Association of image‐defined risk factors with clinical features, histopathology, and outcomes in neuroblastoma. (13th December 2020)

• Record Type: Journal Article
• Authors: Temple, William C.; Vo, Kieuhoa T.; Matthay, Katherine K.; Balliu, Brunilda; Coleman, Christina; Michlitsch, Jennifer; Phelps, Andrew; Behr, Spencer; Zapala, Matthew A.
• Is Part Of: Cancer medicine. Volume 10:Number 7(2021)
• Page Start: 2232
• Page End: 2241
• Publication Date: 2020-12-13
• Subjects: pathology -- pediatric cancer -- surgical oncology -- survival; 616.994005
• DOI: 10.1002/cam4.3663
• Languages: English
• ISSNs: 2045-7634

Abstract

Abstract: Background: Clinical, molecular, and histopathologic features guide treatment for neuroblastoma, but obtaining tumor tissue may cause complications and is subject to sampling error due to tumor heterogeneity. We hypothesized that image‐defined risk factors (IDRFs) would reflect molecular features, histopathology, and clinical outcomes in neuroblastoma. Methods: We performed a retrospective cohort study of 76 patients with neuroblastoma or ganglioneuroblastoma. Diagnostic CT scans were reviewed for 20 IDRFs, which were consolidated into five IDRF groups (involvement of multiple body compartments, vascular encasement, tumor infiltration of adjacent organs/structures, airway compression, or intraspinal extension). IDRF groups were analyzed for association with clinical, molecular, and histopathologic features of neuroblastoma. Results: Patients with more IDRF groups had a higher risk of surgical complications (OR = 3.1, p = 0.001). Tumor vascular encasement was associated with increased risk of surgical complications (OR = 5.40, p = 0.009) and increased risk of undifferentiated/poorly differentiated histologic grade (OR = 11.11, p = 0.013). Tumor infiltration of adjacent organs and structures was associated with decreased survival (HR = 8.90, p = 0.007), MYCN amplification (OR = 9.91, p = 0.001), high MKI (OR = 6.20, p = 0.003), and increased risk of International Neuroblastoma Staging System stage 4 disease (OR = 8.96, p < 0.001). Conclusions: The presence of IDRFs at diagnosis was associated with high‐risk clinical, molecular, and histopathologic features of neuroblastoma. The IDRF group tumor infiltration into adjacent organs and structures was associated with decreased survival. Collectively, these findings may assist surgical planning and medical management for neuroblastoma patients. Abstract : This is an original research article that explored the association between neuroblastoma image‐defined risk factors (IDRFs) present at diagnosis and various histopathologic, surgical, and survival outcomes. To our knowledge, this is the first report showing that neuroblastoma IDRFs were associated with histopathology in addition to MYCN amplification. It is also the first time, to our knowledge, that specific imaging biomarkers in neuroblastoma, such as tumor vascular encasement and tumor infiltration into adjacent organs and structures, were associated with histopathology and decreased survival.