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Vol. 58. Issue 1.
Pages 3-9 (1 January 2003)
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Vol. 58. Issue 1.
Pages 3-9 (1 January 2003)
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Supervivencia y aspectos clínicos del retinoblastoma
Survival and clinical features of retinoblastoma
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18700
F. Cerecedo Díaza,
Corresponding author
drarias@hotmail.com

Correspondencia: Servicio de Oncología Pediátrica. Hospital del Pediatría del Centro Médico Nacional Siglo XXI. Instituto Mexicano del Seguro Social. Av. Cuauhtémoc 330, Colonia Doctores. CP 67200. México, D.F.
, E. López Aguilara, H. Rivera Márqueza, J. Arias Gómezb, F. Ramírez Santaritaa, M. Rodríguez Cruzd
a Servicios de Oncología Pediátrica. Hospital de Pediatría, CMNSXXI. Instituto Mexicano del Seguro Social. México.
b Servicios de Escolares y Adolescentes. Hospital del Pediatría del Centro Médico Nacional
c Servicios de Pediatría Médica. Hospital Médica Sur
d Servicios de Unidad de Investigación Médica en Nutrición-Unidad de Investigación Médica en Genética Humana. Hospital de Pediatría, CMNSXXI. Instituto Mexicano del Seguro Social. México.
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Article information
Introducción

El retinoblastoma es el tumor intraocular maligno más frecuente en pediatría. Representa el 3 % de las neoplasias de la infancia. En México, la incidencia anual varía de acuerdo con la zona geográfica estudiada en un rango de 4 a 24 casos por millón en menores de 15 años y el 95 % de los casos se presenta en la etapa de lactante y preescolar.

Pacientes y método

Estudio observacional, retrospectivo, descriptivo y transversal. Se incluyeron todos los niños con retinoblastoma atendidos en 10 años en el Servicio de Oncología del Hospital de Pediatría del Centro Médico Nacional IMSS.

Resultados

Se incluyeron 56 pacientes. La mediana de edad fue de 24 meses. Presentaron retinoblastoma unilateral 42 casos. Los síntomas presentes al diagnóstico fueron: leucocoria, estrabismo y disminución de la agudeza visual. La distribución de acuerdo con la clasificación de Pratt fue: etapa I, 5; etapa II, 32; etapa III, 14; etapa IV, 5. Por histología: 24 pacientes con retinoblastoma pobremente diferenciado, 16 bien diferenciados y 13 moderadamente diferenciados, 7 casos no diferenciados y en 8 casos la variedad histológica no se identificó. En el grupo de pacientes estudiados 12 de los 56 se incluyeron en un protocolo de estudio citogenético y molecular. Todos los pacientes se sometieron a cirugía. La quimioterapia se indicó en los estadios tempranos. El 26,7 % presentaron recidivas. La supervivencia libre de enfermedad fue del 87,5 % a 10 años.

Conclusiones

El retinoblastoma al igual que en otras neoplasias en pediatría, el diagnóstico oportuno y el manejo multidisciplinario ha mejorado el pronóstico y la supervivencia. Los síntomas, el tratamiento y la supervivencia de la presente cohorte son similares a lo comunicado en la literatura.

Palabras clave:
Retinoblastoma
Supervivencia
Quimioterapia
Introduction

Retinoblastoma (RB) is the most frequent intraocular tumor in the pediatric age group, representing 3% of all childhood neoplasms. In Mexico, the annual incidence varies according to the geographical area studied, ranging from 4-24 cases/million in patients younger than 15 years. Ninety-five percent of cases occur in infants and pre-school children.

Patients and method

An observational, retrospective, descriptive, cross-sectional study of all children with RB admitted to the Oncology Department of the Pediatric Hospital of the National Medical Center in a 10-year period was performed.

Results

Fifty-six patients were included. The median age was 24 months. Forty-two children presented unilateral RB. Symptoms at diagnosis were leukokoria, strabismus and reduced visual sharpness. Distribution according to Prats‚ classification was the following: stage I, 5 patients; stage II, 32; stage III, 14; stage IV, 5. Histological analysis revealed 24 patients with poorly differentiated RB, 16 with well-differentiated RB, 13 with moderately differentiated RB and 7 with undifferentiated RB. In eight patients histological type was not identified. In 12 of the 56 patients cytogenetic and molecular studies were performed. All patients underwent surgery. Patients in the early stages were treated with chemotherapy. A total of 26.7 % of the group presented relapse. The disease-free survival at 10 years was 87.5%.

Conclusions

As with other childhood neoplasms, early diagnosis and multidisciplinary management of RB has improved prognosis and survival. The symptoms, treatment and survival reported in this pediatric cohort are similar to those of other published series

Key words:
Retinoblastoma
Survival
Chemotherapy
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