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Salvage rates after progression of high-risk neuroblastoma with a soft tissue mass.
- Source :
-
Journal of pediatric surgery [J Pediatr Surg] 2016 Feb; Vol. 51 (2), pp. 285-8. Date of Electronic Publication: 2015 Nov 05. - Publication Year :
- 2016
-
Abstract
- Purpose: Treatment of progression in high-risk neuroblastoma remains challenging despite improved survival. We retrospectively evaluated outcomes in children with a first progression that included soft-tissue masses.<br />Methods: We reviewed records of 903 consecutive children with high-risk neuroblastoma diagnosed between 2004 and 2014, and identified 42 whose first progression included soft-tissue masses. Data on demographics, disease characteristics, treatment, and survival were collected. Primary outcome was 5-year overall survival (OS) from time of first progression. Secondary outcomes were local disease-free progression (LDFR) and progression-free survival (PFS) postprogression. We evaluated the prognostic significance of concomitant bone/bone marrow involvement, MYCN status, and multifocality of soft tissue relapse.<br />Results: Median age at diagnosis was 3.0 (range: 1-10.7) years. Median time to first relapse or progression was 1.2 (range: 0.1-4.5) years after complete remission or minimal stable residual disease. Twelve (29%) patients had concomitant bone or marrow involvement at progression/relapse. There were 11 (26%) patients with International Neuroblastoma Staging System stage 3 disease (all with MYCN amplification), and 31 (74%) with stage 4 disease (12 with MYCN amplification). Nine (21%) patients had multifocal soft tissue progression. R1 resection was achieved in 41 children (95%), 38 (95%) of whom also received salvage radiation therapy. Five-year OS postprogression was 35% (95% CI: 19-51%), 5-year LDFS was 52% (95% CI: 32-72%), and 5-year PFS postprogression was 20% (95% CI: 6-34%).<br />Conclusion: Among children with high-risk neuroblastoma who underwent aggressive treatment of a first soft-tissue recurrence, 5-year postprogression overall survival was 34%. Multifocality and MYCN amplification were the predominant prognostic correlates for worse survival.<br /> (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Subjects :
- Child
Child, Preschool
Disease Progression
Disease-Free Survival
Female
Humans
Infant
Male
Neuroblastoma mortality
Neuroblastoma pathology
Prognosis
Remission Induction
Retrospective Studies
Soft Tissue Neoplasms mortality
Soft Tissue Neoplasms pathology
Neuroblastoma therapy
Salvage Therapy
Soft Tissue Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1531-5037
- Volume :
- 51
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of pediatric surgery
- Publication Type :
- Academic Journal
- Accession number :
- 26651282
- Full Text :
- https://doi.org/10.1016/j.jpedsurg.2015.10.075