Prognostic factors in neuroblastic tumors

Data of 101 patients with neuroblastic tumors from 1950 to1974 at The Johns Hopkins Hospital have been abstracted onto specially designed summary sheets, and subjected to multifactorial analysis. One-third of the 21 benign ganglioneuromas showed evidence for spontaneous maturation. The overall cure rate among the malignant tumors was 39%. Cures were higher with an extraabdominal primary, with more mature histologic differentiation, and if excision, even partial, was carried out. Neither radiotherapy nor evolving modalities of chemotherapy appear to have had benefit over this 25-yr period. An age at diagnosis less than 2 yr, and a less extensive clinical stage both were independent predictors of survival. The apparent effects of a favorable site of tumor origin, or more mature histologic differentiation were not of major impact in and of themselves, but correlated better with clinical stage. Two prognostic schemata, based on stage plus age, and stage plus histologic differentiation plus age respectively, proved to be 95% accurate in our experience. With more extensive evaluation and experience, either or both may be helpful in the management of malignant neuroblastic tumors, and assessment of therapeutic regimens.