Neuroblastoma. Mass screening for early detection and its prognosis

Abstract

Since July 1973, the authors began developing a mass screening system using a VMA (vanilmandelic acid) spot test on 6‐to‐7 month‐old infants for early detection of neuroblastoma in Kyoto city, Japan. Using this method, six infants with this tumor were discovered; five of the six infants were cured, and one is under treatment. These patients showed a favorable prognosis on early diagnosis. in this article, 57 neuroblastoma patients from the Department of Pediatrics, Kyoto Prefectural University of Medicine, treated during the last 20 years, from July 1962 to June 1982, are evaluated. Since the mass screening program has run smoothly since July 1974, clinical findings are compared between 35 neuroblastoma cases before mass screening from the 12‐year period from July 1962 to June 1974 and 22 cases after mass screening, during the 8‐year period from July 1974 to June 1982. Before mass screening, only 20% (7/35) of the patients were discovered with neuroblastoma younger than 12 months of age and 68.6% were older than 2 years of age. After mass screening, 54.6% (12/22) of the patients were younger than 12 months of age and only 31.8% (7/22) were older than 2 years of age. Before mass screening, 17.1% (6/35) survived with five of the six surviving patients being younger than 12 months of age at the time of diagnosis; 72.7% (16/22) of the patients detected after mass screening are living now. Eleven of the 16 patients have already been cured, and the remaining 5 patients are presently undergoing treatment. A marked improvement of their prognoses is dependent on the early detection of this tumor by mass screening. To date, using the VMA spot test for early detection in infancy is convenient and effective for improvement of its prognosis.

Newborn screening for inborn errors of metabolism and endocrinopathies: an update

“…Thus, there is now hope that many diseases which were formerly associated with poor outcomes will have a much better prognosis because they can be detected early by newborn screening [25,27,28]. Unfortunately, not all new disease screens have been successful; for example, attempts to screen for neuroblastoma in urine [29] did not meet expectations.…”

Neuroblastome de l’enfant: challenges et perspectives

“…Des é tudes entreprises dans les anné es 1980 montrè rent qu'il é tait effectivement possible de dé tecter une é lé vation des caté cholamines urinaires dè s l'â ge de six mois, suggé rant qu'une dé tection pré clinique pourrait amé liorer la survie [63]. La plupart des é tudes qui suivirent dé montrè rent un excè s de diagnostic des formes favorables et non des formes les plus graves [29,76].…”

Acidic Catecholamine Metabolites and 5-Hydroxyindoleacetic Acid in Urine: The Influence of Diet

“…Recently, we developed a high-performance liquid chromatography (HPLC) system with a mixed-mode (C 1s/anion-exchange) column and eight-channel electrochemical detector for simultaneous assays of acidic catecholamine metabolites [vanillylmandelic acid (VMA), 3,4 Correspondence: Dr F Mashige. dihydroxyphenylacetic acid (DOPAC), homovanillic acid (HVA) and vanillic acid (VA) 1 and 5-hydroxyindoleacetic acid (5-HIAA) in urine.…”