Related Experiment Videos
Prognosis of neuroblastic tumours in children
S Venugopal1, G Char, N D Duncan
1Department of Surgery, U.W.I., Jamaica.
Insights
Prognosis for neuroblastic tumours in children depends on multiple factors including age, tumor site, stage, and histology. A developed scoring system effectively predicts survival outcomes for these pediatric cancers.
Area of Science:
- Pediatric Oncology
- Cancer Research
- Tumor Biology
Background:
- Neuroblastic tumours are a significant group of pediatric cancers.
- Prognostic factors for these tumours require further elucidation.
Purpose of the Study:
- To evaluate factors influencing prognosis in children with neuroblastic tumours.
- To develop a scoring system for predicting outcomes.
Main Methods:
- Retrospective analysis of 26 pediatric cases treated between 1970-1991.
- Evaluation of patient age, tumour site, clinical stage, histological type, and treatment modalities.
Main Results:
- Peak incidence observed in children aged 48-60 months; 75% of deaths occurred in those over 3 years.
- Abdominal and adrenal primary tumours, and Stage IV disease were associated with dismal outcomes.
- Favourable histology (ganglioneuroma) showed significantly better survival (87.5% survival) compared to unfavourable histology (38.9% survival).
- Surgery alone or with adjuvant therapy yielded better survival rates (63.6% survival) than chemotherapy alone (0% survival).
- A scoring system incorporating age, location, stage, histology, and therapy predicted survival: scores ≤21 indicated survival, while scores ≥22 indicated mortality.
Conclusions:
- Prognosis for pediatric neuroblastic tumours is multifactorial.
- Age, tumour location, stage, histology, and treatment significantly impact survival.
- The developed scoring system can aid in predicting outcomes and guiding clinical management.
Abstract:
A retrospective analysis of 26 children with neuroblastic tumours treated at the University Hospital of the West Indies (UHWI) between 1970 and 1991 was undertaken to evaluate factors affecting prognosis. The peak incidence was between 48 months and 60 months of age, and 75% of the deaths occurred in children older than 3 years. The abdomen was the most common site of the tumours 79% of which were from the adrenal gland and carried a dismal outcome. Other sites were thoracic, pelvic and cervical. Extra-adrenal tumours have a good outcome even when the histology is unfavourable; 92% of the tumours were in Stages III or IV at the time of initial presentation. Stage IV disease accounted for all but one of the deaths. Of the 8 children with favourable histology (ganglioneuroma or well-differentiated ganglioneuroblastoma), only one (12.5%) died, wheras of the remaining 18 cases with unfavourable histology (neuroblastoma and undifferentiated ganglioneuroblastoma), eleven (61.1%) died. When managed by surgery alone or with adjuvant chemo- and/or radio-therapy, only 36.4% succumbed while all 4 children with chemotherapy only died. Ten children are alive without disease for more than three years post-therapy. A scoring system was designed which takes into account the factors influencing the outcome in neuroblastic tumours, namely, age, location, stage and histological types of the tumours and therapy. All the children with a score of 21 or less survived, whereas all those with scores of 22 or above succumbed. This underlines the multifactorial influences on the final outcome of neuroblastic tumours.