Neuroblastoma, Body Mass Index, and Survival. Issue 14 (April 2015)

• Record Type: Journal Article
• Authors: Small, Annabel G.; Thwe, Le M.; Byrne, Jennifer A.; Lau, Loretta; Chan, Albert; Craig, Maria E.; Cowell, Chris T.; Garnett, Sarah P.; Segura., Miguel F
• Is Part Of: Medicine. Volume 94:Issue 14(2015)
• Publication Date: 2015-04
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000000713
• Languages: English
• ISSNs: 0025-7974

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Abstract</title> <p>Extremes of body mass index (BMI) at diagnosis of childhood cancers have been associated with poorer prognosis.</p> <p>The aims of this retrospective review were to examine the growth and BMI status of children diagnosed with neuroblastoma (NB) and determine if BMI status at diagnosis affected survival.</p> <p>Between 1985 and 2005, 154 children were diagnosed with NB at Sydney Children's Hospitals Network (Westmead), Australia, of which 129 had both length/height and weight recorded in the medical records at diagnosis. BMI was calculated and children were classified as underweight (BMI <15th percentile), normal weight, and overweight (BMI >85th percentile). Disease stage was classified according to the International NB Staging System.</p> <p>At diagnosis, 24.0% of the children were classified as underweight and 11.6% were overweight. Six months after diagnosis all children except those with stage 4s disease had a decrease in BMI z-score; difference in estimated marginal mean −0.73, <italic>P</italic> < .001. After 12 months an increase in BMI z-score was observed and by 2 years BMI z-score was significantly higher than BMI z-score at baseline; difference in estimated marginal mean 0.81, <italic>P</italic> = .007. At the last follow-up (median 5.6 years [range 3–7] after diagnosis) the proportion of children who were classified as underweight decreased to 8.7% and the proportion of children who were classified as overweight increased to 27.5%. The overall survival rate was 61.2%; however, BMI status did not predict survival. In multivariable Cox regression modeling, stage at diagnosis was the only predictor of survival; children diagnosed with stage 4 were less likely to survive (hazard ratio [HR] [95%CI]: 7.02 [1.7–29.0], <italic>P</italic> = .007).</p> <p>Almost a quarter of children with NB were underweight at diagnosis. However, we did not demonstrate a prognostic association between BMI status and survival. The high proportion of children who were classified as overweight at follow-up indicates a need for nutritional interventions to prevent potential late effects.</p> </sec> </abstract>