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Neuroblastoma: experience from National University Health System, Singapore (1987-2008)
Introduction:
Neuroblastoma is the most common extracranial solid tumour in childhood. We report our experience at National University Health System (NUHS), Singapore.
Methods:
We performed a retrospective chart review of 43 patients diagnosed with neuroblastoma, who were seen and treated at the Department of Paediatrics, NUHS from November 1987 to November 2008.
Results:
The median age of the patients at diagnosis was 1.9 (range 0.1-20.2) years. The majority (70.1%) of primary tumours were of abdominal and/or adrenal origin. According to the International Neuroblastoma Staging System, six (14.0%) patients were in stages 1 and 2, 11 (25.6%) in stage 3, 19 (44.2%) in stage 4, and seven (16.2%) in stage 4s. Therapy for all patients included surgery and/or chemotherapy and/or radiation therapy. Patients with stage 4 disease also underwent autologous stem cell transplant. The median follow-up for the cohort was 2.5 (range 0.4-21.0) years. At the time of analysis, 29 (67.4%) patients were alive. The two- and five-year overall survival for the cohort was 65.0% (95% confidence interval [CI] 51.0%-80.0%) and 62.0% (95% CI 45.0%-79.0%), respectively. The five-year overall survival rates according to risk status were 100.0% for low-risk, 75.0% for intermediate risk and 28.2% for high-risk neuroblastoma.
Conclusion:
The prognosis for those with advanced stage neuroblastoma remains poor. A collaborative effort, with an emphasis on research in detecting biologic characteristics of aggressive disease and tailoring therapy, needs to be strengthened in order to further our understanding of this disease.
