{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T16:55:20Z","timestamp":1781801720468,"version":"3.54.5"},"reference-count":31,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ocul Oncol Pathol"],"abstract":"<jats:p>Introduction: Retinoblastoma (Rb) is a rare but aggressive pediatric eye cancer. This study aimed to examine its epidemiological characteristics, diagnostic stages, and survival factors in Kazakhstan, where national-level data have previously been limited. Methods: A retrospective national registry study was conducted using data from the Scientific Center for Pediatrics and Pediatric Surgery, the country\u2019s referral center for Rb (2015\u20132024). Incidence was calculated using a birth cohort approach per 100,000 live births. Demographic and clinical characteristics, including diagnostic intervals (lag time 1: symptom onset to diagnosis; lag time 2: diagnosis to treatment initiation), were analyzed. Survival was estimated using Kaplan-Meier methods. Prognostic factors were assessed using univariate and multivariable Cox proportional hazards regression. Results: A total of 167 cases were recorded. The cumulative birth cohort incidence was 4.18 per 100,000 live births (1:23,915). Median age at diagnosis was 14 months (IQR: 6.5\u201327.5). Unilateral disease occurred in 78.4% of patients, and 76.9% were diagnosed at advanced stages (D or E). Extraocular involvement was observed in 9.8% of affected eyes. Hereditary Rb accounted for 6% of cases. Median lag time 1 was 60 days (IQR: 30\u2013120), and median lag time 2 was 12 days (IQR: 7\u201320). Overall mortality was 11.4%, with most deaths occurring within 18 months. Older age at diagnosis (adjusted HR: 1.031; 95% CI: 1.008\u20131.054; p = 0.009) and longer lag time 2 (adjusted HR: 1.006; 95% CI: 1.004\u20131.008; p &lt; 0.001) were independently associated with increased mortality. Conclusion: Rb in Kazakhstan remains characterized by a high proportion of advanced-stage disease and measurable early mortality. Delays in treatment initiation and older age at diagnosis independently predict poorer survival, underscoring the need to strengthen early detection and optimize care pathways.<\/jats:p>","DOI":"10.1159\/000551899","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:03:24Z","timestamp":1777392204000},"page":"1-9","source":"Crossref","is-referenced-by-count":0,"title":["Retinoblastoma in Kazakhstan: Incidence Trends and Survival Analysis 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