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01-05-2015 | Original Article

Outcome in Neuroblastoma

Authors: Ali Aykan Ozguven, Sema Anak, Aysegul Unuvar, Arzu Akcay, Zeynep Karakas, Gulyuz Ozturk, Omer Devecioglu, Leyla Agaoğlu

Published in: Indian Journal of Pediatrics | Issue 5/2015

Abstract

Objective

To determine outcome of neuroblastoma (NBL) in children under 18 mo of age who had been treated with national protocols.

Methods

The characteristics and treatment outcomes of 27 children were evaluated retrospectively.

Results

The event-free survival (EFS) at 60 and 108 mo were 84.7 % ± 7.7 and 72.6 % ± 7.7, respectively. The overall survival (OS) was 91.7 % ± 8 at 108 mo. The only significant risk factor for OS in children with neuroblastoma was the treatment response at the end of therapy (p = 0.001). “Wait and see” policy was applied to two infants with low risk NBL and one infant with stage 4S neuroblastoma and all 3 of these infants have been in remission at last followup. Four of the five patients with MYCN-amplified neuroblastoma were alive at a median follow-up time of 54 mo (range: 5–108 mo).

Conclusions

The EFS and OS of the present group were similar to that of the previous series which included children under 18 mo of age with neuroblastoma. Well known prognostic factors did not affect EFS and OS significantly; this may be related to the retrospective design of the present study and the small number of patients reviewed. High survival rate in infants with MYCN-amplified tumors suggests the difference in the biology of infant neuroblastoma.

Cozzi DA, Mele E, Ceccanti S, Natale F, Clerico A, Schiavetti A, et al. Long-term follow-up of the “wait and see” approach to localized perinatal adrenal neuroblastoma. World J Surg. 2013;37:459–65.CrossRefPubMed

Kim S, Chung DH. Pediatric solid malignancies: neuroblastoma and Wilms’ tumor. Surg Clin N Am. 2006;86:469–87.CrossRefPubMed

Rubie H, Plantaz D, Coze C, Michon J, Frappaz D, Baranzelli MC, et al; Neuroblastoma Study Group, Société Française d’Oncologie Pédiatrique. Localised and unresectable neuroblastoma in infants: excellent outcome with primary chemotherapy. Neuroblastoma Study Group, Société Française d’Oncologie Pédiatrique. Med Pediatr Oncol. 2001;36:247–50.

Vermeulen J, De Preter K, Naranjo A, Vercruysse L, Van Roy N, Hellemans J, et al. Predicting outcomes for children with neuroblastoma using a multigene-expression signature: a retrospective SIOPEN/COG/GPOH study. Lancet Oncol. 2009;10:663–71.CrossRefPubMedCentralPubMed

Weinstein LJ, Katzenstein MH, Cohn LS. Advances in diagnosis and treatment of neuroblastoma. Oncologist. 2003;8:278–92.CrossRefPubMed

London WB, Castleberry RP, Matthay KK, Look AT, Seeger RC, Shimada H, et al. Evidence for an age cutoff greater than 365 d for neuroblastoma risk group stratification in the children’s oncology group. J Clin Oncol. 2005;23:6459–65.CrossRefPubMed

Rubie H, Hartmann O, Michon J, Frappaz D, Coze C, Chastagner P, et al. N-Myc gene amplification is a major prognostic factor in localized neuroblastoma: results of the French NBL 90 study. Neuroblastoma Study Group of the Société Francaise d’Oncologie Pédiatrique. J Clin Oncol. 1997;15:1171–82.PubMed

Bagatelle R, Beck-Popovic M, London WB, Zhang Y, Pearson AD, Matthay KK, et al. Significance of MYCN amplification in international neuroblastoma staging system stage 1 and 2 neuroblastoma: a report from the ınternational neuroblastoma risk group database. J Clin Oncol. 2009;27:365–70.CrossRef

Fritsch P, Kerbl R, Lackner H, Urban C. “Wait and see” strategy in localized neuroblastoma in infants: an option not only for cases detected by mass screening. Pediatr Blood Cancer. 2004;43:679–82.CrossRefPubMed

10.

Brodeur GM, Seeger RC, Barrett A, Berthold F, Castleberry RP, D’Angio G, et al. International criteria for diagnosis, staging, and response to treatment in patients with neuroblastoma. J Clin Oncol. 1988;6:1874–81.PubMed

11.

Yamamoto K, Hanada R, Kikuchi A, Ichikawa M, Aihara T, Oguma E, et al. Spontaneous regression of neuroblastoma detected by mass screening. J Clin Oncol. 1998;16:1265–9.PubMed

12.

Nishihira H, Toyoda Y, Tanaka Y, Ijiri R, Aida N, Takeuchi M, et al. Natural course of neuroblastoma detected by mass screening: a 5-year prospective study at a single institution. J Clin Oncol. 2000;18:3012–7.PubMed

13.

Kretschmar CS, Frantz CN, Rosen EM, Cassady JR, Levey R, Sallan SE. Improved prognosis for infants with stage IV neuroblastoma. J Clin Oncol. 1984;2:799–803.PubMed

14.

Horner MJ, Ries LA, Krapcho M, Neyman N. SEER Cancer Statistics Review, 1975–2006. Bethesda, Md: National Cancer Institute; 2009. Also available online.

15.

Kulkarni KP, Marwaha RK. Outcome of neuroblastoma in India. Indian J Pediatr. 2013;80:832–7.CrossRefPubMed

16.

Hero B, Simon T, Spitz R, Ernestus K, Gnekow AK, Scheel-Walter HG, et al. Localized infant neuroblastomas often show spontaneous regression: results of the prospective trials NB95-S and NB97. J Clin Oncol. 2008;26:1504–10.CrossRefPubMed

17.

George RE, London WB, Cohn SL, Maris JM, Kretschmar C, Diller L, et al. Hyperdiploidy plus nonamplified MYCN confers a favorable prognosis in children 12 to 18 mo old with disseminated neuroblastoma: A Pediatric Oncology Group study. J Clin Oncol. 2005;23:6466–73.CrossRefPubMed

18.

Schmidt ML, Lal A, Seeger RC, Maris JM, Shimada H, O’Leary M, et al. Favorable prognosis for patients 12 to 18 mo of age with stage 4 nonamplified MYCN neuroblastoma: A Children’s Cancer Group study. J Clin Oncol. 2005;23:6474–80.CrossRefPubMed

19.

Bowman LC, Castleberry RP, Cantor A, Joshi V, Cohn SL, Smith EI, et al. Genetic staging of unresectable metastatic neuroblastoma in infants: a pediatric oncology group study. J Natl Cancer Inst. 1997;89:373–80.CrossRefPubMed

20.

Nakagawa A, Matsuoka K, Okita H, Iwafuchi H, Hori H, Kumagai M. Neuroblastomas with discordant genotype-phenotype relationships: report of four cases with MYCN amplification and favorable histology. Pediatr Dev Pathol. 2011;14:87–92.CrossRefPubMed

21.

Tonini GP, Boni L, Pession A, Rogers D, Iolascon A, Basso G, et al. MYCN oncogene amplification in neuroblastoma is associated with worse prognosis, except in stage 4 s: the Italian experience with 295 children. J Clin Oncol. 1997;15:85–93.PubMed

22.

Bordow SB, Norris MD, Haber P, Marshall GM, Haber M. Prognostic significance of MYCN oncogene expression in childhood neuroblastoma. J Clin Oncol. 1998;16:3286–94.PubMed

23.

Gigliotti AR, Di Cataldo A, Sorrentino S, Parodi S, Rizzo A, Buffa P, et al. Neuroblastoma in the newborn. A study of the Italian neuroblastoma registry. Eur J Cancer. 2009;45:3220–7.CrossRefPubMed

Title: Outcome in Neuroblastoma
Authors: Ali Aykan Ozguven
Sema Anak
Aysegul Unuvar
Arzu Akcay
Zeynep Karakas
Gulyuz Ozturk
Omer Devecioglu
Leyla Agaoğlu
Publication date: 01-05-2015
Publisher: Springer India
Published in: Indian Journal of Pediatrics / Issue 5/2015
Print ISSN: 0019-5456
Electronic ISSN: 0973-7693
DOI: https://doi.org/10.1007/s12098-014-1578-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Outcome in Neuroblastoma

Abstract

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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