How Telemedicine and Centralized Care Changed the Natural History of Retinoblastoma in a Developing Country: Analysis of 478 Patients

The Yousef et al. study has reviewed the outcomes of 478 retinoblastoma patients who were treated at King Hussein Cancer Centre after implementing a telemedicine-based eye salvage program with St. Jude Children’s Research Hospital and compared that with outcomes for retinoblastoma patients who were treated before implementing a telemedicine-based retinoblastoma service. After the twinning program was established in 2003, the mortality rate decreased from 38% to 5% (P < 0.0001), and the overall eye salvage rate increased from 4% to 61%. Initially, all cases were discussed via telemedicine, but as knowledge transfer increased, the proportion of cases that required discussion decreased to less than 3% 10 years later. Similarly, treatment changes based on consultations decreased from 70% to 7% after 10 years. Both survival and eye-salvage rates were comparable at the early and later stages of implementing the twinning program. At a median follow-up of 120 months, 5% of patients had died of metastases or secondary neoplasms, 81% were alive, and 14% were lost to follow-up. The study concludes that Centralization of care at a single center in developing countries can achieve patient outcomes comparable with those of developed countries via twinning and telemedicine.

Link to the paper on PubMed