Association between image-defined risk factors and neuroblastoma outcomes

Area of Science:

• Pediatric Oncology
• Surgical Oncology
• Radiology

Background:

• The current neuroblastoma (NBL) staging system utilizes image-defined risk factors (IDRFs) to assess anatomical features.
• The impact of IDRFs on surgical and oncologic outcomes in NBL patients remains unclear.

Purpose of the Study:

• To evaluate the association between IDRFs and perioperative and oncologic outcomes in neuroblastoma patients.
• To determine if IDRFs influence surgical resectability and patient survival.

Main Methods:

• Retrospective cohort study of 106 NBL patients treated between 2002 and 2017.
• Radiographic measurement of tumor volume (TV) and IDRFs at diagnosis and before resection.
• Evaluation of perioperative outcomes (blood loss, operating time, complications, ICU admission, hospital stay) and oncologic outcomes (gross total resection, relapse-free survival, overall survival).

Main Results:

• At diagnosis, 61% of NBLs were IDRF positive, associated with MYCN amplification, undifferentiation, higher stage, risk, and TV.
• At resection, 43% of NBLs were IDRF positive, associated with increased operative difficulty and perioperative morbidity, including higher blood loss, longer operating times, more complications, and longer hospital stays.
• No significant difference was observed in the rates of gross total resection or 5-year relapse-free and overall survival between IDRF-negative and IDRF-positive NBLs.

Conclusions:

• IDRFs at diagnosis are linked to more aggressive NBL subtypes and advanced disease.
• IDRFs at resection indicate increased surgical complexity and perioperative complications.
• Despite associations with tumor characteristics and surgical difficulty, IDRFs do not appear to affect the success of resection or long-term patient survival.