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Neuroblastoma originating from extra-abdominal sites: association with favorable clinical and biological features.

Sung KW, Yoo KH, Koo HH, Kim JY, Cho EJ, Seo YL, Kim J, Lee SK - J. Korean Med. Sci. (2009)

Bottom Line: The event-free survival rate (EFS) was also compared between the two groups.Levels of lactate dehydrogenase, ferritin and neuron-specific enolase were significantly lower in the extra-abdominal group than in the abdominal group.The probability of 5-yr EFS (+/-95% confidence interval) was higher in the extra-abdominal group than in the abdominal group (94.4+/-10.6% vs. 69.4+/-9.4%, P=0.026).

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT
Neuroblastomas originating from different sites might have different clinical and biological characteristics. In the present study, the clinical (age, sex and stage) and biological (N-myc amplification, Shimada pathology and levels of lactate dehydrogenase, ferritin and neuron-specific enolase) characteristics of patients with newly diagnosed neuroblastoma were compared according to the site of tumor origin (extra-abdominal versus abdominal). The event-free survival rate (EFS) was also compared between the two groups. Among 143 neuroblastomas, 115 tumors originated from the abdomen, 26 from extra-abdominal sites and 2 from unknown primary sites. Frequencies of stage 4 tumor and N-myc amplified tumor were lower in the extra-abdominal group than in the abdominal group (34.6% vs. 60.0%, P=0.019 and 4.2% vs. 45.0%, P<0.001, respectively). Levels of lactate dehydrogenase, ferritin and neuron-specific enolase were significantly lower in the extra-abdominal group than in the abdominal group. The probability of 5-yr EFS (+/-95% confidence interval) was higher in the extra-abdominal group than in the abdominal group (94.4+/-10.6% vs. 69.4+/-9.4%, P=0.026). Taken together, neuroblastomas originating from extra-abdominal sites might be associated with more favorable clinical and biological characteristics and a better outcome than neuroblastomas originating from abdomen.

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Levels of serum LDH (A), ferritin (B), NSE (C) and 24-hr urine VMA (D) were lower in the extra-abdominal group than in the abdominal group.
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Figure 1: Levels of serum LDH (A), ferritin (B), NSE (C) and 24-hr urine VMA (D) were lower in the extra-abdominal group than in the abdominal group.

Mentions: Table 3 shows the clinical and biological characteristics of the extra-abdominal and abdominal neuroblastomas. As for sex, there was no difference between the two groups. The median age at diagnosis in the abdominal and extra-abdominal group was 28 (range 1-129) months and 22.5 (range 7-74) months, respectively (P=0.484). In addition, there was no difference in the number of patients older than 1 yr of age at diagnosis between the two groups. The frequency of disseminated tumors (stage 4 and 4S) was lower in the extra-abdominal group than in the abdominal group (34.6% vs. 60.0%, P=0.019). The frequency of N-myc amplified tumors was also lower in the extra-abdominal group than in the abdominal group (4.2% vs. 45.0%, P<0.001). Accordingly, the proportion of high-risk tumors was lower in the extra-abdominal group than in the abdominal group (34.6% vs. 62.6%, P=0.026). Furthermore, the frequency of unfavorable Shimada pathology was lower in the extra-abdominal group than in the abdominal group, albeit this difference was not significant. The levels of serum LDH, ferritin, NSE and urine VMA were lower in the extra-abdominal group than in the abdominal group (median 679 vs. 1,391 IU/L, P<0.001, Fig. 1A; median 36 vs. 171 ng/mL, P=0.042, Fig. 1B; median 17 vs. 103 ng/mL, P<0.001, Fig. 1C; median 3.9 vs. 6.2 mg/day, P=0.056, Fig. 1D). The characteristics of the five extra-thoracic and extra-abdominal tumors were very similar to those of thoracic tumors. All five tumors were localized (stage 1 in 1 patient, stage 2 in 2 and stage 3 in 2). All of four both extra-thoracic and extra-abdominal tumors analyzed had non-amplified N-myc results. The levels of serum LDH, ferritin and NSE were very low (median 504 IU/L, 24 ng/mL and 12 ng/mL, respectively).


Neuroblastoma originating from extra-abdominal sites: association with favorable clinical and biological features.

Sung KW, Yoo KH, Koo HH, Kim JY, Cho EJ, Seo YL, Kim J, Lee SK - J. Korean Med. Sci. (2009)

Levels of serum LDH (A), ferritin (B), NSE (C) and 24-hr urine VMA (D) were lower in the extra-abdominal group than in the abdominal group.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2698193&req=5

Figure 1: Levels of serum LDH (A), ferritin (B), NSE (C) and 24-hr urine VMA (D) were lower in the extra-abdominal group than in the abdominal group.
Mentions: Table 3 shows the clinical and biological characteristics of the extra-abdominal and abdominal neuroblastomas. As for sex, there was no difference between the two groups. The median age at diagnosis in the abdominal and extra-abdominal group was 28 (range 1-129) months and 22.5 (range 7-74) months, respectively (P=0.484). In addition, there was no difference in the number of patients older than 1 yr of age at diagnosis between the two groups. The frequency of disseminated tumors (stage 4 and 4S) was lower in the extra-abdominal group than in the abdominal group (34.6% vs. 60.0%, P=0.019). The frequency of N-myc amplified tumors was also lower in the extra-abdominal group than in the abdominal group (4.2% vs. 45.0%, P<0.001). Accordingly, the proportion of high-risk tumors was lower in the extra-abdominal group than in the abdominal group (34.6% vs. 62.6%, P=0.026). Furthermore, the frequency of unfavorable Shimada pathology was lower in the extra-abdominal group than in the abdominal group, albeit this difference was not significant. The levels of serum LDH, ferritin, NSE and urine VMA were lower in the extra-abdominal group than in the abdominal group (median 679 vs. 1,391 IU/L, P<0.001, Fig. 1A; median 36 vs. 171 ng/mL, P=0.042, Fig. 1B; median 17 vs. 103 ng/mL, P<0.001, Fig. 1C; median 3.9 vs. 6.2 mg/day, P=0.056, Fig. 1D). The characteristics of the five extra-thoracic and extra-abdominal tumors were very similar to those of thoracic tumors. All five tumors were localized (stage 1 in 1 patient, stage 2 in 2 and stage 3 in 2). All of four both extra-thoracic and extra-abdominal tumors analyzed had non-amplified N-myc results. The levels of serum LDH, ferritin and NSE were very low (median 504 IU/L, 24 ng/mL and 12 ng/mL, respectively).

Bottom Line: The event-free survival rate (EFS) was also compared between the two groups.Levels of lactate dehydrogenase, ferritin and neuron-specific enolase were significantly lower in the extra-abdominal group than in the abdominal group.The probability of 5-yr EFS (+/-95% confidence interval) was higher in the extra-abdominal group than in the abdominal group (94.4+/-10.6% vs. 69.4+/-9.4%, P=0.026).

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT
Neuroblastomas originating from different sites might have different clinical and biological characteristics. In the present study, the clinical (age, sex and stage) and biological (N-myc amplification, Shimada pathology and levels of lactate dehydrogenase, ferritin and neuron-specific enolase) characteristics of patients with newly diagnosed neuroblastoma were compared according to the site of tumor origin (extra-abdominal versus abdominal). The event-free survival rate (EFS) was also compared between the two groups. Among 143 neuroblastomas, 115 tumors originated from the abdomen, 26 from extra-abdominal sites and 2 from unknown primary sites. Frequencies of stage 4 tumor and N-myc amplified tumor were lower in the extra-abdominal group than in the abdominal group (34.6% vs. 60.0%, P=0.019 and 4.2% vs. 45.0%, P<0.001, respectively). Levels of lactate dehydrogenase, ferritin and neuron-specific enolase were significantly lower in the extra-abdominal group than in the abdominal group. The probability of 5-yr EFS (+/-95% confidence interval) was higher in the extra-abdominal group than in the abdominal group (94.4+/-10.6% vs. 69.4+/-9.4%, P=0.026). Taken together, neuroblastomas originating from extra-abdominal sites might be associated with more favorable clinical and biological characteristics and a better outcome than neuroblastomas originating from abdomen.

Show MeSH
Related in: MedlinePlus