Philippine retinoblastoma initiative multi-eye center study 2010-2020
Authors:   Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila 1000, Philippines; Department of Ophthalmology, Baguio General Hospital and Medical Center, Baguio City 2600, Philippines, Tan Roland Joseph D. , Cabrera Patricia E. ,   Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila 1000, Philippines; Department of Ophthalmology, Rizal Medical Center, Pasig City 1600, Philippines, Astudillo Paulita Pamela P. ,   Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila 1000, Philippines; Department of Ophthalmology, Jose B. Lingad Memorial Regional Hospital, Pampanga 2000, Philippines, Domingo Rolando Enrique D. ,   Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila 1000, Philippines, Poblete Josept Mari S. ,   Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila 1000, Philippines, Cabebe Charmaine Grace M. ,   Department of Ophthalmology, Southern Philippines Medical Center, Davao City 8000, Philippines, Te Adriel Vincent R. ,   Department of Ophthalmology, Southern Philippines Medical Center, Davao City 8000, Philippines, Gonzales Melissa Anne S. ,   Department of Ophthalmology, Southern Philippines Medical Center, Davao City 8000, Philippines, Sy Jocelyn G. ,   Department of Ophthalmology, Southern Philippines Medical Center, Davao City 8000, Philippines, Aclan Beltran Alexis A. ,   Department of Ophthalmology, East Avenue Medical Center, Quezon City 1100, Philippines, So Jayson T. ,   Department of Ophthalmology, East Avenue Medical Center, Quezon City 1100, Philippines, Regala Fatima G. ,   Department of Ophthalmology, East Avenue Medical Center, Quezon City 1100, Philippines, Comia Kimberley Amanda K. ,   Department of Ophthalmology, Manila Doctors Hospital, Manila 1000, Philippines, Castro Josemaria M. ,   Department of Ophthalmology, Manila Doctors Hospital, Manila 1000, Philippines, Galang Mara Augustine S. ,   Department of Ophthalmology, Manila Doctors Hospital, Manila 1000, Philippines, Cabanlas Aldous Dominic C. ,   Department of Ophthalmology, Northern Mindanao Medical Center, Cagayan de Oro City 9000, Philippines, Aguilar Benedicto Juan E. ,   Department of Ophthalmology, Northern Mindanao Medical Center, Cagayan de Oro City 9000, Philippines, Evangelista Gabrielle S. ,   Department of Ophthalmology, Northern Mindanao Medical Center, Cagayan de Oro City 9000, Philippines, Maniwan Jo Michael ,   Department of Ophthalmology, Rizal Medical Center, Pasig City 1600, Philippines, Martin Andrei P. ,   Department of Ophthalmology, Rizal Medical Center, Pasig City 1600, Philippines, Martinez Calvin Y. ,   Department of Ophthalmology, Cebu Velez General Hospital, Cebu City 6000, Philippines, Lim John Alfred H. ,   Department of Ophthalmology, Cebu Velez General Hospital, Cebu City 6000, Philippines, Bascuna Rena Ivy ,   Legazpi Eye Center, Legazpi City 4500, Philippines, Ng Rachel M. ,   Legazpi Eye Center, Legazpi City 4500, Philippines, Agsaoay Kevin B. ,   Department of Ophthalmology, Cagayan Valley Medical Center, Tuguegarao City 3500, Philippines, Acluba-Arao Kris Zanna A. ,   Department of Ophthalmology, Cagayan Valley Medical Center, Tuguegarao City 3500, Philippines, Apostol Ellaine Rose V. ,   Department of Ophthalmology, East Avenue Medical Center, Quezon City 1100, Philippines, Prieto Beatriz M. ,   Department of Ophthalmology, East Avenue Medical Center, Quezon City 1100, Philippines
Published: December 2023

AIM: To provide a comprehensive and more representative national data on the disease, especially on treatment options and outcomes, and to determine access of retinoblastoma patients from Luzon, Visayas and Mindanao to eye care, and determine if access is associated with delay in consultation, staging and outcomes.
METHODS: Cohort study of retinoblastoma patients seen in eleven institutions located in the three major areas of the Philippines namely Luzon, Vizayas and Mindanao from 2010-2020.
RESULTS: Totally 636 patients, involving 821 eyes, were included. Majority (57%) were from Luzon and were seen in institutions in Luzon (72%). Annually, 58±10 new cases were seen with 71% having unilateral disease. Median delay of consultation remained long at 9 (3, 17)mo, longest in patients with unilateral disease (P&#x0026;#x003C;0.02) and those from the Visayas (P&#x0026;#x003C;0.003). Based on the International Retinoblastoma Staging System, only 35% of patients had Stage 1 while 47% already had extraocular disease. Enucleation was the most common treatment received by 484 patients while intravenous chemotherapy was received by 469. There were 250 (39%) patients alive, 195 (31%) dead, 85 (13%) abandoned, 17 (3%) refused and 89 (14%) with no data.
CONCLUSION: This study presents the largest cohort of retinoblastoma patients in the Philippines in terms of patients' and participating institutions' number and geographical location and type of institution (private and public). It also presents more comprehensive data on the treatments used and outcomes (survival, globe salvage, and vision retention rates). Delay in consultation was still long among patients leading to advanced disease stage and lower survival rate. Despite increasing capacity to diagnose and manage retinoblastoma in the country, the delay of consultation remains long primarily due to accessibility issues to eye care institutions especially in the Visayas and financial concerns. The delay was still significant that overall survival rate remain low.