Abstract
Background: Retinoblastoma has a high cure rate if detected and treated early. Though there is paucity
of data of the outcome of retinoblastoma management in Africa, literature shows wide disparity in
survival between children with retinoblastoma in the developed and the developing countries.
Objective: To estimate the 3 year survival of patients diagnosed with retinoblastoma at Kenyatta
National Teaching and Referral Hospital, Kenya.
Methods: This was a retrospective audit of records of patients admitted with retinoblastoma between
January 2000 and December 2004. Demographic data, clinical presentation, intra-operative findings
and histology report were recorded and parents/guardians were contacted to ascertain the patients’
outcome. The data was analyzed using the Statistical Package for Social Scientists version 12 and
survival calculated using the Kaplan-Meier survival probability curve.
Results: The cumulative 3-year survival was 26.6%. The mean survival time for the survivors was 68
months (SD 16.6) and the Kaplan-Meier survival probability at 36-months of follow-up was 0.2. The
factors that significantly influenced good outcome were; age at presentation of <12 months, early
disease at presentation (leucocoria only) OR=4.13(1.48-11.68) p<0.001, intraocular disease on histology
OR=8.5(2.23-34.49) p<0.001 and total delay to management of ≤5 months OR=3.5(1.31-9.68) p=0.005.
Proptosis and tumor recurrences were associated with 100% mortality.
Conclusions: The survival of patients with retinoblastoma was found to be very low. The main
reasons were the late presentation and recurrent disease. The factors associated with poor outcome
were presentation with proptosis, metastatic disease, extraocular disease on histology and delay in
diagnosis to management of >5months.
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