, Joaquin Oporto, Miriam Ortega-Hernández, Diego Ossandon, Claudia R Pascual Morales, Katherine E Paton, David A Plager, Rodrigo A Polania, Jimena Ponce, Karina Quintero D, Aparna Ramasubramanian, Marco A Ramirez-Ortiz, Jasmeen K Randhawa, Livia Romero, Beatriz Salas, Gissela L Sánchez, Alma Janeth Sanchez Orozco, Mariana Sgroi, Ankoor S Shah, Carol L Shields, Arun D Singh, Alison H Skalet, Andrew W Stacey, Erin D Stahl, Caron Strahlendorf, Maria Estela Coleoni Suarez, Rosanne Superstein, Fanny F Tarrillo Leiva, Luiz F Teixeira, Ogul E Uner, Jacqueline Karina Vasquez Anchaya, Leon O Vaughan, Victor M Villegas, Matthew W Wilson, Antonio Yaghy, Roberto I Yee, Arturo M López, Marcia Zondervan
来源：
AMERICAN JOURNAL OF OPHTHALMOLOGY
摘要：
在全球范围内，高收入国家和低收入国家之间的视网膜母细胞瘤治疗结果存在差异，但缺乏对美洲国家的独立分析。我们报告美国视网膜母细胞瘤患者的结局，并探讨与生存和全球挽救相关的因素。前瞻性队列研究数据的亚分析。对 23 个不同经济水平国家的 57 个美国治疗中心进行多中心分析（低收入=LIC，中低收入=LMIC，中上=UMIC，高=HIC）对 2017 年诊断的 491 名初治视网膜母细胞瘤患者进行随访，并随访至 2020 年。使用 Kaplan-Meier 分析和 Cox 比例风险模型分析生存率和全球挽救率。患者中，8 名（1.6%） 、58 名（11.8%）、235 名（47.9%）和 190 名（38.7%）分别来自低收入国家、中低收入国家、中低收入国家和高收入国家。低收入国家的三年生存率为 60.0%（95% CI，12.6-88.2），而高收入国家的三年生存率为 99.2%（94.6-99.9）。四岁以上患者死亡的可能性较小（与四岁或以下患者相比，HR=0.45 [95% CI, 0.27 - 0.78]，P=0.048）。晚期肿瘤患者（例如，cT3 与 cT1，HR= 4.65×109 [95% CI，1.25×109 - 1.72×1010]，P<0.001）和女性（与男性相比，HR=1.98 [1.27-3.10] ]，P=0.04）更有可能死亡。中低收入国家的三年全球挽救率为 13.3%（95% CI，5.1-25.6），高收入国家为 46.2%（38.8-53.3）。三年后，70.1% 的 cT1 眼（95% CI，54.5-81.2）得以挽救，而 cT3 眼的比例为 8.9%（5.5-13.3）。晚期肿瘤分期与较高的摘除风险相关（例如，cT3 与 cT1，SHR=4.98 [95% CI，2.36-10.5），P<0.001）。美国国家根据经济水平和经济水平，在生存率和眼球抢救方面存在差异。肿瘤分期表明需要儿童癌症计划。版权所有 © 2023。由 Elsevier Inc. 出版。
Globally, disparities exist in retinoblastoma treatment outcomes between high- and low-income countries, but independent analysis of American countries is lacking. We report outcomes of American retinoblastoma patients and explore factors associated with survival and globe salvage.Subanalysis of prospective cohort study data.Multicenter analysis at 57 American treatment centers in 23 countries of varying economic levels (low income=LIC, lower-middle=LMIC, upper-middle=UMIC, high=HIC) of 491 treatment-naïve retinoblastoma patients diagnosed in 2017 and followed through 2020. Survival and globe salvage rates analyzed with Kaplan-Meier analysis and Cox proportional hazard models.Of patients, 8 (1.6%), 58 (11.8%), 235 (47.9%) and 190 (38.7%) were from LIC, LMIC, UMIC and HIC, respectively. Three-year survival rates in LICs were 60.0% (95% CI, 12.6-88.2) compared to 99.2% (94.6-99.9) in HICs. Death was less likely in patients older than four years (vs. four or younger, HR=0.45 [95% CI, 0.27 - 0.78], P=0.048). Patients with more advanced tumors (e.g., cT3 vs. cT1, HR= 4.65 × 109 [95% CI, 1.25 × 109 - 1.72 × 1010], P<0.001) and females (vs. males, HR=1.98 [1.27-3.10], P=0.04) were more likely to die. Three-year globe salvage rates were 13.3% (95% CI, 5.1-25.6) in LMICs and 46.2% (38.8-53.3) in HICs. At three years, 70.1% of cT1 eyes (95% CI, 54.5-81.2) versus 8.9% of cT3 eyes (5.5-13.3) were salvaged. Advanced tumor stage was associated with higher enucleation risk (e.g., cT3 vs. cT1, SHR=4.98 [95% CI, 2.36-10.5), P<0.001).Disparities exist in survival and globe salvage in American countries based on economic level and tumor stage demonstrating a need for childhood cancer programs.Copyright © 2023. Published by Elsevier Inc.