Improved survival rates in children over 1 year of age with stage III or IV neuroblastoma following an intensive chemotherapeutic regimen

Ikeda, Keiichi; Nakagawara, Akira; Yano, Hiromichi; Akiyama, Hiroshi; Tasaka, H; Ueda, Kohji; Hara, Toshiro; Ishii, Eiichi; Ohgami, Hiroshi; Sera, Yoshihisa; Shimoda, Hozumi; Kishida, Kunio; Tobo, Yunosuke; Hiyoshi, Y; Kawakami, Kiyoshi; Ohmori, Harunori; Kuwano, Satoshi

doi:10.1016/s0022-3468(89)80247-7

Cited by 20 publications

(1 citation statement)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, relapse and poor long-term prognosis continue to be major problems in this high-risk group [45]. Recently intensive regimens have been described with 4-year cumulative survival rates or 76% in Evans' stage 111, and 20% in stage IV disease [46]. These chemotherapy protocols include a combination of high dose cyclophosphamide (40 mg/kg x 2 days) and repetitive doses of cisplatinum (20 mg/m2 x 5 days) plus VM-26 (100 mg/m2) and doxorubicin (60 mg/m2) and DTIC (250 mg/m2).…”

Section: Stagingmentioning

confidence: 99%

Current biologic and therapeutic implications in the surgery of neuroblastoma

Azizkhan

Haase

1993

Seminars in Surgical Oncology

View full text Add to dashboard Cite

Advances in the understanding of neuroblastoma biology have helped distinguish those patients who require maximum therapy from those who do not. However, management of children with advanced disease remains a significant problem. New more intensive multiagent chemotherapy, ablative chemoradiotherapy with bone marrow transplantation, radiolabelled monoclonal antibody technology and a host of biologic response modifiers are currently being intensively studied. Nevertheless, surgery remains crucial for diagnosis, for providing adequate tissue for biological and histopathologic staging, for primary and secondary resections as well as restaging after therapy. Major surgical questions remain to be addressed in cooperative group studies.

show abstract

Section: Stagingmentioning

confidence: 99%

Current biologic and therapeutic implications in the surgery of neuroblastoma

Azizkhan

Haase

1993

Seminars in Surgical Oncology

View full text Add to dashboard Cite

show abstract

Different genomic and metabolic patterns between mass screening-positive and mass screening-negative later-presenting neuroblastomas

Nakagawara

Zaizen

Ikeda

et al. 1991

Cancer

Self Cite

View full text Add to dashboard Cite

The mass screening of neuroblastoma has been undertaken in Japan by measuring urinary vanillylmandelic acid (VMA) and homovanillic acid (HVA) in all infants at the age of 6 months. This program may not only improve the prognosis but also provide important insights into the biology and evolution of human neuroblastoma. The authors studied and discuss the clinical significance of the N‐myc oncogene, catecholamine metabolism, and other tumor markers in 43 patients with neuroblastoma who underwent the urinary screening test at 6 months of age. Thirty patients were found by the screening, and 13 were negative at the screening but later had a tumor. In the former group, the tumors were mostly in early stages (Stage I, 12; Stage II, 11; Stage III, seven), no amplification of N‐myc was observed, and all patients are alive without disease. Although two patients whose urine at the screening showed elevated VMA and HVA levels and accidentally were not treated for 13 and 17 months, there was no change in the values of VMA and HVA during that time. However, in the latter group, the tumors were mostly in advanced stages (Stage I, one; Stage III, four; Stage IV, eight), and N‐myc amplification was observed in seven of 13. Only two of these 13 are alive without disease. The age at diagnosis of the screening‐negative group was 23 months compared with 8 months in the patients identified by screening, and the pattern of catecholamine metabolites in the screening‐negative group tended to be dopaminergic with a low VMA–HVA ratio, especially in cases with N‐myc amplification. These data suggest that the screening‐positive patients with neuroblastoma may have favorable characteristics, and the biology of these tumors may be different from that of screening‐negative later‐presenting tumors. They also suggest that there may be at least two distinct subsets of neuroblastoma. For the early detection of the poor prognostic neuroblastomas, the measurement of urinary dopamine with VMA and HVA at later ages, such as 1 to 2 years, should be considered.

show abstract

Neuroblastoma stage IV‐S: A heterogeneous disease

Wilson

Coppes

Solh

et al. 1991

Med. Pediatr. Oncol.

View full text Add to dashboard Cite

Eighteen patients were diagnosed and treated for Stage IV-S neuroblastoma at The Hospital for Sick Children, Toronto between January 1971 and December 1988. All patients were 6 months of age or younger at diagnosis. Nine patients (50%) have remained disease free with a mean follow-up of 9.3 years. Of the seven patients under 6 weeks of age at presentation, four presented in the early neonatal period and died, three due to mechanical complications related to progressive disease, and one due to late recurrence. The remaining three patients under 6 weeks of age, two of whom had skin involvement at diagnosis, are alive and disease free. Six of the 11 patients over 6 weeks of age at presentation survived, combined modality therapy (CMT) being more effective than single modality treatment. N-myc was studied from tumor tissue at diagnosis in four patients and was amplified in three (25x, 25x, 100x), all of whom had late disease progression and died. The patient with a single gene copy has no evidence of disease 24 months following diagnosis. Our study confirms the heterogeneity described in this clinically defined group of patients. Because of it, management of Stage IV-S neuroblastoma cannot be uniform and until further development of a subclassification, or a reclassification based on molecular biologic markers is developed, pediatric oncologists will regularly be confronted with a decision whether or not to treat a newly presenting patient that fits into the clinical classification IV-S.

show abstract

Improved survival rates in children over 1 year of age with stage III or IV neuroblastoma following an intensive chemotherapeutic regimen

Cited by 20 publications

References 11 publications

Current biologic and therapeutic implications in the surgery of neuroblastoma

Current biologic and therapeutic implications in the surgery of neuroblastoma

Different genomic and metabolic patterns between mass screening-positive and mass screening-negative later-presenting neuroblastomas

Neuroblastoma stage IV‐S: A heterogeneous disease

Contact Info

Product

Resources

About