Lag time between onset of first symptom and treatment of retinoblastoma: An international collaborative study of 692 patients from 10 countries

Swathi Kaliki*, Xunda Ji, Yihua Zou, Riffat Rashid, Sadia Sultana, Sadik Taju Sherief, Nathalie Cassoux, Rosdali Y. Diaz Coronado, Juan Luis Garcia Leon, Arturo Manuel Zapata López, Vladimir G. Polyakov, Tatiana L. Ushakova, Soma Rani Roy, Alia Ahmad, Lamis Al Harby, M. Ashwin Reddy, Mandeep S. Sagoo, Jesse L. Berry, Jonathan Kim, Ashley PolskiNicholas J. Astbury, Covadonga Bascaran, Sharon Blum, Richard Bowman, Matthew J. Burton, Allen Foster, Nir Gomel, Naama Keren-Froim, Shiran Madgar, Andrew W. Stacey, David M. Steinberg, Ashik Mohamed, Marcia Zondervan, Ido Didi Fabian

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The relationship between lag time and outcomes in retinoblastoma (RB) is unclear. In this study, we aimed to study the effect of lag time between onset of symptoms and diagnosis of retinoblastoma (RB) in countries based on their national-income and analyse its effect on the outcomes. Methods: We performed a prospective study of 692 patients from 11 RB centres in 10 countries from 1 January 2019 to 31 December 2019. Results: The following factors were significantly different among different countries based on national-income level: age at diagnosis of RB (p = 0.001), distance from home to nearest primary healthcare centre (p = 0.03) and mean lag time between detection of first symptom to visit to RB treatment centre (p = 0.0007). After adjusting for country income, increased lag time between onset of symptoms and diagnosis of RB was associated with higher chances of an advanced tumour at presentation (p < 0.001), higher chances of high-risk histopathology features (p = 0.003), regional lymph node metastasis (p < 0.001), systemic metastasis (p < 0.001) and death (p < 0.001). Conclusions: There is a significant difference in the lag time between onset of signs and symptoms and referral to an RB treatment centre among countries based on national income resulting in significant differences in the presenting features and clinical outcomes.

Original languageEnglish
Article number1956
JournalCancers
Volume13
Issue number8
DOIs
StatePublished - 2 Apr 2021

Funding

FundersFunder number
Operation Eyesight Universal Institute for Eye Cancer
Wellcome Trust207472/Z/17/Z
Hyderabad Eye Research Foundation

    Keywords

    • Eye
    • Lag time
    • National income level
    • Retinoblastoma
    • Tumour

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