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Histologic Response to Induction Chemotherapy in High-Risk Neuroblastoma
Monica Pomaville1, Pei-Chi Kao2,3, Antonio Perez-Atayde2,4
1Department of Pediatric Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Cancer Medicine
|November 26, 2025
Summary
Neuroblastoma tumors show significant histologic changes after chemotherapy, becoming more differentiated. However, these changes do not predict patient survival outcomes.
Area of Science:
- Pediatric Oncology
- Cancer Biology
- Tumor Microenvironment
Background:
- Tumor histology is crucial for risk stratification and therapy assignment in neuroblastoma.
- Treatment response in high-risk neuroblastoma is assessed via imaging after chemotherapy and tumor resection.
Purpose of the Study:
- To quantify histologic changes in neuroblastoma primary tumors from diagnosis to resection.
- To evaluate the prognostic capability of these histologic alterations.
Main Methods:
- Paired tumor samples from 94 high-risk neuroblastoma patients were analyzed.
- Histologic features including stroma, differentiation, mitosis karyorrhexis index (MKI), and necrosis were annotated.
- Changes were assessed for association with overall survival (OS) and progression-free survival (PFS).
Main Results:
- All histologic parameters significantly changed post-therapy, indicating increased tumor differentiation.
- A higher MKI at diagnosis correlated with lower PFS and OS.
- The percentage of intermediate-high MKI decreased by 75% from diagnosis to resection.
Conclusions:
- Neuroblastoma tumors exhibit significant morphologic differentiation after induction chemotherapy.
- Despite observed changes, histologic alterations are not prognostic for patient outcomes at resection or when considering the change from diagnosis.
