Patient-related factors and clinical management outcomes of retinoblastoma in Calabar, Nigeria: A single-center, retrospective study

Background Retinoblastoma is curable in industrialized countries. However, it is associated with mortality in resource-poor nations due to disparities and poor access to eyecare. The aim was to determine the relationships between patient-related factors and clinical outcomes of retinoblastoma in a tertiary hospital in Nigeria. Material and methods This was a retrospective study of all children diagnosed and treated for retinoblastoma from January 2017 through December 2022. Information obtained from their records included bio-socioeconomic data, symptoms, lag time from initial symptoms, staging, treatment, and survival outcome. Results Fifty-three patients, aged 6–88 months on first hospital presentation were recruited. There were 29 (54.7%) females. Twenty (37.7%) patients died. Majority were last child of their parents (62.3%) with parental low socioeconomic class (86.8%) and lived in rural areas (50.9%). The median (interquartile) age at diagnosis [24 (18–36) months, p = 0.005] and lag time [13 (6–20)months, p = 0.274] were lower in those who survived than in those who died. The prevalence of bilateral disease (20.8%, p = 0.002), brain metastasis (22.6%, p < 0.001), stage IV disease (18.9%, p = 0.01) and relapse (34%, p < 0.001) was higher among the patients who died. The median (interquartile) overall survival (OS) was 22 (11.77–32.23)months with a 1-year OS of 63%. Treatment with only chemotherapy [HR 4.76 (95%CI:1.726–13.128)], incomplete chemotherapy [HR 5.61 (95%CI:1.271–24.741)], relapse [HR 5.98 (95%CI:1.376–25.983)] and eye surgery delayed after 3 chemotherapy cycles [HR 8.22 (95%CI:1.087–62.239)] were predictors of mortality. Conclusion Early presentation of retinoblastoma may lead to improved survival if chemotherapy and eye surgery are appropriately performed. Routine screening and immediate referral of retinoblastoma, particularly in rural areas, are recommended.