A prospective study of a long-term follow-up of an observation program for neuroblastoma detected by mass screening
Mio Tanaka1, Hisato Kigasawa, Keisuke Kato
1Division of Pathology, Kanagawa Children's Medical Center, Minami-ku, Yokohama, Japan. mio@zc4.so-net.ne.jp
Insights
Over 70% of infants with neuroblastoma (NBL) detected via mass screening (MS6M) could be safely observed without surgery. This study evaluated the usefulness of an NBL observation program for selected screened patients.
Area of Science:
- Pediatric Oncology
- Cancer Screening
- Clinical Research
Background:
- A nationwide mass screening for neuroblastoma (NBL) in 6-month-old infants (MS6M) was conducted in Japan from 1985 to 2003.
- Most detected NBL tumors exhibited favorable biological features, leading to the establishment of an observation program in 1993 for selected patients.
Purpose of the Study:
- To evaluate the clinicopathological findings and current status of patients enrolled in the NBL observation program.
- To assess the usefulness of the observation strategy for managing NBL detected through mass screening.
Main Methods:
- 53 out of 101 NBL patients detected by MS6M were enrolled in the observation program between 1993 and 2003.
- Patients were categorized into four groups based on changes in urinary VMA/HVA levels and tumor size.
Main Results:
- Urinary VMA and HVA levels decreased in 39 of 53 patients; 17 showed undetectable tumors (Group A), and 22 had detectable tumors (Group B).
- Seven patients (Group C) had variable tumor markers and gradual volume increase; six (Group D) showed short-term increases.
- Surgical intervention was performed on tumors in Groups C and D, some in Group B, and one multiple tumor case; no unfavorable biologic factors were found in excised tumors.
Conclusions:
- The observation program, a large series for MS6M, demonstrated that over 70% of eligible patients could be managed non-surgically.
- This supports the utility of observation for specific neuroblastoma cases identified through infant mass screening.
Background:
A nationwide mass screening for neuroblastoma (NBL) in 6-month-old infants (MS6M) was performed in Japan from 1985 to 2003. Favorable biological features were identified for most of the detected tumors; consequently, we began an observation program for selected screened patients in 1993. Here, we report the clinicopathological findings and present status of patients enrolled in our observation program, with the goal of evaluating its usefulness.
Procedure:
Between 1993 and 2003, 53 of 101 patients with NBL detected by MS6M were enrolled. The patients were divided into four groups according to changes in urinary VMA and HVA levels and tumor size.
Results:
Urinary VMA and HVA levels decreased in 39 of 53 patients. In 17 of these 39 patients, the tumor became undetectable (Group A); in 22 patients the tumor was detectable (Group B). In seven patients, tumor marker levels varied, and tumor volume gradually increased (Group C). In six patients, tumor marker levels and tumor volume increased in the short term (Group D). One patient had multiple tumors (1M according to International Neuroblastoma Staging System). All tumors in Groups C and D, four tumors in Group B, and one tumor in the 1M patient were removed. No unfavorable biologic factors were noted in any excised tumor.
Conclusions:
The observation program of the present study, one of the largest series for MS6M, confirmed that over 70% of patients who fulfilled the criteria could be observed without surgery.
