Experience with Retinoblastoma at a Tertiary Centre in Port Harcourt, Nigeria: Trends in Outcome

Abstract

Background: Retinoblastoma is the most common primary intraocular malignancy in children, and remains the most curable of all childhood cancers in the developed world. However, ocular and patient survival rates have remained very low in resource limited countries, where more than 90% of children with retinoblastoma live.
 Objectives: To review the pattern of presentation of children with retinoblastoma at the University of Port Harcourt Teaching Hospital (UPTH), Nigeria, and compare their treatment outcome with what was obtained in the previous decade in same centre.
 Methods: All patients with retinoblastoma admitted into the Paediatric Oncology Unit of the UPTH from January 2011 to June 2017 were reviewed. Their demographics, clinical profile and outcome of treatment were analyzed using SPSS version 20.0.
 Results: Nineteen children had retinoblastoma which represented 11% of all childhood malignancies. Eight(42%) males and 11(58%) females, all under-fives, were studied with M:F=1:1.4. Mean duration of symptoms was 29.6 weeks, with majority (73.7%) having been ill for more than 3 months. White spot in the eye and eye protrusion were commonest presenting complaints while loss of vision was found in all affected eyes. More children (57.8% versus 30.8% previously) were lost to follow up, 5(26%) died and 3(15.7%) completed treatment, whereas none did a decade earlier.
 Conclusion: Retinoblastoma affected only under-five children. Late presentation with proptosis and loss of vision were common presenting features. A marginal improvement in outcome was noted while high default rate and lack of radiotherapy facilities in the State had remained important challenges to completion of therapy.