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Clinical prognostic factors in 1277 patients with neuroblastoma: results of The European Neuroblastoma Study Group 'Survey' 1982-1992

Lookup NU author(s): Simon Cotterill, Professor Andrew Pearson

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Abstract

In 1982 the European Neuroblastoma Study Group (ENSG) established a prospective registry for patients with newly diagnosed neuroblastoma ('The ENSG Survey'). Clinical information was collected primarily to: (a) establish an ENSG database; and (b) investigate prognostic factors in neuroblastoma. This paper summarises the results of the survey. By 1992, 1277 patients with a median age of 26 months (range: 0-289 months), gender ratio of 1.19 M:F had been registered from 30 centres. The median followup of survivors is 9.7 years (range: 1-14 years). Overall 5-year survival (S) is 45% (95% CI 42-48%), and event-free survival (EFS) is 43% (95% CI 40-45%). For both survival and EFS the key established prognostic factors, stage and age, are highly significant (P < 0.001). In particular, patients under 1 year of age at diagnosis, whatever the disease stage, had a more favourable prognosis than older patients; stage 2 (EFS 93% (95% (CI 85-97) versus 76% (95% CI 67-86), P = 0.02), stage 3 (EFS 91% (95% CI 82-96) versus 52% (95% CI 44-60), P < 0.001) and stage 4 (EFS 59% (95% CI 48-69) versus 16% (95% CI 13-19), P < 0.001). Multivariate analysis established that the anatomical location of the primary tumour (i.e. abdominal versus other sites) and primary tumour volume also conferred a statistically significant difference. In stage 4 disease the 20% of patients without demonstrable bone marrow involvement had a more favourable prognosis than those with infiltrated marrow (EFS 36% (95% CI 13-19) versus 16% (95% CI 29-45), P < 0.001). Urine catecholamine metabolite levels (raised versus normal), histology (ganglioneuroblastoma versus neuroblastoma) and gender had no significant effect on outcome after stage and age were accounted for. 5-year survival following first relapse is only 5.6% (95% CI 2.8-8.4). This ENSG Survey provides secure data for future comparisons with new prognostic factors and treatment programmes. (C) 2000 Elsevier Science Ltd. All rights reserved.

Publication metadata

Author(s): Cotterill, S. J., Pearson, A. D. J., Pritchard, J., Foot, A. B. M., Roald, B., Kohler, J. A., Imeson, J.

Publication type: Article

Publication status: Published

Journal: European Journal of Cancer

Year: 2000

Volume: 36

Issue: 7

Pages: 901-908

ISSN (print): 0959-8049

ISSN (electronic): 1879-0852

URL: http://dx.doi.org/10.1016/S0959-8049(00)00058-7

DOI: 10.1016/S0959-8049(00)00058-7

PubMed id: 10785596

Notes: Group Authors: European Neuroblastoma Study Group, UK Childrens Cancer Study Group UKC

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