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Epidemiological and Clinical Presentation of Retinoblastoma among Nepalese Children in 2019

Objectives  Retinoblastoma (RB) is rare but potentially fatal if left untreated. This study aimed to evaluate the epidemiological profile, clinical manifestation, classification, and affordability of RB treatment among Nepalese children in the year 2019. Materials and Method  A multicentric, multiet...

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Autores principales: Limbu, Ben, Kafle, Prerna Arjyal, Lamichanne, Diwa Hamal, Pant, Suresh Raj, Shakya, Samyek, Rasaily, Suresh B.K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical and Scientific Publishers Pvt. Ltd. 2022
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10635776/
https://www.ncbi.nlm.nih.gov/pubmed/37969676
http://dx.doi.org/10.1055/s-0042-1757581
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author Limbu, Ben
Kafle, Prerna Arjyal
Lamichanne, Diwa Hamal
Pant, Suresh Raj
Shakya, Samyek
Rasaily, Suresh B.K.
author_facet Limbu, Ben
Kafle, Prerna Arjyal
Lamichanne, Diwa Hamal
Pant, Suresh Raj
Shakya, Samyek
Rasaily, Suresh B.K.
author_sort Limbu, Ben
collection PubMed
description Objectives  Retinoblastoma (RB) is rare but potentially fatal if left untreated. This study aimed to evaluate the epidemiological profile, clinical manifestation, classification, and affordability of RB treatment among Nepalese children in the year 2019. Materials and Method  A multicentric, multiethnic hospital-based cross-sectional study after ethical approval from the National Health Research Council was conducted from January 2019 to December 2019 by incorporating ophthalmologists all over the nation. Twenty-seven RB centers were selected. All the RB presented in the RB centers either newly diagnosed or ongoing treatment consented to the study were included and failed to consent for the study, RB survivors were excluded from the study. Data based on demographic profile, clinical manifestation, ethnical and geographical distribution, and treatment received were collected in the customized Google Form. Each case was classified at the time of diagnosis as per the International Classification of Retinoblastoma groups and different treatment modalities offered as per grouping and staging. The affordability of treatment was calculated using a catastrophic approach. Statistical Analysis  Data were entered into Microsoft Excel 2010 and analyzed using Statistical Package for Social Sciences version 20. Result  A total of 34 RB cases, 21 (61.76%) in ongoing treatment group and 13 (38.2%) in newly diagnosed group presented in the RB centers. Out of total, 32 (64.7%) had unilateral and 12 (35.3%) cases had bilateral involvement. The majority of patients was from Province 1 (35.3%) and belonged to the upper caste (38.2%). Leukocoria was the most common presentation (73.9%) followed by proptosis, red eye, and phthisis bulbi. More than 75% patients presented at advanced group D (54%) and E (21%) and stage 0 (90%). More than 90% of patients received systemic chemotherapy, and 42.6% received transpupillary thermotherapy. The average cost of RB treatment was estimated to be 521% of the nonfood expense of the family which is unaffordable to almost all cases (100%). Conclusion  Leukocoria is the most common mode of clinical presentation in both unilateral and bilateral RBs. Early diagnosis and appropriate treatment are key to success for saving life, sight, and eye. However, community awareness programs against RB, active referral networks, and the establishment of chemotherapy centers with trained human resources are needed to reduce loss of life, sight, and eye.
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spelling pubmed-106357762023-11-15 Epidemiological and Clinical Presentation of Retinoblastoma among Nepalese Children in 2019 Limbu, Ben Kafle, Prerna Arjyal Lamichanne, Diwa Hamal Pant, Suresh Raj Shakya, Samyek Rasaily, Suresh B.K. South Asian J Cancer Objectives  Retinoblastoma (RB) is rare but potentially fatal if left untreated. This study aimed to evaluate the epidemiological profile, clinical manifestation, classification, and affordability of RB treatment among Nepalese children in the year 2019. Materials and Method  A multicentric, multiethnic hospital-based cross-sectional study after ethical approval from the National Health Research Council was conducted from January 2019 to December 2019 by incorporating ophthalmologists all over the nation. Twenty-seven RB centers were selected. All the RB presented in the RB centers either newly diagnosed or ongoing treatment consented to the study were included and failed to consent for the study, RB survivors were excluded from the study. Data based on demographic profile, clinical manifestation, ethnical and geographical distribution, and treatment received were collected in the customized Google Form. Each case was classified at the time of diagnosis as per the International Classification of Retinoblastoma groups and different treatment modalities offered as per grouping and staging. The affordability of treatment was calculated using a catastrophic approach. Statistical Analysis  Data were entered into Microsoft Excel 2010 and analyzed using Statistical Package for Social Sciences version 20. Result  A total of 34 RB cases, 21 (61.76%) in ongoing treatment group and 13 (38.2%) in newly diagnosed group presented in the RB centers. Out of total, 32 (64.7%) had unilateral and 12 (35.3%) cases had bilateral involvement. The majority of patients was from Province 1 (35.3%) and belonged to the upper caste (38.2%). Leukocoria was the most common presentation (73.9%) followed by proptosis, red eye, and phthisis bulbi. More than 75% patients presented at advanced group D (54%) and E (21%) and stage 0 (90%). More than 90% of patients received systemic chemotherapy, and 42.6% received transpupillary thermotherapy. The average cost of RB treatment was estimated to be 521% of the nonfood expense of the family which is unaffordable to almost all cases (100%). Conclusion  Leukocoria is the most common mode of clinical presentation in both unilateral and bilateral RBs. Early diagnosis and appropriate treatment are key to success for saving life, sight, and eye. However, community awareness programs against RB, active referral networks, and the establishment of chemotherapy centers with trained human resources are needed to reduce loss of life, sight, and eye. Thieme Medical and Scientific Publishers Pvt. Ltd. 2022-11-02 /pmc/articles/PMC10635776/ /pubmed/37969676 http://dx.doi.org/10.1055/s-0042-1757581 Text en MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Limbu, Ben
Kafle, Prerna Arjyal
Lamichanne, Diwa Hamal
Pant, Suresh Raj
Shakya, Samyek
Rasaily, Suresh B.K.
Epidemiological and Clinical Presentation of Retinoblastoma among Nepalese Children in 2019
title Epidemiological and Clinical Presentation of Retinoblastoma among Nepalese Children in 2019
title_full Epidemiological and Clinical Presentation of Retinoblastoma among Nepalese Children in 2019
title_fullStr Epidemiological and Clinical Presentation of Retinoblastoma among Nepalese Children in 2019
title_full_unstemmed Epidemiological and Clinical Presentation of Retinoblastoma among Nepalese Children in 2019
title_short Epidemiological and Clinical Presentation of Retinoblastoma among Nepalese Children in 2019
title_sort epidemiological and clinical presentation of retinoblastoma among nepalese children in 2019
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10635776/
https://www.ncbi.nlm.nih.gov/pubmed/37969676
http://dx.doi.org/10.1055/s-0042-1757581
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