RETINOBLASTOMA - PROBLEMS AND PERSPECTIVES FROM INDIA

This study examined the salient clinical and epidemiological character istics of retinoblastoma (RB) in India, thereby highlighting the probl ems encountered there. The epidemiological characteristics of 296 pati ents with RB over 8 years were evaluated using hospital records and po stal follow-ups. Unilateral disease was sea in 61.8 % of patients. The overall median age at presentation was 3.5 years (3.5 years for unila teral RB and 1.0 years for bilateral RB). The male/female ratio was 1. 4:1. The median duration of symptomatic disease was 8 months. Consangu ineous marriage was sea in 17% and family history of RB was noted in 1 .7% cases. Also, 2% had a history of other malignancy in the family. A ssociated congenital malformation was seen in 10.5% of cases. A second malignancy was seen in 0.67% of cases at a mean duration of 4.5 years after completion of therapy. A predominance of advanced-stage disease (74.5 % had Reese-Ellsworth group IV and V disease) was seen in our s eries. Only 43.6% of patients had disease localized to the globe witho ut any infiltration/invasion. The majority of cases had advanced-stage disease at presentation and came from the underprivileged class of so ciety. Patients with bilateral RB presented much earlier than those wi th unilateral disease. In patients with unilateral RB, higher age at p resentation as well as advanced disease may be related to much delay i n seeking medical attention. In view of the advanced stage at presenta tion, there also exist a possibility of difference in the biology of t he tumor sea in these patients.