Retinoblastoma: Staging and Grouping

A commonly used tumor classification is essential in order to plan initial treatment, determine prognosis, assess treatment response, compare outcomes, and plan clinical trials. Berman maintains that for tumor classifications to be successful, they must reflect clinical reality and must be changed as information is accrued. Almost never does the staging of the tumor rest solely with the subspecialty surgeon. It usually results from interaction between pathologists, oncologists, and the surgeon, often aided by a tissue biopsy. This is not the case for retinoblastoma, and currently, classification is based on clinical features, although the growing use of liquid biopsy may change this clinical paradigm. For almost all solid childhood malignancies, the survival of the patient is the sole endpoint against which to assess treatment efficacy and side effects. In retinoblastoma, effective salvage of the globe is a secondary endpoint.