Lag time, high-risk histopathological features, metastasis, and survival interrelation in retinoblastoma: a perspective from lower-middle income country
Authors:   Department of Ophthalmology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada-Prof. Dr. Sardjito General Hospital, Yogyakarta 55281, Indonesia, Utomo Purjanto Tepo , Ardianto Bambang ,   Department of Child Health, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada-Prof. Dr. Sardjito General Hospital, Yogyakarta 55281, Indonesia, Rinonce Hanggoro Tri ,   Department of Anatomical Pathology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada-Prof. Dr. Sardjito General Hospital, Yogyakarta 55281, Indonesia, Heriyanto Didik Setyo ,   Department of Anatomical Pathology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada-Prof. Dr. Sardjito General Hospital, Yogyakarta 55281, Indonesia, Dibyasakti Banu Aji ,   Department of Ophthalmology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada-Prof. Dr. Sardjito General Hospital, Yogyakarta 55281, Indonesia, Darajati Irene Titin ,   Department of Ophthalmology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada-Prof. Dr. Sardjito General Hospital, Yogyakarta 55281, Indonesia, Mahayana Indra Tri ,   Department of Ophthalmology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada-Prof. Dr. Sardjito General Hospital, Yogyakarta 55281, Indonesia, Supartoto Agus ,   Department of Ophthalmology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada-Prof. Dr. Sardjito General Hospital, Yogyakarta 55281, Indonesia
Published: November 2022

AIM: To investigate the impact of lag time to metastasis and survival rates among patients with retinoblastoma.
METHODS: This retrospective study was conducted with 52 patients from the Department of Ophthalmology and the Department of Pediatrics of Dr. Sardjito General Hospital, between 1st January 2014 and 31st December 2020. Lag time was defined as the time delay between the first sign of retinoblastoma to the diagnosis of retinoblastoma. The subjects with lag time > one year were included in the case group, while the subjects with lag time < one year were included in the control group.
RESULTS: The lag time was significantly correlated with American Joint Committee on Cancer and Intraocular Classification of Retinoblastoma staging of retinoblastoma (P=0.005 and P=0.006, respectively). The lag time was also significantly correlated with both metastasis event [odds ratio (OR): 5.06, 95%Cl: 1.56-16.44, P=0.006] and mortality (OR: 4.54, 95%Cl: 1.37-15.07, P=0.011). The follow-up was continued for 32 subjects for 3y after initial diagnoses. Survival analysis revealed a significant difference among these two groups (P=0.021). Furthermore, lag time was significantly correlated with survival of retinoblastoma (r=-0.53, P=0.046).
CONCLUSION: The study highlights the importance of lag time between the onset of first symptoms and the time of retinoblastoma diagnosis which significantly contribute to metastasis and mortality of patients with retinoblastoma. Examinations for the early detection of retinoblastoma should be performed for individuals at-risk to minimize lag time and improve the outcomes.