Retinoblastoma classification: Difference between revisions
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==== Intraocular [[Classification|Classifications]] of Retinoblastoma and their [[Features (pattern recognition)|Features]] ==== | ==== Intraocular [[Classification|Classifications]] of Retinoblastoma and their [[Features (pattern recognition)|Features]] ==== | ||
{| border="3" | {| border="3" | ||
! | ! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF}} !! style="background: #4479BA; width: 600px;" | {{fontcolor|#FFF|International Intraocular Retinoblastoma Classification (IIRC)}} !! style="background: #4479BA; width: 600px;" | {{fontcolor|#FFF|Intraocular Classification of Retinoblastoma (ICRB)}} | ||
|- | |- | ||
! Group A | ! style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Group A | ||
(very low | (very low | ||
risk) | risk) | ||
| | |style="padding: 5px 5px; background: #F5F5F5; | | ||
* Small [[Retina|intraretinal]] [[tumors]] away from foveola and [[optic nerve]] | * Small [[Retina|intraretinal]] [[tumors]] away from foveola and [[optic nerve]] | ||
* 3mm or smaller in the greatest dimension, confined to the [[retina]] | * 3mm or smaller in the greatest dimension, confined to the [[retina]] | ||
* Located > 3 mm from the [[Foveola suprameatica|foveola]] and 1.5 mm from the [[optic disc]] | * Located > 3 mm from the [[Foveola suprameatica|foveola]] and 1.5 mm from the [[optic disc]] | ||
| | |style="padding: 5px 5px; background: #F5F5F5; | | ||
* [[Tumors]] ≤ 3 mm (in basal dimension or thickness) | * [[Tumors]] ≤ 3 mm (in basal dimension or thickness) | ||
|- | |- | ||
!Group B | !style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Group B | ||
(low risk) | (low risk) | ||
| | |style="padding: 5px 5px; background: #F5F5F5; | | ||
* [[Tumors]] confined to the [[retina]] | * [[Tumors]] confined to the [[retina]] | ||
* Not in group A | * Not in group A | ||
* [[Tumor]]-associated [[Retina|subretinal]] fluid less than 3 mm from the [[tumor]] with no [[Retina|subretinal]] seeding | * [[Tumor]]-associated [[Retina|subretinal]] fluid less than 3 mm from the [[tumor]] with no [[Retina|subretinal]] seeding | ||
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* [[Tumors]] > 3 mm (in basal dimension or thickness) or | * [[Tumors]] > 3 mm (in basal dimension or thickness) or | ||
* [[Macular]] location (≤ 3 mm to [[Foveola suprameatica|foveola]]) | * [[Macular]] location (≤ 3 mm to [[Foveola suprameatica|foveola]]) | ||
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* Additional [[Retina|subretinal]] fluid (≤3 mm from margin) | * Additional [[Retina|subretinal]] fluid (≤3 mm from margin) | ||
|- | |- | ||
! Group C | ! style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Group C | ||
(moderate | (moderate | ||
risk) | risk) | ||
| | |style="padding: 5px 5px; background: #F5F5F5; | | ||
* Local [[disease]] with minimal [[Retina|subretinal]] or [[vitreous]] seeding with the following characteristics: | * Local [[disease]] with minimal [[Retina|subretinal]] or [[vitreous]] seeding with the following characteristics: | ||
** Discrete | ** Discrete | ||
| Line 50: | Line 50: | ||
** Local fine [[vitreous]] seeding may be present close to the discrete [[tumor]] | ** Local fine [[vitreous]] seeding may be present close to the discrete [[tumor]] | ||
** Local [[Retina|subretinal]] seeding less than 3 mm (2 DD) from the [[tumor]] | ** Local [[Retina|subretinal]] seeding less than 3 mm (2 DD) from the [[tumor]] | ||
| | |style="padding: 5px 5px; background: #F5F5F5; | | ||
* [[Tumor]] with: | * [[Tumor]] with: | ||
** [[Retina|Subretinal]] seeds ≤ 3 mm from [[tumor]] | ** [[Retina|Subretinal]] seeds ≤ 3 mm from [[tumor]] | ||
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** Both [[Retina|subretinal]] and [[vitreous]] seeds ≤ 3 mm from the [[tumor]] | ** Both [[Retina|subretinal]] and [[vitreous]] seeds ≤ 3 mm from the [[tumor]] | ||
|- | |- | ||
!Group D | !style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Group D | ||
(high risk) | (high risk) | ||
| | |style="padding: 5px 5px; background: #F5F5F5; | | ||
* Diffuse [[tumor]] with significant [[vitreous]] or [[Retina|subretinal]] seeding | * Diffuse [[tumor]] with significant [[vitreous]] or [[Retina|subretinal]] seeding | ||
* Maybe massive or diffuse | * Maybe massive or diffuse | ||
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* The diffuse or massive [[vitreous]] [[disease]] may include “greasy” seeds or [[avascular]] [[tumor]] [[Mass|masses]] | * The diffuse or massive [[vitreous]] [[disease]] may include “greasy” seeds or [[avascular]] [[tumor]] [[Mass|masses]] | ||
* Diffuse [[Retina|subretinal]] seeding may include [[Retina|subretinal]] plaques or [[tumor]] [[Nodule (medicine)|nodules]] | * Diffuse [[Retina|subretinal]] seeding may include [[Retina|subretinal]] plaques or [[tumor]] [[Nodule (medicine)|nodules]] | ||
| | |style="padding: 5px 5px; background: #F5F5F5; | | ||
* [[Tumor]] with: | * [[Tumor]] with: | ||
** [[Retina|Subretinal]] seeds > 3 mm from [[tumor]] | ** [[Retina|Subretinal]] seeds > 3 mm from [[tumor]] | ||
| Line 70: | Line 70: | ||
** Both [[Retina|subretinal]] and [[vitreous]] seeds > 3 mm from retinoblastoma | ** Both [[Retina|subretinal]] and [[vitreous]] seeds > 3 mm from retinoblastoma | ||
|- | |- | ||
!Group E | !style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Group E | ||
(very high | (very high | ||
risk) | risk) | ||
| | |style="padding: 5px 5px; background: #F5F5F5; | | ||
* Presence of any one or more of the following poor [[prognosis|prognostic]] [[Features (pattern recognition)|features]]: | * Presence of any one or more of the following poor [[prognosis|prognostic]] [[Features (pattern recognition)|features]]: | ||
** [[Tumor]] touching the [[lens]] | ** [[Tumor]] touching the [[lens]] | ||
| Line 82: | Line 82: | ||
** [[Tumor]] [[necrosis]] with [[aseptic]] [[orbital cellulitis]] | ** [[Tumor]] [[necrosis]] with [[aseptic]] [[orbital cellulitis]] | ||
** [[Phthisis bulbi]] | ** [[Phthisis bulbi]] | ||
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* Extensive [[tumor]] filling >50% globe or with<br>[[neovascular glaucoma]] | * Extensive [[tumor]] filling >50% globe or with<br>[[neovascular glaucoma]] | ||
* Opaque media from [[hemorrhage]] in the [[anterior chamber]], [[vitreous]], or [[Retina|subretinal]] space | * Opaque media from [[hemorrhage]] in the [[anterior chamber]], [[vitreous]], or [[Retina|subretinal]] space | ||
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|} | |} | ||
=== Reese-Ellsworth [[Classification]] for Intraocular [[ | === Reese-Ellsworth [[Classification]] for Intraocular [[Tumors]]<ref name="pmid15763190">{{cite journal |vauthors=Linn Murphree A |title=Intraocular retinoblastoma: the case for a new group classification |journal=Ophthalmol Clin North Am |volume=18 |issue=1 |pages=41–53, viii |date=March 2005 |pmid=15763190 |doi=10.1016/j.ohc.2004.11.003 |url=}}</ref> === | ||
*This [[classification]] system was first introduced in 1960 and used to predict the chance of salvaging the [[eye]] after [[external beam radiotherapy]]. | *This [[classification]] system was first introduced in 1960 and used to predict the chance of salvaging the [[eye]] after [[external beam radiotherapy]]. | ||
*However, following the introduction of [[chemotherapy]] for retinoblastoma treatment, it lost its significance. | *However, following the introduction of [[chemotherapy]] for retinoblastoma treatment, it lost its significance. | ||
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{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Medicine]] | [[Category:Medicine]] | ||
[[Category:Oncology]] | [[Category:Oncology]] | ||
[[Category:Up-To-Date]] | [[Category:Up-To-Date]] | ||
[[Category:Surgery]] | [[Category:Surgery]] | ||
Latest revision as of 15:26, 17 January 2021
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Retinoblastoma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Retinoblastoma classification On the Web |
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American Roentgen Ray Society Images of Retinoblastoma classification |
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Risk calculators and risk factors for Retinoblastoma classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2] Simrat Sarai, M.D. [3]
Overview
There are several classification systems available for retinoblastoma. As the treatment of the tumor has evolved, a new classification system has been introduced. For intraocular disease, the available grouping systems include International Intraocular Retinoblastoma Classification (IIRC), Intraocular Classification of Retinoblastoma (ICRB), and cTNMH systems. For extraocular disease, the International Retinoblastoma Staging System (IRSS) and cTNMH schemes can be used.
Classification
- Retinoblastoma has been classified according to different classification systems for variable purposes.[1]
- Each classification system has been developed depending on the change in the management of the tumor.
- For treatment purposes, retinoblastoma is classified into:
Intraocular Retinoblastoma Classification System
- This classification system incudes the following:
Intraocular Classifications of Retinoblastoma and their Features
| International Intraocular Retinoblastoma Classification (IIRC) | Intraocular Classification of Retinoblastoma (ICRB) | |
|---|---|---|
| Group A
(very low risk) |
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| Group B
(low risk) |
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| Group C
(moderate risk) |
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| Group D
(high risk) |
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| Group E
(very high risk) |
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Reese-Ellsworth Classification for Intraocular Tumors[5]
- This classification system was first introduced in 1960 and used to predict the chance of salvaging the eye after external beam radiotherapy.
- However, following the introduction of chemotherapy for retinoblastoma treatment, it lost its significance.
Reese-Ellsworth Classification[6]
| Stage | Sub-stage | Features | Prognosis |
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| Group I |
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| Group II |
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| Group III |
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| Group IV |
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| Group V |
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Extra-ocular Retinoblastoma Classification System
- To see the full staging system click here.
References
- ↑ Chantada GL, Sampor C, Bosaleh A, Solernou V, Fandiño A, de Dávila MT (September 2013). "Comparison of staging systems for extraocular retinoblastoma: analysis of 533 patients". JAMA Ophthalmol. 131 (9): 1127–34. doi:10.1001/jamaophthalmol.2013.260. PMID 23787805.
- ↑ Shields CL, Mashayekhi A, Au AK, Czyz C, Leahey A, Meadows AT, Shields JA (December 2006). "The International Classification of Retinoblastoma predicts chemoreduction success". Ophthalmology. 113 (12): 2276–80. doi:10.1016/j.ophtha.2006.06.018. PMID 16996605.
- ↑ Zage PE, Reitman AJ, Seshadri R, Weinstein JL, Mets MB, Zeid JL, Greenwald MJ, Strauss LC, Goldman S (March 2008). "Outcomes of a two-drug chemotherapy regimen for intraocular retinoblastoma". Pediatr Blood Cancer. 50 (3): 567–72. doi:10.1002/pbc.21301. PMID 17729249.
- ↑ Novetsky DE, Abramson DH, Kim JW, Dunkel IJ (March 2009). "Published international classification of retinoblastoma (ICRB) definitions contain inconsistencies--an analysis of impact". Ophthalmic Genet. 30 (1): 40–4. doi:10.1080/13816810802452168. PMID 19172510.
- ↑ Linn Murphree A (March 2005). "Intraocular retinoblastoma: the case for a new group classification". Ophthalmol Clin North Am. 18 (1): 41–53, viii. doi:10.1016/j.ohc.2004.11.003. PMID 15763190.
- ↑ Murphree, A. Linn; Chantada, Guillermo L. (2015). "Retinoblastoma: Staging and Grouping": 29–37. doi:10.1007/978-3-662-43451-2_3.
- ↑ "TNM8: The updated TNM classification for retinoblastoma". Community Eye Health. 31 (101): 34. 2018. PMC 5998398. PMID 29915471.