Retrospective five year follow up study of retinoblastoma : at Gujarat Cancer and Research Institute

Material: A retrospective study was undertaken to analyse the epidemiological and clinical aspects of retinoblastoma at the Gujarat Cancer and Research Institute, Amadavad, From June 1992 to December 1999 a total of 200 children with retinoblastoma were observed at GCRI, out of a total 3272 cases (6 percent) of paediatric cancers. Results: The present study reports the specific characteristics of retinoblastoma in the paediatric population of Gujarat and its neighbouring States, Only 77 (38.5 percent) patients were living in the Amadavad and nearby districts while the remaining had come from far off districts. There was male preponderance (65.5 percent). Thirteen percent of our patients had presented before the age of one and 89.5 percent were before their 5th birth date. The ration of unilateral to bilateral disease was 2.6:1. In 64 cases (32 percent) symptoms were present for more than 6 months. The most common presenting symptom was orbital mass. All eyes underwent fundoscopic examination and the staging work up was done. Majority of our patients had advanced disease(Stage III, 37.5 percent, Stage IV, 35 percent). Patients were treated with the help of surgery, chemotherapy, radiotherapy and photocoagulation according to their stage. One hundred and forty three cases (71.5 percent) were lost to follow up. In the final outcome 9 cases (15.7 percent) expired on treatment, 10 cases (17.5 percent) relapsed, 20 cases (25 percent) are taking treatment and 18 cases (31.5 percent) are in remission. Conclusion: Delay in diagnosis, extraocular disease at the time of presentation, lack of awareness and low socioeconomic and educational conditions may be the major factors for the high rate of failure and high drop out rate. There is a need to detect early intraocular disease and a campaign to increase general awareness.