Cultivating consciousness with science

El proyecto Cultivando Consciencia con Ciencia propone el establecimiento de una granja agroecológica en la comunidad educativa de la Escuela N° 263 Provincia de Catamarca, del Barrio El Molino de la Ciudad de Belén, Departamento Belén, Provincia de Catamarca. Avances en su implementación demostraron oportunidades de aprendizaje combinando contenidos de primer y segundo ciclo de la educación formal con la producción de alimentos en una granja agroecológica, la formación en valores ecológicos y el trabajo en equipo. Para los actores involucrados en el proyecto, el espacio que se construye permite vivenciar valiosas experiencias. Docentes investigadores junto a estudiantes avanzados de Agronomía y becarios intervienen con acciones de capacitación teórico-prácticas para la elaboración de secuencias didácticas que estimule el aprendizaje científico basado en la indagación, permitiendo al capacitando explorar, descubrir y desarrollar nuevos conocimientos aplicados a necesidades concretas de su contexto. En estas instancias, la difusión de información científico técnica crea condiciones que asegura que se enseñe lo que se necesita, que lo enseñado se aprenda y que lo aprendido sea transferido a otros problemas.The project “Cultivating consciousness with science” proposes locating an agroecological farm in the educational community of School N° 263 Province of Catamarca, District El Molino, Belén Department, Province of Catamarca. Developments in its implementation proved learning opportunities by combining contents of first and second cycle of formal education with food production in an agroecological farm, as well as training in ecology values and teamwork. For the actors participating in the project, the space built provides valuable experiences. Teachers-researchers together with advanced agronomy students and scholarships play an important role through theoretical-practical training actions for the elaboration of didactic sequences that stimulate scientific learning based on research. This allows students to explore, discover and develop new knowledge applied to their contextual specific needs. In this context, technical scientific knowledge dissemination creates conditions to ensure the teaching of what is needed by students. Also, to promote learning and knowledge and their transfer to other problems.Fil: Denett, Gabriel Omar. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Catamarca. Facultad de Ciencias Agrarias; ArgentinaFil: Barros, Lucas Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Catamarca. Facultad de Ciencias Agrarias; ArgentinaFil: Denett, Yanina Lorena. Universidad Nacional de Catamarca. Facultad de Ciencias Agrarias; ArgentinaFil: Espeche, Lucas Javier. Universidad Nacional de Catamarca. Facultad de Ciencias Agrarias; ArgentinaFil: Campos Olmos, María Virginia. Universidad Nacional de Catamarca. Facultad de Ciencias Agrarias; ArgentinaFil: Lencina, Sibila Ivonne. Universidad Nacional de Catamarca. Facultad de Ciencias Agrarias; ArgentinaFil: Soria, Rosana R.. Universidad Nacional de Catamarca. Facultad de Ciencias Agrarias; ArgentinaFil: Mohamed, Carolina B.. Universidad Nacional de Catamarca. Facultad de Ciencias Agrarias; ArgentinaFil: Salas, Monica Delia. Universidad Nacional de Catamarca. Facultad de Ciencias Agrarias; ArgentinaFil: Cisterna Fernandez, Maria Ines. Universidad Nacional de Catamarca. Facultad de Tecnología y Cs.aplicadas. Departamento de Formación Basica; ArgentinaFil: Ortiz, Erlinda del Valle. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Catamarca. Facultad de Tecnología y Ciencias Aplicadas; Argentina. Universidad Nacional de Catamarca. Facultad de Tecnología y Ciencias Aplicadas. Instituto de Monitoreo y Control de la Degradación Geoambiental; ArgentinaFil: Comelli, Nieves Carolina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro de Investigaciones y Transferencia de Catamarca. Universidad Nacional de Catamarca. Centro de Investigaciones y Transferencia de Catamarca; Argentina. Universidad Nacional de Catamarca. Facultad de Ciencias Agrarias; Argentin

Global Retinoblastoma Presentation and Analysis by National Income Level.

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

The global retinoblastoma outcome study : a prospective, cluster-based analysis of 4064 patients from 149 countries

DATA SHARING : The study data will become available online once all analyses are complete.BACKGROUND : Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. METHODS : We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. FINDINGS : The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). INTERPRETATION : This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes.The Queen Elizabeth Diamond Jubilee Trust and the Wellcome Trust.https://www.thelancet.com/journals/langlo/homeam2023Paediatrics and Child Healt

¿Es posible el diagnóstico de la neoplasia folicular no invasiva con características nucleares de tipo de carcinoma papilar de tiroides (NIFTP) en nuestro medio?

Introducción: La variante folicular encapsulada no invasiva del carcinoma papilar detiroides (CPT) se re-clasificó como neoplasia folicular de tiroides no invasiva concaracterísticas nucleares de tipo papilar (NIFTP). Estos tumores se consideran comoneoplasias de muy bajo potencial maligno, con riesgo casi nulo de recurrencia ymortalidad. Objetivos: i) valorar la prevalencia de NIFTP en pacientes con CPT, ii) evaluar laevolución de los mismos y, iii) determinar las alteraciones moleculares halladas en estetipo de neoplasia.Materiales y Métodos: Estudio multicéntrico retrospectivo, observacional,longitudinal, que incluyó a pacientes con diagnóstico de CPT mayores de 18 añospertenecientes a 11 centros asistenciales de Argentina, diagnosticados entre el 1 deenero de 2006 y el 31 de diciembre de 2016. El diagnóstico de NIFTP se efectuó segúnlos criterios referidos por Nikiforov en el año 2016 y fue confirmado por al menos dospatólogos. Se incluyeron 2677 muestras de pacientes con diagnóstico de carcinomapapilar de tiroides. De estos, 612 (22%) fueron carcinoma papilar variante folicular y33 (1,23%) reunieron criterios diagnósticos de NIFTP. Resultados: De las 2677 muestras analizadas, se diagnosticó NIFTP en 33 pacientes(1,23%), el total de pacientes evaluados habían sido tratados con tiroidectomía total y el51% recibió ablación con radioyodo (mediana 100 mCi). Ningún paciente presentómetástasis ganglionares, a distancia, o necesidad de re-intervención quirúrgica. Luegode un seguimiento promedio de 30,5 meses, la respuesta final se consideró excelente enel 82% y 3% presentó una respuesta indeterminada. En 5 casos (15%) no huboseguimiento para establecer respuesta. Se observaron mutaciones de RAS en 4 (17%) yde BRAF V600E en 3 (13%). Conclusiones: La prevalencia de NIFTP en esta serie se encuentra dentro de las másbajas reportadas. La respuesta excelente al tratamiento en la mayoría de pacientes conseguimiento confirma el carácter indolente de estos tumores. Los hallazgos molecularesdifieren de lo publicado, lo que podría deberse a particularidades geográficas y/o étnicas.Introduction: Non-invasive encapsulated follicular variant of papillary thyroid cancer was reclassified as non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) in 2016. These neoplasms have an extremely low potential of malignancy. Objectives: i) to assess the prevalence of NIFTP in patients with papillary thyroid carcinoma, ii) to evaluate their outcomes and iii) to determine their molecular profile. Materials and methods: Multicenter, descriptive, retrospective study. Patients from 11 referral centers with papillary thyroid cancer diagnosed from January 2006 to December 2016 were included. Diagnosis of NIFTP was based on criteria described by Nikiforov in 2016. At least two pathologists agreed on the diagnosis. Two thousand six hundred and seventy seven patients with papillary thyroid cancer were included; 612 (22%) of them were follicular variant papillary thyroid cancer, and 33 (1.23%) were classified as NIFTP. Results: Thirty three patients (1.23%) fulfilled diagnostic criteria for NIFTP. All patients underwent total thyroidectomy, and 51% were treated with radioiodine (median dose 100 mCi). No metastatic lymph nodes, distant metastases or recurrences were found. After a mean follow up of 30.5 months, 82% of patients had an excellent response, 3% had an indeterminate response and data was missing in the remaining 15%. RAS mutations were detected in 4 patients (17%) and BRAF V600E in 3 (13%). Discussion: The prevalence of NIFTP in our series is among the lowest reported. Excellent outcomes of patients underscore their low malignant potential. However, molecular findings differ from other series, which may be related to environmental or ethnic features of our population.Fil: Saban, Melina. Hospital Británico de Buenos Aires; ArgentinaFil: Orlandi, Ana Maria. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Dr. Teodoro Álvarez"; ArgentinaFil: Deutsch, Susana I. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Juan A. Fernández"; ArgentinaFil: Pitoia, Fabián. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Lowenstein, Alicia Edita. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Ramos Mejía"; ArgentinaFil: Calabrese, M. C.. Gobierno de la Ciudad Autónoma de Buenos Aires. Hospital General de Agudos Carlos Durand; ArgentinaFil: Cavallo, Andrea. Hospital de Alta Complejidad de Formosa; ArgentinaFil: Lotti, Alejandro. Hospital Británico de Buenos Aires; ArgentinaFil: Mosnteros Albi, M.. Hospital Dr. Arturo Oñativia - Salta Capital.; ArgentinaFil: Tolaba, N. Hospital Dr. Arturo Oñativia - Salta Capital.; ArgentinaFil: Nallar Dera, Marcelo. Hospital Dr. Arturo Oñativia - Salta Capital.; ArgentinaFil: Jaen, A.. Hospital Italiano; ArgentinaFil: Figurelli, Silvina. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Juan A. Fernández"; ArgentinaFil: Carrizo, F.. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Oncología "Ángel H. Roffo"; ArgentinaFil: Colobraro, A.. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Ramos Mejía"; ArgentinaFil: Garcia Tascon, G.. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Dr. Teodoro Álvarez"; ArgentinaFil: Saccoliti, M.. Gobierno de la Ciudad Autonoma de Buenos Aires. Hospital General de Agudos Carlos Durand.; ArgentinaFil: Paes de Lima, A.. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Lencioni, María Julia. Hospital de Alta Complejidad de Formosa; ArgentinaFil: Califano, Ines. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Oncología "Ángel H. Roffo"; ArgentinaFil: Cabezon, C.. Hospital Italiano; ArgentinaFil: Abelleira, E.. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Alcaraz, G.. Hospital Privado Universitario de Córdoba; ArgentinaFil: Brenta, Gabriela. Hospital Cesar Milstein; ArgentinaFil: Bielski, Laila. Sanatorio Guemes Sociedad Anonima.; ArgentinaFil: Castro Jozami, Lorena. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Juan A. Fernández"; ArgentinaFil: Corino, M.. Hospital Italiano; ArgentinaFil: Faure, Eduardo. Complejo Medico Policial Bartolome Churruca Andres Visca; ArgentinaFil: Frascaroli, G.. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Dr. Teodoro Álvarez"; ArgentinaFil: Gauna, Alicia Teresa. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Ramos Mejía"; ArgentinaFil: Guerra, Jorgelina. Universidad Austral. Hospital Universitario Austral; ArgentinaFil: Gutierrez, S.. Gobierno de la Ciudad Autonoma de Buenos Aires. Hospital General de Agudos Carlos Durand.; ArgentinaFil: Ilera, Veronica. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Ramos Mejía"; ArgentinaFil: Iorcansky, S.. Hospital Italiano; ArgentinaFil: Martinez, Maria Paz. Hospital Alemán; ArgentinaFil: Moldes, Sofia. Complejo Medico Policial Bartolome Churruca Andres Visca; ArgentinaFil: Negueruela, M.. Universidad Austral. Hospital Universitario Austral; ArgentinaFil: Oneto, A.. Gobierno de la Ciudad Autonoma de Buenos Aires. Hospital General de Agudos Carlos Durand.; ArgentinaFil: Parisi, Carina. Hospital Italiano; ArgentinaFil: Reyes, Adriana. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Ramos Mejía"; ArgentinaFil: Rosemblit, Cinthia. Pontificia Universidad Católica Argentina "Santa María de los Buenos Aires". Instituto de Investigaciones Biomédicas. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas; ArgentinaFil: Russo Picasso, Maria Fabiana. Hospital Italiano; ArgentinaFil: Salas, Monica Delia. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Sartorio, Mariana Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Biología Molecular y Celular de Rosario. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario; ArgentinaFil: Schnitman, M.. Hospital Italiano; ArgentinaFil: Sklate, Roxana. Hospital Tornu; ArgentinaFil: Croome, Silva. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Ramos Mejía"; ArgentinaFil: Storani, Maria Elena. Municipalidad de Vicente Lopez (buenos Aires); ArgentinaFil: Vazquez, A.. Gobierno de la Ciudad Autonoma de Buenos Aires. Hospital General de Agudos Carlos Durand.; ArgentinaFil: Zund, Santiago. Centro de Educaciones Médicas e Investigación Clínica "Norberto Quirno"; ArgentinaFil: Zunino, A.. Gobierno de la Ciudad de Buenos Aires; Argentin

The Global Retinoblastoma Outcome Study: a prospective, cluster-based analysis of 4064 patients from 149 countries

Background Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. Methods We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1,2017, and Dec 31,2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. Findings The cohort included 4064 children from 149 countries. The median age at diagnosis was 23.2 months (IQR 11.0-36.5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0.8%) of 636 children from high-income countries, 55 (5.4%) of 1027 children from upper-middle-income countries, 342 (19. 7%) of 1738 children from lower-middle-income countries, and 196 (42.9%) of 457 children from low-income countries. Enudeation surgery was available for all children and intravenous chemotherapy was available for 4014 (98.8%) of 4064 children. The 3-year survival rate was 99.5% (95% CI 98.8-100.0) for children from high-income countries, 91.2% (89.5-93.0) for children from upper-middle-income countries, 80.3% (78.3-82.3) for children from lower-middle-income countries, and 57.3% (524-63-0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16.67; 95% CI 4.76-50.00), cT4 advanced tumour compared to cT1 (8.98; 4.44-18.18), and older age at diagnosis in children up to 3 years (1.38 per year; 1.23-1.56). For children aged 3-7 years, the mortality risk decreased slightly (p=0.0104 for the change in slope). Interpretation This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.Y

Global Retinoblastoma Presentation and Analysis by National Income Level

This cross-sectional analysis reports the retinoblastoma stage at diagnosis across the world during a single year, investigates associations between clinical variables and national income level, and investigates risk factors for advanced disease at diagnosis. Key PointsQuestionIs the income level of a country of residence associated with the clinical stage of presentation of patients with retinoblastoma? FindingsIn this cross-sectional analysis that included 4351 patients with newly diagnosed retinoblastoma, approximately half of all new retinoblastoma cases worldwide in 2017, 49.1\% of patients from low-income countries had extraocular tumor at time of diagnosis compared with 1.5\% of patients from high-income countries. MeaningThe clinical stage of presentation of retinoblastoma, which has a major influence on survival, significantly differs among patients from low-income and high-income countries, which may warrant intervention on national and international levels. ImportanceEarly diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. ObjectivesTo report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and ParticipantsA total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and MeasuresAge at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. ResultsThe cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4\%) were female. Most patients (n=3685 {[}84.7\%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n=2638 {[}62.8\%]), followed by strabismus (n=429 {[}10.2\%]) and proptosis (n=309 {[}7.4\%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5\%) patients having intraocular retinoblastoma and 2 (0.3\%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1\%) having extraocular retinoblastoma and 94 of 498 (18.9\%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 {[}95\% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 {[}95\% CI, 4.30-7.68]). Conclusions and RelevanceThis study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs