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

Abstract Objective To evaluate the efficacy of integrating telemedicine-based twinning partnership and centralized care for Retinoblastoma (RB) on survival and eye salvage. Design A cohort of 478 RB patients from 2003 to 2019 treated at tertiary referral cancer center (King Hussein Cancer Centre, KHCC). Participants 478 RB patients who were treated at KHCC after implementing a telemedicine-based program with St. Jude Children’s Research Hospital. Methods We reviewed the outcomes of RB patients who were treated at King Hussein Cancer Centre (KHCC) after implementing a telemedicine-based eye salvage program with St. Jude Children’s Research Hospital, and we compared that with outcomes for RB patients who were treated before implementing a telemedicine-based RB service at KHCC. Main Outcome Measures We analyzed patient demographics, clinical characteristics, treatments received, consultation type and duration, and long-term patient outcomes before and after implementing the twinning program. Results Over 17 years, 813 eyes from 478 children with RB were treated at KHCC, 335(70%) patients had bilateral disease, and family history of RB was positive in 6(4%) of unilateral cases, and in 66(20%) of bilateral cases. After the twinning program was established in 2003, the mortality rate decreased from 38% to 5%(P  Conclusions Centralization of care at a single center in developing countries can achieve patient outcomes comparable with those of developed countries via twinning and telemedicine. This benefit can extend to a large region because two thirds of patients treated at KHCC were non-Jordanians.