Prognosis and survival for retinoblastoma

You may have questions about your child’s prognosis for retinoblastoma. A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with a child’s medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.

A prognostic factor is an aspect of the cancer or a characteristic of the child that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.

The following are prognostic and predictive factors for retinoblastoma.

Doctors use the stage of retinoblastoma to choose treatment and predict the outlook for a child. There are 3 staging systems that might be used for retinoblastoma.

The International Classification for Intraocular Retinoblastoma uses groupings to help predict the likelihood that the eye can be saved with current treatment options. Children in group A have the most favourable prognosis and are most likely to be able to see after treatment.

The Reese-Ellsworth staging system also uses groupings to help predict whether the child will be able to see after treatment. Children in group 1 (the very favourable stage) are most likely to be able to see after treatment.

The TNM staging system is based on tumour size and spread. The lower the stage of retinoblastoma, the better the expected outcome.

Children with retinoblastoma that has not spread outside the eye (intraocular retinoblastoma) have a better prognosis than children with retinoblastoma that has spread outside the eye (extraocular retinoblastoma) or to other parts of the body (metastatic retinoblastoma). Children with retinoblastoma that has spread to the brain and spinal cord (called the central nervous system, or CNS) often have a poorer prognosis.

Trilateral retinoblastoma is when pineoblastoma develops along with retinoblastoma in both eyes (called bilateral retinoblastoma). Pineoblastoma is a type of childhood brain tumour that occurs in the pineal gland. The pineal gland is a gland in the brain that controls the sleep cycle and plays a role in sexual maturation. Children with trilateral retinoblastoma often have a poorer prognosis.