Management of retinoblastoma in children in Madagascar

Introduction: Retinoblastoma is the most common intraocular tumor in child. The treatment well codified combining chemotherapy, surgery, radiotherapy and conservative treatment. It involves both visual vital prognosis. aim of this study was to describe epidemiological aspect retinoblastoma evaluate therapeutic aspects evolution Madagascar.
 Method: We report retrospective 52 cases found during 5 years, from January 2010 December 2015. have collected information about clinical aspect. Delay diagnosis, done children evolution. Data with excel software analysis Epi info 7.0 software. quantitative variables were expressed as an average qualitative a proportion percentage.
 Result: had cases. incidence 10.4 per year. Mean age 3 no gender predominance. More than half or 53.8% (n=28) presented minor signs: including leucocoria 25 strabismus children. Exophthalmos 46.5% (n=24) Exophthalmia leukocoria associated 6 (10%) delay time before diagnosis 11 months 2 days. 39 pieces sent for examination. Result Anatomo-pathological was: 51% (n=20) undifferentiated retinoblastoma, 36% (n=14) differentiated 13% diffused (n=5) Optic nerve affected 7.69% (n=3). Before 55.8% (n=29) our patients received non-specialized medical 44.2% (n=23) used traditional Four primitive enucleation without first chemotherapy. Nine 18.75% didn’t surgical Neoadjuvant chemotherapy 92.3% (n = 48). enucleation. Only 58% adjuvant marked by 27% 14) remission, 21% 11) death 8% 4) recurrence. Twenty-three (44%) lost follow-up.
 Conclusion: Diagnosis made advanced stage. Number follow-up high. Treatment consist Prognosis worse Madagascar. Communication parents, personal must recommended reduce number follow-up.