Impact of MYCN status on response of high-risk neuroblastoma to neoadjuvant chemotherapy.
J Pediatr Surg
; 55(1): 130-134, 2020 Jan.
Article
em En
| MEDLINE
| ID: mdl-31685267
ABSTRACT
BACKGROUND/PURPOSE:
MYCN-amplification in neuroblastoma is associated with an aggressive clinical phenotype. We evaluated the association of MYCN amplification with tumor response to neoadjuvant chemotherapy.METHODS:
Primary tumor response, assessed by percentage volume change on CT scan and degree of tumor resection, assessed by the operating surgeon, were retrospectively compared in 84 high-risk neuroblastoma patients. There were thirty-four (40%) with MYCN-amplified tumors and fifty (60%) with non-amplified tumors treated at our institution from 1999 to 2016. Metastatic disease response was assessed on MIBG scan by change in Curie score.RESULTS:
MYCN-amplification was associated with a greater mean percentage reduction in primary tumor volume after neoadjuvant chemotherapy (72.27% versus 46.83% [non-amplified tumors], pâ¯=â¯0.001). The percentage of patients with a Curie scoreâ¯>â¯2 at diagnosis who then had a scoreâ¯≤â¯2 after neoadjuvant chemotherapy was not significantly different (8 [61.5%] and 8 [34.8%], respectively, pâ¯=â¯0.37). Twenty-eight (85.7%) patients with MYCN-amplification had ≥90% surgical resection compared to 45 (91.84%) patients with non-amplified tumors (pâ¯=â¯0.303).CONCLUSIONS:
MYCN-amplification in high-risk neuroblastoma was associated with a better response of the primary tumor to neoadjuvant chemotherapy, but not metastatic sites, than in patients with non-amplified tumors. This did not significantly impact the ability to resect ≥90% of the primary tumor/locoregional disease. TYPE OF STUDY Treatment Study LEVEL OF EVIDENCE Level III.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Proteína Proto-Oncogênica N-Myc
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Neuroblastoma
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Antineoplásicos
Tipo de estudo:
Etiology_studies
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Observational_studies
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Risk_factors_studies
Limite:
Child, preschool
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Female
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Humans
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Infant
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Male
Idioma:
En
Revista:
J Pediatr Surg
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Tunísia