Treatment and outcomes of 1041 pediatric patients with neuroblastoma who received multidisciplinary care in China

• Published in: Pediatric investigation 2020-09, Vol.4 (3), p.157-167
• Main Authors: Su, Yan, Qin, Hong, Chen, Chenghao, Wang, Shengcai, Zhang, Shihan, Zhang, Dawei, Jin, Mei, Peng, Yun, He, Lejian, Wang, Xiaoman, Qian, Suyun, Qin, Maoquan, Ge, Ming, Zhang, Fuquan, Zeng, Qi, Wang, Huanmin, Ma, Xiaoli, Ni, Xin
• Format: Article
• Language: English
• Subjects: Age; Antigens; Biomarkers; Biopsy; Bone marrow; Catecholamines; Chemotherapy; Hematology; Histology; Metabolites; Metastasis; Microscopy; Multidisciplinary care; Neuroblastoma; Neurosurgery; Oncology; Original; Ostomy; Otolaryngology; Patients; Pediatric; Pediatrics; Prognosis; Radiation therapy; Stem cells; Thoracic surgery; Tumors
• ISSN: 2574-2272; 2096-3726; 2574-2272
• DOI: 10.1002/ped4.12214

Importance Neuroblastoma is the most common extracranial malignant solid tumor in children. Multidisciplinary care is critical to improving the survival of pediatric patients with neuroblastoma. Objective To systematically summarize the clinical characteristics of children with neuroblastoma and evaluate their prognosis with multidisciplinary care provided in a single center. Methods This retrospective study analyzed the clinical data of 1041 patients with neuroblastoma who were diagnosed, treated, and followed‐up in the Hematology‐Oncology Center of Beijing Children’s Hospital from 2007 to 2019. Results The median age at diagnosis was 34 months; 80.8% of the patients were younger than 5 years of age. Notably, 243 patients (23.3%) were classified as low‐risk, 249 patients (23.9%) were classified as intermediate‐risk, and 549 (52.7%) were classified as high‐risk. Furthermore, 956 patients underwent surgical resections; 986 (94.7%) patients received chemotherapy; and 176 patients with high‐risk neuroblastoma received hematopoietic stem cell transplantation. The 5‐year event‐free survival (EFS) rate was 91.3% and 5‐year overall survival (OS) rate was 97.5% in low‐risk group; in the intermediate‐risk group, these rates were 85.1% and 96.7%, respectively, while they were 37.7% and 48.9% in the high‐risk group (P < 0.001 for both). The 5‐year EFS and OS rates were significantly higher in patients diagnosed between 2015 and 2019 than in patients diagnosed between 2007 and 2014 (P < 0.001). In total, 278 patients (26.7%) exhibited tumor relapse or progression; the median interval until relapse or progression was 14 months. Of the 233 patients who died, 83% died of relapse or progression of neuroblastoma and 4.3% died of therapy‐related complications. Interpretation The 5‐year OS rate was low in high‐risk patients, compared with low‐and intermediate‐risk patients. Multidisciplinary care is critical for improvement of survival in pediatric patients with neuroblastoma. Additional treatment strategies should be sought to improve the prognosis of patients with high‐risk neuroblastoma. A multidisciplinary modality for the diagnosis and treatment of neuroblastoma is the key to improve the survival of children with neuroblastoma.