Survival patterns of childhood neuroblastoma: an analysis of clinical data from Southern-Eastern European countries. Issue 3 (10th May 2023)

• Record Type: Journal Article
• Authors: Karalexi, Maria A.; Servitzoglou, Marina; Papadakis, Vassilios; Kachanov, Denis; Česen Mazič, Maja; Baka, Margaret; Moschovi, Maria; Kourti, Maria; Polychronopoulou, Sofia; Stiakaki, Eftichia; Hatzipantelis, Emmanuel; Dana, Helen; Stefanaki, Kalliopi; Malama, Astero; Themistocleous, Marios S.; Strantzia, Katerina; Shamanskaya, Tatyana; Bouka, Panagiota; Panagopoulou, Paraskevi; Kantzanou, Maria; Ntzani, Evangelia; Dessypris, Nick; Petridou, Eleni Th.
• Is Part Of: European journal of cancer prevention. Volume 32:Issue 3(2023)
• Page Start: 254
• Page End: 263
• Publication Date: 2023-05-10
• Subjects: anti-GD2 antibody treatment -- cancer registration -- childhood -- event-free survival -- neuroblastoma -- overall survival; Cancer -- Prevention -- Periodicals; Neoplasms -- etiology -- Periodicals; Neoplasms -- prevention & control -- Periodicals; Cancer -- Prevention; Periodicals; 616.994052
• DOI: 10.1097/CEJ.0000000000000614
• Languages: English
• ISSNs: 0959-8278

Abstract

Abstract : The prognosis of children with neuroblastoma (NBL) can be dismal with significant variations depending on the stage and biology of the tumor. We assessed the event-free (EFS) and overall (OS) survival using harmonized data from three Southern-Eastern European (SEE) countries. Data for 520 incident NBL cases (2009–2018) were collected from Greece, Slovenia and Russia. Kaplan–Meier curves were fitted, and EFS/OS were derived from Cox proportional models by study variables including the protocol-based risk-group (low/observation, intermediate, high). Over one-third of cases were coded in the high-risk group, of which 23 children (4.4%) received treatment with anti-ganglioside 2 (GD2) mAb. Survival rates were inferior in older (OS 5-year; 1.5–4.9 years: 61%; EFS 5-year; 1.5–4.9 years: 48%) compared to children younger than 1.5 years (OS 5-year; <1.5 years: 91%; EFS 5-year; <1.5 years: 78%). Predictors of poor OS included stage 4 (hazard ratio, HROS : 18.12, 95% confidence intervals, CI: 3.47–94.54), N-myc amplification (HROS : 2.16, 95% CI: 1.40–3.34), no surgical excision (HROS : 3.27, 95% CI: 1.91–5.61) and relapse/progression (HROS : 5.46, 95% CI: 3.23–9.24). Similar unfavorable EFS was found for the same subsets of patients. By contrast, treatment with anti-GD2 antibody in high-risk patients was associated with decreased risk of death or unfavorable events (HROS : 0.11, 95% CI: 0.02–0.79; HREFS : 0.19, 95% CI: 0.07–0.52). Our results confirm the outstanding prognosis of the early NBL stages, especially in children <1.5 years, and the improved outcomes of the anti-GD2 treatment in high-risk patients. Ongoing high-quality clinical cancer registration is needed to ensure comparability of survival across Europe and refine our understanding of the NBL biology.