A five-year review of children with neuroblastoma at Dr. Sardjito General Hospital, Yogyakarta, Indonesia

Abstract

Background Neuroblastoma is the third most common tumor in children, after leukemia and retinoblastoma. The disease presents with a wide range of symptoms.
 Objective To assess the clinical profiles of children with neuroblastoma at Dr. Sardjito General Hospital from 2012-2016.
 Methods A retrospective review of all children with neuroblastoma under 18 years of age in the Children’s Ward of Dr. Sardjito General Hospital, Yogyakarta from 2012-2016. Patients diagnosed and treated in other hospitals were excluded. Data were taken from the Yogyakarta Pediatric Cancer Registry (YPCR) and medical records. Outcomes were assessed by patient status: alive, died, or lost to follow-up.
 Results A total of 40 subjects were included in this study. Six (15.0%) patients were diagnosed at <1 year of age, 26 (65.0%) patients at 1 to <5 years of age, 6 (15.0%) patients at 5 to <10 years of age, and 2 (5.0%) patients at ≥10 years of age. The male to female ratio was 1.5:1. Four (10.0%) patients had stage IV-S, 34 (85.0 %) patients had stage IV, and 2 (5.0 %) patients had stage II/III of the disease. Proptosis (40.0%) and abdominal mass (35.0%) were the most common chief complaints. Eight (20.0%) patients were alive at the end of observation, 15 (37.5%) died, and 17 (42.5%) were lost to follow-up. The deaths were mostly caused by sepsis.
 Conclusion Most patients are diagnosed at the age of 1 to <5 years, with a median age of 3 years. Proptosis is the most common chief complaint. Most patients present in stage IV. Overall survival rate is very low. The high numbers of lost to follow-up should be noted.

Autologous stem cell transplant for high‐risk neuroblastoma: Achieving cure with low‐cost adaptations

“…In a single‐center outcome analysis from Indonesia, ASCT was not included in the therapy for HR‐NB patients. An OS of 27% at 3.8 years was reported across all stages 29 . Similarly, a 4‐year OS of 17% for HR‐NB has been reported from a single center in Iran 30 .…”

“…An OS of 27% at 3.8 years was reported across all stages. 29 Similarly, a 4-year OS of 17% for HR-NB has been reported from a single center in Iran. 30 Heterogeneous resource allocation, with dependence on private insurance, restricted the availability of ASCT to 3.7% HR-NB patients in South Africa, with radiotherapy and cis-retinoic acid also having limited availability.…”

Predictors of mortality in children with neuroblastoma

“…The INRG stated that the 5-year survival rate after diagnosis was less than 50%, while in Indonesia, it was reported to be 25%6 and 27%. 5 The low survival rate in Indonesia is likely due to late patient presentation at stage IV, which is often accompanied by distant metastases. 2,5,6,16 The similarity between our study and the other two Indonesian studies was that most patients were in stage IV at the time of diagnosis (77.4%, 53%,6 and 85%,5 respectively).…”

“…5 The low survival rate in Indonesia is likely due to late patient presentation at stage IV, which is often accompanied by distant metastases. 2,5,6,16 The similarity between our study and the other two Indonesian studies was that most patients were in stage IV at the time of diagnosis (77.4%, 53%,6 and 85%,5 respectively). The INRG stated that 40% of pediatric neuroblastoma patients were in stage IV at the time of diagnosis.…”

“…2 A survival study conducted in pediatric neuroblastoma patients at Dr. Sardjito Hospital, Yogyakarta, showed an overall five-year survival rate of 27%, while in Dr. Cipto Mangunkusumo Hospital, Jakarta, it was 37%. 5,6…”