The prognostic significance of age and pattern of metastases in stage IV-S neuroblastoma.

ABSTRACT

Stage IV-S neuroblastoma is a unique disseminated neoplasia characterized by remote disease to the liver, skin, or bone marrow. Stage IV-S patients have frequent spontaneous remissions and a 60% to 90% survival rate. Many investigators have recommended minimal or no therapeutic intervention; however, some patients do experience progressive disease and ultimately die of neuroblastoma. Many authors have commented on single prognostic factors such as age and site of metastatic involvement. Five newborns were recently seen at Walter Reed Army Medical Center with Stage IV-S neuroblastoma. Four of these children died of mechanical complications associated with massive hepatomegaly, prompting this review of Stage IV-S neuroblastoma to determine prognostic factors.