Survival outcome of neuroblastoma: a decade of experience in a local tertiary referral central

Abstract

Background/Objectives: Neuroblastoma is the most common pediatric extracranial solid tumor and accounts for 10‐15% of pediatric malignancy‐related mortality. The study aims to evaluate the survival outcome of children with neuroblastoma treated at a tertiary centre and their relationships with various clinical and pathological factors. Design/Methods: A retrospective single‐centre analysis of patients diagnosed with neuroblastoma between 1998 and 2018 was performed. Patients’ demographics, site of primary tumor, stage of disease at presentation, extent of tumor excision, presence of N‐MYC amplification, were extracted and analyzed. Overall survival was calculated using the Kaplan‐Meier method comparing survival probability. Results: A total of 92 patients were identified and included in the study. The median age at diagnosis was 2.25 years (range: 1 month to 7 years). 63% of the patient presented with International Neuroblastoma Staging System Stage 4 disease. Three‐year, five‐year and ten‐year overall survivals for the cohort were 86%, 75% and 65% respectively. INSS Stage 4 disease, N‐MYC amplification and extent of tumor resection were found to have statistically significant influence on the five‐year survival, with 55% of Stage 4 disease patients survive at 5 years as compared with 85% and 75% in patients with stage 2 and 3 diseases respectively (p = 0.045). On the other hand, 55% of N‐MYC positive patients survive at 5 years as compared to 90% in N‐MYC negative patients (p = 0.02). For extent of resection, more complete resection (>90% of tumor resected) was found to have positive influence on survival with 79% five‐year survival verses 40% in patients with subtotal resection (<90% of tumor resected) (p <0.05). Conclusions: There was a predominance of advanced stage patients in our cohort. Despite this, the survival outcome of patients treated in our centre is comparable with international centres (75% five‐year survival versus 61.6‐79.6% in European centres).