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

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. 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. 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. 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.