Retinoblastoma outcomes in Europe: a prospective analysis of 483 patients from 40 countries
Issued Date
2026-02-01
Resource Type
ISSN
0950222X
eISSN
14765454
Scopus ID
2-s2.0-105029630103
Pubmed ID
41408393
Journal Title
Eye Basingstoke
Volume
40
Issue
3
Start Page
390
End Page
398
Rights Holder(s)
SCOPUS
Bibliographic Citation
Eye Basingstoke Vol.40 No.3 (2026) , 390-398
Suggested Citation
Bowman R., Arazi M., Cassoux N., Foster A., Gomel N., Kapelushnik N., MacLeod D., Fabian I.D., Bowman R., Zondervan M., Ziko O.A.O., Zia N., Zhilyaeva K., Zheng X., Zhao J., Zhang Y., Zhang C., Zein E., Zapata López A.M., Yuliawati P., Yousef Y.A., Ye H., Yarovoy A.A., Yarovaya V.A., Yaqub M.A., Yanga J.M., Yang H., Yam J.C., Xiao Y., Xiang D., Wongwai P., Dod C.W., Wiwatwongwana D., Wiwatwongwana A., Wime A.D.C., Wilson M.W., Weiss A., Wang Y.Z., Wali Nigeria A.H., Wade P.D., Waddell K., Wackernagel W., Wachtel A.E., Vora T., Vishnevskia-Dai V., Villacís Chafla E.G., Viksnins M., Victor A.A., Verma N., Veleva-Krasteva N.V., Vaughan L.O., Vasquez L., Varadisai A., van Hoefen Wijsard M., Valeina S., Usmanov R.H., Ushakova T.L., Urbak S.F., Uner O.E., Unal E., Umar A.B., Tyau-Tyau H., Tuncer S., Trichaiyaporn S., Traoré F., Trang D.L., Toledano H., Theophile T., Teh K.H., Teixeira L.F., Tehuteru E.S., Tateshi B., Tashvighi M., Tarrillo Leiva F.F., Tandili A., Tan D., Tamamyan G., Sylla F., Svojgr K., Suzuki S., Surukrattanaskul S., Supriyadi E., Superstein R., Sundy M., Sun X., Sultana S., Suarez M.E.C., Strahlendorf C., Stones D.K., Kranjc B.S., Stathopoulos C., Stahl E.D., Staffieri S.E., Stacey A.W., Ssali G., Sorochynska T., Soebagjo H.D., Skalet A.H., Sitorus R.S., Singha P. Retinoblastoma outcomes in Europe: a prospective analysis of 483 patients from 40 countries. Eye Basingstoke Vol.40 No.3 (2026) , 390-398. 398. doi:10.1038/s41433-025-04144-y Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/115645
Title
Retinoblastoma outcomes in Europe: a prospective analysis of 483 patients from 40 countries
Author(s)
Bowman R.
Arazi M.
Cassoux N.
Foster A.
Gomel N.
Kapelushnik N.
MacLeod D.
Fabian I.D.
Bowman R.
Zondervan M.
Ziko O.A.O.
Zia N.
Zhilyaeva K.
Zheng X.
Zhao J.
Zhang Y.
Zhang C.
Zein E.
Zapata López A.M.
Yuliawati P.
Yousef Y.A.
Ye H.
Yarovoy A.A.
Yarovaya V.A.
Yaqub M.A.
Yanga J.M.
Yang H.
Yam J.C.
Xiao Y.
Xiang D.
Wongwai P.
Dod C.W.
Wiwatwongwana D.
Wiwatwongwana A.
Wime A.D.C.
Wilson M.W.
Weiss A.
Wang Y.Z.
Wali Nigeria A.H.
Wade P.D.
Waddell K.
Wackernagel W.
Wachtel A.E.
Vora T.
Vishnevskia-Dai V.
Villacís Chafla E.G.
Viksnins M.
Victor A.A.
Verma N.
Veleva-Krasteva N.V.
Vaughan L.O.
Vasquez L.
Varadisai A.
van Hoefen Wijsard M.
Valeina S.
Usmanov R.H.
Ushakova T.L.
Urbak S.F.
Uner O.E.
Unal E.
Umar A.B.
Tyau-Tyau H.
Tuncer S.
Trichaiyaporn S.
Traoré F.
Trang D.L.
Toledano H.
Theophile T.
Teh K.H.
Teixeira L.F.
Tehuteru E.S.
Tateshi B.
Tashvighi M.
Tarrillo Leiva F.F.
Tandili A.
Tan D.
Tamamyan G.
Sylla F.
Svojgr K.
Suzuki S.
Surukrattanaskul S.
Supriyadi E.
Superstein R.
Sundy M.
Sun X.
Sultana S.
Suarez M.E.C.
Strahlendorf C.
Stones D.K.
Kranjc B.S.
Stathopoulos C.
Stahl E.D.
Staffieri S.E.
Stacey A.W.
Ssali G.
Sorochynska T.
Soebagjo H.D.
Skalet A.H.
Sitorus R.S.
Singha P.
Arazi M.
Cassoux N.
Foster A.
Gomel N.
Kapelushnik N.
MacLeod D.
Fabian I.D.
Bowman R.
Zondervan M.
Ziko O.A.O.
Zia N.
Zhilyaeva K.
Zheng X.
Zhao J.
Zhang Y.
Zhang C.
Zein E.
Zapata López A.M.
Yuliawati P.
Yousef Y.A.
Ye H.
Yarovoy A.A.
Yarovaya V.A.
Yaqub M.A.
Yanga J.M.
Yang H.
Yam J.C.
Xiao Y.
Xiang D.
Wongwai P.
Dod C.W.
Wiwatwongwana D.
Wiwatwongwana A.
Wime A.D.C.
Wilson M.W.
Weiss A.
Wang Y.Z.
Wali Nigeria A.H.
Wade P.D.
Waddell K.
Wackernagel W.
Wachtel A.E.
Vora T.
Vishnevskia-Dai V.
Villacís Chafla E.G.
Viksnins M.
Victor A.A.
Verma N.
Veleva-Krasteva N.V.
Vaughan L.O.
Vasquez L.
Varadisai A.
van Hoefen Wijsard M.
Valeina S.
Usmanov R.H.
Ushakova T.L.
Urbak S.F.
Uner O.E.
Unal E.
Umar A.B.
Tyau-Tyau H.
Tuncer S.
Trichaiyaporn S.
Traoré F.
Trang D.L.
Toledano H.
Theophile T.
Teh K.H.
Teixeira L.F.
Tehuteru E.S.
Tateshi B.
Tashvighi M.
Tarrillo Leiva F.F.
Tandili A.
Tan D.
Tamamyan G.
Sylla F.
Svojgr K.
Suzuki S.
Surukrattanaskul S.
Supriyadi E.
Superstein R.
Sundy M.
Sun X.
Sultana S.
Suarez M.E.C.
Strahlendorf C.
Stones D.K.
Kranjc B.S.
Stathopoulos C.
Stahl E.D.
Staffieri S.E.
Stacey A.W.
Ssali G.
Sorochynska T.
Soebagjo H.D.
Skalet A.H.
Sitorus R.S.
Singha P.
Author's Affiliation
University of Melbourne
Sun Yat-Sen University
Tel Aviv University
Charles University
University of Montreal
Chinese University of Hong Kong
University of Washington School of Medicine
Zhengzhou University
Oregon Health & Science University
Université de Lausanne (UNIL)
London School of Hygiene & Tropical Medicine
Universidade Federal de São Paulo
Chulalongkorn University
Aarhus Universitetshospital
Ankara Üniversitesi
Chiang Mai University
Universitas Gadjah Mada
Guangzhou Medical University
Hospital Universitari Vall d'Hebron
Medizinische Universität Graz
St. Jude Children's Research Hospital
Prince of Songkla University
Universitas Airlangga
Institut Curie
Royal Children's Hospital, Melbourne
İstanbul Tıp Fakültesi
Great Ormond Street Hospital for Children NHS Foundation Trust
National Cancer Center Hospital
Faculty of Medicine, Ain Shams University
Tata Memorial Hospital
Univerzitetni Klinični Center Ljubljana
Beijing Tongren Hospital, Capital Medical University
King George's Medical University
BC Children's Hospital
Beijing Children's Hospital, Capital Medical University
Children's Mercy Hospitals and Clinics
Faculty of Medicine, Khon Kaen University
National University of Medical Sciences
Blokhin National Medical Research Center of Oncology, Ministry of Health
Universitas Udayana
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Bayero University
Singapore National Eye Centre
University of Jos
University Hospital Alexandrovska
Kuala Lumpur Hospital
Université de Kinshasa
Yerevan State Medical University after Mkhitar Heratsi
King Hussein Cancer Center
Hospital Nacional Edgardo Rebagliati Martins, EsSalud
Emory Eye Center
S.N. Fyodorov Eye Microsurgery State Institution
Instituto Nacional de Enfermedades Neoplasicas
University Hospital Centre Tirana
Indus Hospital & Health Network
Queen Sirikit National Institute of Child Health
The Filatov Institute of Eye Diseases and Tissue Therapy of NAMS of Ukraine
Bērnu klīniskā UniversItātes Slimnīca
Rumah Sakit Kanker Dharmais
Hopital Gabriel Toure
Amsterdam UMC
N.N. Alexandrov National Cancer Center of Belarus
Bustamante Hospital for Children
Vietnam National Institute of Ophthalmology
University of the Free Sate
Ispahani Islamia Eye Institute and Hospital
Mahak Hospital
Hospital del Niño Dr. Francisco de Icaza Bustamante
Medical Academy of Postgraduate Education
Kunming Children's Hospital
Mulago National Referral Hospital
National Cancer Center of Uzbekistan
Kabgayi Eye Unit
Université Adam Barka
University Eye Clinic
National Eye Center Kaduna
National Ophthalmological Institute of Angola
University School of Medicine
Assistante Hospitalo Universitaire
Africa Institute of Tropical Ophtalmology
Pediatra Hemato-Oncologa
Ruharo Eye Hospitalrara
Sun Yat-Sen University
Tel Aviv University
Charles University
University of Montreal
Chinese University of Hong Kong
University of Washington School of Medicine
Zhengzhou University
Oregon Health & Science University
Université de Lausanne (UNIL)
London School of Hygiene & Tropical Medicine
Universidade Federal de São Paulo
Chulalongkorn University
Aarhus Universitetshospital
Ankara Üniversitesi
Chiang Mai University
Universitas Gadjah Mada
Guangzhou Medical University
Hospital Universitari Vall d'Hebron
Medizinische Universität Graz
St. Jude Children's Research Hospital
Prince of Songkla University
Universitas Airlangga
Institut Curie
Royal Children's Hospital, Melbourne
İstanbul Tıp Fakültesi
Great Ormond Street Hospital for Children NHS Foundation Trust
National Cancer Center Hospital
Faculty of Medicine, Ain Shams University
Tata Memorial Hospital
Univerzitetni Klinični Center Ljubljana
Beijing Tongren Hospital, Capital Medical University
King George's Medical University
BC Children's Hospital
Beijing Children's Hospital, Capital Medical University
Children's Mercy Hospitals and Clinics
Faculty of Medicine, Khon Kaen University
National University of Medical Sciences
Blokhin National Medical Research Center of Oncology, Ministry of Health
Universitas Udayana
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Bayero University
Singapore National Eye Centre
University of Jos
University Hospital Alexandrovska
Kuala Lumpur Hospital
Université de Kinshasa
Yerevan State Medical University after Mkhitar Heratsi
King Hussein Cancer Center
Hospital Nacional Edgardo Rebagliati Martins, EsSalud
Emory Eye Center
S.N. Fyodorov Eye Microsurgery State Institution
Instituto Nacional de Enfermedades Neoplasicas
University Hospital Centre Tirana
Indus Hospital & Health Network
Queen Sirikit National Institute of Child Health
The Filatov Institute of Eye Diseases and Tissue Therapy of NAMS of Ukraine
Bērnu klīniskā UniversItātes Slimnīca
Rumah Sakit Kanker Dharmais
Hopital Gabriel Toure
Amsterdam UMC
N.N. Alexandrov National Cancer Center of Belarus
Bustamante Hospital for Children
Vietnam National Institute of Ophthalmology
University of the Free Sate
Ispahani Islamia Eye Institute and Hospital
Mahak Hospital
Hospital del Niño Dr. Francisco de Icaza Bustamante
Medical Academy of Postgraduate Education
Kunming Children's Hospital
Mulago National Referral Hospital
National Cancer Center of Uzbekistan
Kabgayi Eye Unit
Université Adam Barka
University Eye Clinic
National Eye Center Kaduna
National Ophthalmological Institute of Angola
University School of Medicine
Assistante Hospitalo Universitaire
Africa Institute of Tropical Ophtalmology
Pediatra Hemato-Oncologa
Ruharo Eye Hospitalrara
Corresponding Author(s)
Other Contributor(s)
Abstract
Purpose: To describe presentation, treatment and outcomes for a cohort of children presenting with retinoblastoma (Rb) throughout Europe during 2017. Methods: A prospective analysis of 483 patients diagnosed in Europe between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Results: Unilateral cases 339/483 (70%) predominated, presenting older (mean age 26 months) than the 144 (30%) bilateral cases (mean age 12 months p < 0.0005). Only 4/477 (0.8%) children had extra-ocular Rb at presentation (mean age 53 months vs 21 months for those without p = 0.002). Children from middle income countries did not present older, but were more likely (p < 0.001) to present with late-stage disease (3-4) than high-income children (74/151 (49%) vs 108/332 (33%), RR 1.25 95%CI 1.09–1.44). For unilaterals, primary treatment was intravenous chemotherapy (IVC) in 29% and intra-arterial chemotherapy (IAC) in 20%. For bilaterals, primary treatment was IVC in 113/144 (78%) and IAC in 14/144 (10%). Overall, 58% of children underwent enucleation, 36% of which as primary treatment. Risk of enucleation was determined by stage and laterality, but not economic status. Twelve (2.5%) children died from Rb. More children (OR = 146-7 13.9–1549.4, p < 0.0005) presenting with extra-ocular tumour died (3 of 4 (75%)) than with intra-ocular tumour (9/449 (2%)) More children (OR = 29.8 3.8–232.0, p < 0.0005), from middle income countries died from Rb (11/132 (8%)) than from high income countries (1/327 (0.3%)). Conclusion: Even within a wealthy continent such as Europe, economic factors may influence survival, but not global salvage rates. The majority of children still lose an eye.