The Association of Clinical Characteristics and Tumour Markers With Image-Defined Risk Factors in the Management of Neuroblastoma in South Africa. Issue 4 (April 2022)

• Record Type: Journal Article
• Authors: van Heerden, J.; Esterhuizen, T.M.; Hendricks, M.; Poole, J.; Büchner, A.; Naidu, G.; du Plessis, J.; van Emmenes, B.; van Zyl, A.; Mathews, E.; Kruger, M.
• Is Part Of: Clinical oncology. Volume 34:Issue 4(2022)
• Page Start: e149
• Page End: e159
• Publication Date: 2022-04
• Subjects: Ferritin -- image-defined risk factors -- lactate dehydrogenase -- MYCN -- neuroblastoma -- South Africa -- tumour markers; Oncology -- Periodicals; Tumors -- Periodicals; Cancer -- Treatment -- Periodicals; Radiotherapy -- Periodicals; Neoplasms -- Periodicals; Cancer -- Radiotherapy; Cancer -- Treatment; Oncology; Medical radiology; Radiotherapy; Tumors; Electronic journals; Periodicals; 616.994
• DOI: 10.1016/j.clon.2021.10.014
• Languages: English
• ISSNs: 0936-6555

Abstract

Abstract: Aims: Image-defined risk factors (IDRFs) in neuroblastoma predict surgical complications and management outcomes. As there is a lack of data regarding the association of IDRFs with clinical and pathological factors, this study evaluated the prognostic value of IDRFs to predict neuroblastoma survival outcomes. Materials and methods: This was a retrospective study including 345 patients and reviewed diagnostic imaging for 20 IDRFs, pleural effusions and ascites. The IDRFs were grouped into five 'primary IDRFs' cohorts with vascular encasement, involvement of multiple body compartments, organ infiltration, airway obstruction and intraspinal extension. The association between clinical, histopathological and biological characteristics of neuroblastoma and management was evaluated. Results: More patients without IDRFs had operations compared with patients with IDRFs, with a trend towards significance (64.4% versus 35.6%, P = 0.082). Patients with multiple compartment tumour involvement ( P = 0.003) and organ infiltration ( P < 0.001) had a higher risk of surgical complications. The 5-year overall survival of the group with more than one IDRF was 0.0% and those with pleural effusions or ascites 6.7%, associated with the worst outcome ( P = 0.005). The total number of IDRFs was not predictive of the metastatic remission rate ( P = 0.585) or overall survival ( P = 0.142), with no conclusive association found between IDRF groups and clinical or biological markers. Conclusions: Patients with more than one IDRF had the shortest survival time, whereas those with pleural effusions and ascites at diagnosis had a poor outcome. Standardised reporting of IDRFs is crucial for predicting prognosis. Highlights: Children with multiple compartment tumour involvement and organ infiltration had a higher risk of surgical complications. Image defined risk factors did not predict post induction metastatic response rates (mCR). Patients with more than one IDRF, pleural effusions or ascites had the shortest survival time and overall survival (OS).