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LETTER TO EDITOR
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Year : 2011  |  Volume : 48  |  Issue : 3  |  Page : 371--372

Twenty-year trends of retinoblastoma under five hospital-based cancer registries: Few observations

V Khetan, S Sengupta 
 Department of Vitreoretina and Ocular Oncology, Medical Research Foundation, Sankara Nethralaya, Chennai, India

Correspondence Address:
V Khetan
Department of Vitreoretina and Ocular Oncology, Medical Research Foundation, Sankara Nethralaya, Chennai
India




How to cite this article:
Khetan V, Sengupta S. Twenty-year trends of retinoblastoma under five hospital-based cancer registries: Few observations.Indian J Cancer 2011;48:371-372


How to cite this URL:
Khetan V, Sengupta S. Twenty-year trends of retinoblastoma under five hospital-based cancer registries: Few observations. Indian J Cancer [serial online] 2011 [cited 2020 Sep 27 ];48:371-372
Available from: http://www.indianjcancer.com/text.asp?2011/48/3/371/84920


Full Text

Sir,

We read with interest the paper titled "Trend of reported cases of retinoblastoma under five hospital based cancer registries" by Sachdeva S. in your esteemed journal. [1] The initiative taken up by the Indian Council of Medical Research (ICMR) is commendable and should be applauded. In fact, from March 2009, ICMR has started a project called National Retinoblastoma Registry, the purpose of which is to try and capture all cases of retinoblastoma in the country. Presently, there are 10 centers in the registry, but it is expanding, and we intend to reach every nook and corner of the country.

However, we believe that in most instances retinoblastoma cases do not primarily report to cancer hospitals directly. These are treated largely by ophthalmologists and are referred to cancer hospitals only for the purpose of receiving chemotherapy or external beam radiotherapy. Eyes salvaged by treatment modalities like transpupillary thermotherapy, cryotherapy and those undergoing primary enucleation not requiring adjuvant chemotherapy do not reach these centers. Also, only a small percentage of eyes that undergo enucleation for retinoblastoma get referred to cancer hospitals after histopathological examination. Hence, it is evident that only a small proportion of retinoblastoma cases get referred to cancer hospitals. An estimate of total retinoblastoma cases from mere records of cancer hospitals would lead to under reporting in the incidence of this potentially lethal cancer.

For these reasons, retinoblastoma may in fact constitute a higher proportion of childhood cancers than that reported by the authors.

The authors should also specify the names and exact locations of the cancer registries in the cities mentioned. We are an ophthalmic tertiary care center catering to nearly 80-100 retinoblastoma cases every year, and have reported the clinical spectrum and treatment outcomes of a cohort of 488 eyes of 355 patients with retinoblastoma over a 14-year period (1990-2004). [2] However, we may not be referring our cases to these cancer registries leading to omission of our patient pool from the concerned studies.

In conclusion, we are of the opinion that the total number of retinoblastoma cases has been underestimated in this study.

References

1Sachdeva S. Trend of reported cases of retinoblastoma under five hospital based cancer registries. Indian J Cancer 2010;47:473-4.
2Shanmugam MP, Biswas J, Gopal L, Sharma T, Nizamuddin SH. The clinical spectrum and treatment outcome of retinoblastoma in Indian children. J Pediatr Ophthalmol Strabismus 2005;42:75-81.