A Comparison of Retinoblastoma Cases in the Philippines
Roland Joseph D. Tan, MD, MS, MIH1,2,3, Gary John V. Mercado, MD1,3, Patricia E. Cabrera, MD1,4, Paulita Pamela P. Astudillo, MD1,5, Rolando Enrique D. Domingo, MD1, Josept Mari S. Poblete, MD, PhD1,Charmaine Grace M. Cabebe, MD6, Adriel Vincent R. Te, MD6, Melissa Anne S. Gonzales, MD6, Jocelyn G. Sy, MD6, Beltran Alexis A. Aclan, MD7, Jayson T. So, MD7, Fatima G. Regala, MD7, Kimberley Amanda K. Comia, MD3,Josemaria M. Castro, MD3, Mara Augustine S. Galang, MD3, Aldous Dominic C. Cabanlas, MD8, Benedicto Juan E. Aguilar, MD8, Gabrielle S. Evangelista, MD8, John Michael Maniwan, MD4, Andrei P. Martin, MD4, Calvin Y. Martinez, MD9, John Alfred A. Lim, MD9, Rena Ivy Bascuna, MD10, Rachel M. Ng, MD, MPH10, Kevin B. Agsaoay, MD11, Kris Zana A. Arao, MD11, Ellaine Rose V. Apostol, MD5 and Beatriz M. Prieto, MD7
1Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila, Philippines
2Department of Ophthalmology, Baguio General Hospital and Medical Center, Baguio City, Philippines
3Department of Ophthalmology, Manila Doctors Hospital, Manila, Philippines
4Department of Ophthalmology, Rizal Medical Center, Pasig City, Philippines
5Department of Ophthalmology, Jose B. Lingad Memorial Regional Hospital, Pampanga, Philippines 6Department of Ophthalmology, Southern Philippines Medical Center, Davao City, Philippines
7Department of Ophthalmology, East Avenue Medical Center, Quezon City, Philippines
8Department of Ophthalmology, Northern Mindanao Medical Center, Cagayan de Oro City, Philippines 9Department of Ophthalmology, Cebu Velez General Hospital, Cebu City, Philippines
10Legazpi Eye Center, Legazpi City, Philippines
11Department of Ophthalmology, Cagayan Valley Medical Center, Tuguegarao City, Philippines
Corresponding author: Roland Joseph D. Tan, MD, MS, MIH
Mailing address: Room 212, Pueblo de Maria Building, Notre Dame de Chartres Hospital, General Luna Road, Baguio City, Philippines 2600
Clinic Phone Number: +639951455491
Email address: rdtan@up.edu.ph
Disclosures: The authors report no financial conflict of interest, and received no financial support for this paper.
ABSTRACT
Objective: This study compared the demographics, clinical profile, treatment, and outcomes of retinoblastoma patients seen at medical institutions in the Philippines between two time periods: 2010 to 2015 and 2016 to 2020.
Methods: This was a multicenter, analytical, cohort study using review of medical charts and databases of retinoblastoma patients seen in 11 medical institutions from 2010 to 2020.
Results: There were 636 patients (821 eyes) included in this study: 330 patients were seen in 2010 to 2015 while 306 in 2016 to 2020. More cases per annum were seen in the latter timeline. The number of patients with unilateral disease was not significantly different between the two time periods (p=0.51). Age at onset of symptom, age at initial consultation, and delay in consult were also not significantly different between the two time periods (p>0.05). Patients had significantly different distributions of intraocular grades (p<0.0001) and systemic staging (p<0.0001) between the two time periods. Enucleation was the most common surgical treatment performed in both timelines. There was significant difference in the status of patients based on the need for systemic chemotherapy (p<0.01). There was significant difference in outcome between the two time periods, including the proportions of living and deceased patients.
Conclusion: This study compared the most comprehensive data on retinoblastoma patients in the country. There was no improvement in early health seeking behavior based on similar age at initial consult and delay in consult. Enucleation remained the most common treatment mode as opposed to chemotherapy due to similar percentage of patients with unilateral disease, an indication for enucleation rather than chemotherapy.
Keywords: retinoblastoma, Philippines, epidemiology, clinical profile, treatment, outcomes