TY - JOUR
T1 - Histopathologic grading of anaplasia in retinoblastoma
AU - Mendoza, Pia R.
AU - Specht, Charles
AU - Hubbard, G. Baker
AU - Wells, Jill R.
AU - Lynn, Michael J.
AU - Zhang, Qing
AU - Kong, Jun
AU - Grossniklaus, Hans E.
N1 - Publisher Copyright:
© 2015 Elsevier Inc. All Rights Reserved.
PY - 2015/4/1
Y1 - 2015/4/1
N2 - Purpose To determine whether the degree of tumor anaplasia has prognostic value by evaluating its correlation with high-risk histopathologic features and clinical outcomes in a series of retinoblastoma patients. Design Retrospective clinicopathologic study. Methods The clinical and pathologic findings in 266 patients who underwent primary enucleation for retinoblastoma were reviewed. The histologic degree of anaplasia was graded as retinocytoma, mild, moderate, or severe as defined by increasing cellular pleomorphism, number of mitoses, nuclear size, and nuclear hyperchromatism. Nuclear morphometric characteristics were measured. The clinical and pathologic data of 125 patients were compared using Kaplan-Meier estimates of survival. Fisher exact test and multivariate regression were used to analyze the association between anaplasia grade and high-risk histologic features. Results Increasing grade of anaplasia was associated with decreased overall survival (P =.003) and increased risk of metastasis (P =.0007). Histopathologic features that were associated with anaplasia included optic nerve invasion (P <.0001), choroidal invasion (P <.0001), and anterior segment invasion (P =.04). Multivariate analysis considering high-risk histopathology and anaplasia grading as predictors of distant metastasis and death showed that high-risk histopathology was statistically significant as an independent predictor (P =.01 for metastasis, P =.03 for death) but anaplasia was not (P =.63 for metastasis, P =.30 for death). In the absence of high-risk features, however, severe anaplasia identified an additional risk for metastasis (P =.0004) and death (P =.01). Conclusion Grading of anaplasia may be a useful adjunct to standard histopathologic criteria in identifying retinoblastoma patients who do not have high-risk histologic features but still have an increased risk of metastasis and may need adjuvant therapy.
AB - Purpose To determine whether the degree of tumor anaplasia has prognostic value by evaluating its correlation with high-risk histopathologic features and clinical outcomes in a series of retinoblastoma patients. Design Retrospective clinicopathologic study. Methods The clinical and pathologic findings in 266 patients who underwent primary enucleation for retinoblastoma were reviewed. The histologic degree of anaplasia was graded as retinocytoma, mild, moderate, or severe as defined by increasing cellular pleomorphism, number of mitoses, nuclear size, and nuclear hyperchromatism. Nuclear morphometric characteristics were measured. The clinical and pathologic data of 125 patients were compared using Kaplan-Meier estimates of survival. Fisher exact test and multivariate regression were used to analyze the association between anaplasia grade and high-risk histologic features. Results Increasing grade of anaplasia was associated with decreased overall survival (P =.003) and increased risk of metastasis (P =.0007). Histopathologic features that were associated with anaplasia included optic nerve invasion (P <.0001), choroidal invasion (P <.0001), and anterior segment invasion (P =.04). Multivariate analysis considering high-risk histopathology and anaplasia grading as predictors of distant metastasis and death showed that high-risk histopathology was statistically significant as an independent predictor (P =.01 for metastasis, P =.03 for death) but anaplasia was not (P =.63 for metastasis, P =.30 for death). In the absence of high-risk features, however, severe anaplasia identified an additional risk for metastasis (P =.0004) and death (P =.01). Conclusion Grading of anaplasia may be a useful adjunct to standard histopathologic criteria in identifying retinoblastoma patients who do not have high-risk histologic features but still have an increased risk of metastasis and may need adjuvant therapy.
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U2 - 10.1016/j.ajo.2014.12.014
DO - 10.1016/j.ajo.2014.12.014
M3 - Article
C2 - 25528954
AN - SCOPUS:84924901153
SN - 0002-9394
VL - 159
SP - 764-776.e3
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
IS - 4
ER -