To assess retinoblastoma epidemiological trends in the Surveillance, Epidemiology, and End Results (SEER) registry.
All cases of retinoblastoma in the SEER database from 1973–2009 were identified. Kaplan-Meier survival analyses were performed for pathological grade, patient age, gender, year of diagnosis, and treatment modality. Cox proportional hazards regression assessed the impact of patient and tumor characteristics on survival.
1,452 cases of retinoblastoma were analyzed. The mean patient age at diagnosis was 1.44 years. The tumor was unilateral in 71.0% or bilateral in 29.0%. The mean follow-up was 129.1 months. Overall survival increased during the study interval. Patients with bilateral tumors were diagnosed at an earlier age (0.46 years) than patients with unilateral disease (1.77 years; P < 0.0001). Bilateral retinoblastoma (90.3% 10-year overall survival) was associated with decreased overall survival than unilateral retinoblastoma (96.1% 10-year overall survival). Bilateral retinoblastoma was also associated with an increased incidence of non-ocular malignancies (7.8%) compared with unilateral retinoblastoma (1.3%; P < 0.0001). Grade 1 tumors were diagnosed at a younger age (0.94 years) than grade 3 (2.24 years) and grade 4 tumors (2.14 years; P < 0.0001). Lower grade and lower stage tumors were independently associated with increased survival. In multivariate Cox proportional hazards analysis, T stage and laterality were the only covariates that correlated with overall survival.