Lag Time between Onset of First Symptom and Treatment of Retinoblastoma: An International Collaborative Study of 692 Patients from 10 Countries.

Kaliki, SwathiORCID logo; Ji, Xunda; Zou, Yihua; Rashid, Riffat; Sultana, Sadia; Taju Sherief, SadikORCID logo; Cassoux, Nathalie; Y Diaz Coronado, RosdaliORCID logo; Luis Garcia Leon, Juan; López, Arturo Manuel ZapataORCID logo; +24 more...Polyakov, Vladimir G; Ushakova, Tatiana L; Rani Roy, Soma; Ahmad, AliaORCID logo; Al Harby, LamisORCID logo; Reddy, M AshwinORCID logo; Sagoo, Mandeep SORCID logo; L Berry, JesseORCID logo; Kim, Jonathan; Polski, AshleyORCID logo; Astbury, Nicholas JORCID logo; Bascaran, CovadongaORCID logo; Blum, Sharon; Bowman, RichardORCID logo; Burton, Matthew JORCID logo; Foster, AllenORCID logo; Gomel, Nir; Keren-Froim, Naama; Madgar, Shiran; W Stacey, AndrewORCID logo; M Steinberg, DavidORCID logo; Mohamed, AshikORCID logo; Zondervan, MarciaORCID logo; and Fabian, Ido DidiORCID logo (2021) Lag Time between Onset of First Symptom and Treatment of Retinoblastoma: An International Collaborative Study of 692 Patients from 10 Countries. Cancers, 13 (8). p. 1956. ISSN 2072-6694 DOI: 10.3390/cancers13081956
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BACKGROUND: The relationship between lag time and outcomes in retinoblastoma (RB) is unclear. In this study, we aimed to study the effect of lag time between onset of symptoms and diagnosis of retinoblastoma (RB) in countries based on their national-income and analyse its effect on the outcomes. METHODS: We performed a prospective study of 692 patients from 11 RB centres in 10 countries from 1 January 2019 to 31 December 2019. RESULTS: The following factors were significantly different among different countries based on national-income level: age at diagnosis of RB (p = 0.001), distance from home to nearest primary healthcare centre (p = 0.03) and mean lag time between detection of first symptom to visit to RB treatment centre (p = 0.0007). After adjusting for country income, increased lag time between onset of symptoms and diagnosis of RB was associated with higher chances of an advanced tumour at presentation (p < 0.001), higher chances of high-risk histopathology features (p = 0.003), regional lymph node metastasis (p < 0.001), systemic metastasis (p < 0.001) and death (p < 0.001). CONCLUSIONS: There is a significant difference in the lag time between onset of signs and symptoms and referral to an RB treatment centre among countries based on national income resulting in significant differences in the presenting features and clinical outcomes.


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