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Journal of Cancer Research and Clinical Oncology

, Volume 143, Issue 7, pp 1327–1335 | Cite as

Multivariate analysis of risk factors for patients with stage 4 neuroblastoma who were older than 18 months at diagnosis: a report from a single institute in Shanghai, China

  • Jiaoyang Cai
  • Ci Pan
  • Yanjing Tang
  • Jing Chen
  • Min Zhou
  • Benshang Li
  • Huiliang Xue
  • Shuhong Shen
  • Yijin Gao
  • AnAn Zhang
  • Jingyan TangEmail author
Original Article – Clinical Oncology

Abstract

This retrospective study evaluated the long-term outcomes and prognostic indicators of patients with stage 4 neuroblastoma who were older than 18 months at diagnosis. The medical records of 118 such children who were treated at Shanghai Children’s Medical Center, China, from June 1998–December 2013 were reviewed. Event-free survival (EFS) and overall survival (OS) were analyzed by log-rank tests. Of the 118 patients, 14 improving patients did not complete treatment because of parental decisions, and 1 patient died during surgery. Of the 103 patients who completed the comprehensive protocols, 60 (58.3%) achieved very good partial remission (VGPR), 26 (25.2%) achieved partial remission (PR) after four courses of chemotherapy, and 17 (16.5%) progressed during treatment. The response to induction (including VGPR + PR) was 83.5%. After a median follow-up of 105 months (range 36–160 months), the 5- and 10-year OS were 21 and 18%, and the EFS was 19 and 13%, respectively. EFS was significantly better for patients with normal levels of urinary vanillylmandelic acid (VMA) at diagnosis, who had complete resection of the primary tumor, who were minimal residual disease- (MRD-) negative in their bone marrow after four courses of chemotherapy, and who achieved VGPR at the end of treatment (P < 0.05). The prognosis remains poor for patients with stage 4 neuroblastoma who are older than 18 months at diagnosis. Elevated VMA level, incomplete tumor resection, persistent MRD in bone marrow, and poor curative effect are associated with worse prognosis.

Keywords

Neuroblastoma Stage 4 Risk factors 

Notes

Compliance with ethical standards

Conflict of interest

Author Jiaoyang Cai, Ci Pan, Yanjing Tang, Jing Chen, Min Zhou, Benshang Li, Huiliang Xue, Shuhong Shen, Yijin Gao, AnAn Zhang, and Jingyan Tang declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Jiaoyang Cai
    • 1
  • Ci Pan
    • 1
  • Yanjing Tang
    • 1
  • Jing Chen
    • 1
  • Min Zhou
    • 1
  • Benshang Li
    • 1
  • Huiliang Xue
    • 1
  • Shuhong Shen
    • 1
  • Yijin Gao
    • 1
  • AnAn Zhang
    • 1
  • Jingyan Tang
    • 1
    Email author
  1. 1.Key Laboratory of Pediatric Hematology and Oncology, Ministry of Health, Department of Pediatric Hematology and Oncology, Shanghai Children’s Medical CenterShanghai JiaoTong University School of Medicine (SJTU-SM)ShanghaiChina

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