A 30-month prospective study on the treatment of retinoblastoma in the Gabriel Toure Teaching Hospital, Bamako, Mali.

Abstract

Retinoblastoma is one of the most common malignant tumours among children in Africa. However, very few studies on this disease have been published, especially studies from French-speaking countries in Africa. Prospective study over a period of 30 months from 1 January 2005 to 30 June 2007 on all cases of retinoblastoma diagnosed and treated in the Paediatric Oncology Unit of the Gabriel Touré Hospital in Bamako, Mali. Treatment was two courses of pre-operative chemotherapy (cyclophosphamide, adriamycine and vincristine), enucleation for many patients, and then two courses of adjuvant chemotherapy with the same drugs. During the study period, 55 cases of retinoblastoma were treated, which represents 33.1% of all the solid tumours, coming second in frequency after lymphomas (39.7%). The mean age of the patients was 4.2 years. Boys were the most affected, with a sex ratio of 2:1. Forty-nine mothers (89.1%) and 46 fathers (83.6%) had no formal education. Thirty-seven children (67.3%) were from rural areas. Unilateral cases were predominant (49 cases (89.1%)). Ten cases (10.9%) were bilateral. Exophthalmos was the leading symptom (30 cases (54.5%)). The survival rate at 30 months was 56% with 18% lost at follow-up. Mortality as a result of retinoblastoma remains high in our region because diagnosis is always late and it is difficult to follow-up the patients. Education of healthcare workers and raising awareness in the general population would improve the survival rate of retinoblastoma patients in Africa.