Pediatric Oncology Original Paper

Annals of Surgical Oncology

, Volume 14, Issue 12, pp 3575-3580

First online:

L1 Is Associated With Favorable Outcome in Neuroblastomas in Contrast to Adult Tumors

  • Robin WachowiakAffiliated withDepartment of Pediatric Surgery, University Medical Center Email author 
  • , Henning C. FiegelAffiliated withDepartment of Pediatric Surgery, University Medical Center
  • , Jussuf T. KaifiAffiliated withDepartment of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf
  • , Alexander QuaasAffiliated withInstitute for Pathology, University Medical Center Hamburg-Eppendorf
  • , Annika KrickhahnAffiliated withDepartment of Pediatric Surgery, University Medical Center
  • , Paulus G. SchurrAffiliated withDepartment of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf
  • , Rudolf ErttmannAffiliated withPediatric Hematology/Oncology, University Medical Center Hamburg-Eppendorf
  • , Melitta SchachnerAffiliated withCenter for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf
  • , Dietrich KluthAffiliated withDepartment of Pediatric Surgery, University Medical Center
    • , Guido SauterAffiliated withInstitute for Pathology, University Medical Center Hamburg-Eppendorf
    • , Jakob R. IzbickiAffiliated withDepartment of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf

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Abstract

Background

Neuroblastoma is the most common solid tumor in childhood with unconventional clinical behavior. L1, a neuronal cell adhesion molecule, is associated with poor survival in malignant adult tumors. The aim of the current study was to determine expression of L1 in pediatric neuroblastoma.

Methods

L1 expression was assessed on a tissue microarray with 66 surgically resected neuroblastoma samples by immunohistochemistry with a monoclonal antibody and peroxidase method. Additionally, mRNA expression was analyzed by reverse transcriptase–polymerase chain reaction with L1-specific primers. Data were correlated survival data by log rank test and Cox regression multivariate analysis.

Results

L1 was detected in 57 (86%) of 66 neuroblastomas, whereas 9 (14%) were L1 negative. Median survival of all children was 72 months. Analysis with Kaplan-Meier method revealed a surprising and contrary finding to adult tumor entities: an association of L1 positivity with better event-free and overall survival (P < .001 and P < .01 by log rank test). Multivariate Cox regression analysis showed an independent prognostic impact of L1 negativity for event-free and overall survival of the children (P < .05).

Conclusions

In contrast to adult tumor entities, where L1 is associated with aggressive clinical behavior, our data show that L1 predicts good outcome in children with neuroblastoma. This novel finding suggests an inverse role of L1 in neuroblastoma. Future studies might focus on the molecular basis of the varying effect of L1 in different tumors.

Keywords

Neuroblastoma Childhood cancer L1 Prognostic marker