Pelvic neuroblastoma—Implications for a new favorable subgroup: A Children's cancer group experience |
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Authors: | Dr Gerald M Haase MD Maura C O'Leary MD Daniel O Stram PhD John N Lukens MD Robert C Seeger MD Hiroyuki Shimada MD Katherine K Matthay MD |
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Institution: | (1) the Department of Pediatric Surgery, University of Colorado and Children's Hospital, Denver, Colorado, USA;(2) Department of Pediatric Hematology-Oncology, Children's Medical Center, Minneapolis, Minnesota, USA;(3) Data and Statistical Center, Childrens Cancer Group, Arcadia, California, USA;(4) Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA;(5) Department of Pediatrics, Children's Hospital, Los Angeles, California, USA;(6) Department of Pediatrics, University of California, San Francisco, California, USA |
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Abstract: | Background: The survival in neuroblastoma is influenced by patient age, disease stage, tumor site, and several biologic factors. This
study was undertaken to determine if primary pelvic lesions are associated with an unusually favorable outcome.
Methods: Nine hundred eighty-six patients registered on Children's Cancer Group studies from 1980 to 1993 were reviewed, and 41 (4.3%)
were found to have pelvic tumors. Survival was analyzed, and correlations among age, stage of disease, surgical resectability,
histopathology, serum ferritin, and N-myc oncogene amplification were evaluated.
Results: Age at diagnosis was comparable between patients with pelvic and nonpelvic tumors. Disease distribution was similar, with
stages III and IV comprising 78% (32 of 41) of pelvic lesions compared with 73% (692 of 945) for nonpelvic tumors. There was
no outcome difference in favorable stages (I, II, and IV-S), with 3-year progression-free survival rates of 88% and 82% for
pelvic and nonpelvic sites, respectively. However, in stages III and IV, the 3-year progression-free survival was 70% for
pelvic lesions compared with 47% for nonpelvic tumors (p=0.04). Some favorable biologic factors were more common in children
with pelvic lesions.
Conclusions: The pelvis is an unusual primary site for neuroblastoma but represents a more favorable prognostic subgroup, which is most
evident in advanced-stage disease.
Presented at the 47th Annual Cancer Symposium of The Society of Surgical Oncology, Houston, Texas, March 17–20, 1994. |
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Keywords: | Neuroblastoma Pelvic tumors Pediatric solid tumors |
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