The treatment of advanced neuroblastoma. Results of the spanish neuroblastoma study group (SNSG) studies

Castel, Victoria; Garcı́a-Miguel, P; Melero, Carmen; Navajas, Aurora; Navarro, Samuel; Molina, J.; Badal, Madan

doi:10.1016/0959-8049(95)00072-q

Cited by 20 publications

(6 citation statements)

References 17 publications

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“…The cases were collected between January 1992 and December 1999 from the 26 hospitals enrolled in the Spanish Cooperative Neuroblastoma Study N-II-92 [12]. Each case was diagnosed and staged in accordance with the International Neuroblastoma Staging System (INSS) [6,7].…”

Section: Methodsmentioning

confidence: 99%

Prognostic value of the International Neuroblastoma Pathology Classification in Neuroblastoma (Schwannian stroma-poor) and comparison with other prognostic factors: a study of 182 cases from the Spanish Neuroblastoma Registry

et al. 2006

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In addition to clinical and biological factors, further valuable prognostic information in neuroblastoma (Schwannian stroma-poor) (NB) patients is provided by the histopathologic analysis and the application of the International Neuroblastoma Pathology Classification (INPC) system. The objective of this study was to assess the prognostic impact of the INPC classification in a series of NB (Schwannian stroma-poor) and its relation with other prognostic factors. One hundred eighty-two cases of NB were collected from the files of the Spanish Neuroblastoma Registry. Slides were reviewed, and NB cases were grouped into favorable and unfavorable categories according to INPC criteria, taking into account morphological features (mitosis-karyorrhexis index, histological subtype) and patient's age at diagnosis. Other pathological [presence of calcifications, tissular components, and number of mitotic cells per 10 high-power field (HPF)], immunohistochemical (P-glycoprotein and Ki-67 protein expression) and genetic (MYCN amplification and chromosome 1p deletion) features were also studied. Statistical analyses of overall survival with Kaplan-Meier curves and a multivariate study using Cox regression were performed (40.3% of NBs were considered favorable and 59.7% unfavorable). Unfavorable NB showed a mean survival time of 57 months compared with 89 months in favorable cases. Advanced stage, more than ten mitoses per 10 HPF, Ki-67 expression in more than 30% of tumor cells, MYCN oncogene amplification and chromosome 1p deletion were observed more frequently in unfavorable NB. The Cox regression analysis demonstrated that clinical stage (International Neuroblastoma Staging System stage 4) and histological subtype (undifferentiated NB) were the most important factors that influence the overall survival (p<0.001). INPC classification results are major prognostic indicators in NB and should be considered in the therapeutic stratification of NB patients.

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Section: Methodsmentioning

confidence: 99%

Prognostic value of the International Neuroblastoma Pathology Classification in Neuroblastoma (Schwannian stroma-poor) and comparison with other prognostic factors: a study of 182 cases from the Spanish Neuroblastoma Registry

et al. 2006

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“…High-risk NB (ageN 1 year, INSS stage 4), despite many therapeutic advancements, has a very poor prognosis [1][2][3]17]. In this study, we compared the surgical morbidity and mortality of 51 patients undergoing chemotherapy treatment protocols for high-risk NB: 22 in the previous CCG 3891 and POG 9341 protocols vs 29 in the current COG A3973 protocol.…”

Section: Discussionmentioning

confidence: 97%

“…The role of surgery in high-risk NB is controversial, with some studies stating that aggressive surgery improves survival rate in advanced stages [6,7], whereas others have not found any improvement with complete excision [8][9][10]. In the literature, surgical complication rates for patients with NB have ranged from 3% to 57% [3,[10][11][12][13]. Incidental nephrectomy, operative hemorrhage (includes surgical procedures performed before and after chemotherapy started), postoperative intussusception, and injury to major vessels or nerves are some of the more common complications associated with high-stage tumors [13][14][15][16].…”

mentioning

confidence: 98%

“…Currently, this risk-based approach uses the following factors: age, stage, MYCN status, Shimada histopathology, and DNA ploidy. Advanced stage tumors that fit into the high-risk category usually require a multimodality approach, including surgery, radiation, chemotherapy, and autologous stem cell transplantation [3][4][5]. High-risk NB was defined as an occurrence at an age older than 1 year and International Neuroblastoma Staging System [INSS] stage 4.…”

mentioning

confidence: 99%

“…After a response to chemotherapy, resection of the primary tumor should be attempted, followed by autologous stem cell transplantation and maintenance chemotherapy [3][4][5]. The role of surgery in high-risk NB is controversial, with some studies stating that aggressive surgery improves survival rate in advanced stages [6,7], whereas others have not found any improvement with complete excision [8][9][10].…”

mentioning

confidence: 99%

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The treatment of advanced neuroblastoma. Results of the spanish neuroblastoma study group (SNSG) studies

Cited by 20 publications

References 17 publications

Prognostic value of the International Neuroblastoma Pathology Classification in Neuroblastoma (Schwannian stroma-poor) and comparison with other prognostic factors: a study of 182 cases from the Spanish Neuroblastoma Registry

Prognostic value of the International Neuroblastoma Pathology Classification in Neuroblastoma (Schwannian stroma-poor) and comparison with other prognostic factors: a study of 182 cases from the Spanish Neuroblastoma Registry

Surgical challenges associated with intensive treatment protocols for high-risk neuroblastoma

High dose chemotherapy and autologous stem cell rescue for children with high risk neuroblastoma

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