Prognostic factors for intermediate- or high-risk neuroblastomas in children in China.

ABSTRACT

BACKGROUND: Evidence regarding the characteristics and prognosis of neuroblastoma (NBL) in China is limited. We aimed to investigate the characteristics and prognosis of intermediate- or high-risk NBL in children in China. METHODS: We included 147 patients with intermediate- or high-risk NBL evaluated from January 2006 to March 2015. The patients were aged 1 month to 15.5 years, 66% of them were boys, and 117 (79.6%) were diagnosed with high-risk NBL. RESULTS: After a median follow-up of 32.5 months, 80 (45.6%) patients survived, with a median survival time of 48 months (95% confidence interval [CI] 36.41-59.59). High-risk patients (hazard ratio [HR] 12.467; 95% CI 11.029-12.951), partial response (PR) (HR 1.200; 95% CI 1.475-2.509) or progression disease (PD) (HR 1.924; 95% CI 1.623-3.012) after induction chemotherapy, and intracranial metastasis (HR 3.057; 95% CI 0.941-4.892) were independent risk factors for survival (p < 0.05) and postrelapse survival (p < 0.05). NBL relapse, male sex, and PR or PD after induction chemotherapy were risk factors for event-free survival (p < 0.05). CONCLUSIONS: In addition to previously established independent risk factors, such as age, risk group, and relapse, efficacy of induction chemotherapy and intracranial metastasis play significant roles in the prognosis of NBL.