All issues > Volume 52(1); 2009

Original Article

Korean J Pediatr. 2009;52(1):93-98. Published online January 15, 2009.

Outcome of patients with neuroblastoma aged less than 1 year at diagnosis

Jung Min JM Suh¹, Sang Goo SG Lee¹, Keon Hee KH Yoo¹, Ki Woong KW Sung¹, Hong Hoe HH Koo¹, Ju Youn JY Kim¹, Eun Joo EJ Cho¹, Suk Koo SK Lee², Jhingook JG Kim³, Do Hoon DH Lim⁴

¹Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
²Department of Pediatric Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
³Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
⁴Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence Ki Woong KW Sung ,Email: kwsped@skku.edu

Abstract

Purpose
: The purpose of this study was to evaluate the clinical characteristics and outcomes of patients with neuroblastoma aged less than 1 year.
Methods
: From January 1997 to December 2007, 41 patients aged less than 1 year were diagnosed with neuroblastoma. Patients were divided into 3 risk groups according to the stage of the disease and N-myc amplification. Low-risk patients underwent surgery with (stage 2) or without (stage 1) short-term chemotherapy. Intermediate-risk patients underwent chemotherapy and surgery with or without local radiation therapy. High-risk patients underwent chemotherapy, surgery, radiation therapy, and high-dose chemotherapy/autologous stem cell rescue (HDCT/ASCR).
Results
: While tumor relapse occurred in only 1 patient, 7 patients died of treatment-related toxicities. Causes of treatment- related death included infection during conventional chemotherapy in 5 patients and acute myocarditis during HDCT/ASCR in 2 patients. The overall 5-year survival (¡¾standard error) and 5-year event-free survival (EFS) rates after diagnosis for all 41 patients were 82.8¡¾5.9% and 80.0¡¾6.3%, respectively, with a median follow-up of 58 (9-137) months. The 5-year EFS rates for low-risk, intermediate-risk, and high-risk patients were 100%, 68.4¡¾10.8%, and 66.7¡¾19.3%, respectively.
Conclusion
: Increased efforts to reduce infection-associated toxicity deaths during conventional chemotherapy are needed to further improve the survival of patients with neuroblastoma aged less than 1 year.

Keywords :Neuroblastoma, Prognosis