Long-Term Survival of Neuroblastoma Patients Receiving Surgery, Chemotherapy, and Radiotherapy: A Propensity Score Matching Study

Abstract

Neuroblastoma is the most common extracranial solid malignancy in children. This study was undertaken to determine the long-term survival of neuroblastoma patients receiving conventional therapeutics (surgery, chemotherapy, and radiotherapy). The neuroblastoma patients examined were registered in the Surveillance, Epidemiology and End Results (SEER) database (1975–2016). Using propensity score matching analysis, the patients were paired by record depending on whether they received surgery, chemotherapy, or radiotherapy. Univariate and multivariate analyses of the disease-specific survival of the paired patients were performed by the log-rank test and Cox regression assay. A total of 4568 neuroblastoma patients were included in this study. During 1975–2016, the proportion of histopathological grade III/IV cases receiving surgery gradually increased, while the number of patients with tumors of grade I to IV undergoing chemotherapy or radiotherapy was stable or even decreased. After propensity score analysis, for Grade I + II and Grade III tumors, surgery obviously improved the disease-specific survival of patients, while chemotherapy was unfavorable for patient prognosis, and radiotherapy exerted no obvious effect on the patients. However, no matter what treatment was chosen, the patients with advanced-histopathological-grade tumors had a poor prognosis. Meanwhile, for all histopathological grades, the patients receiving surgery and subsequent chemotherapy or radiotherapy suffered from worsen disease-specific survival than those simply undergoing surgery. Fortunately, the negative effects of surgery, chemotherapy, or radiotherapy improved gradually over time. Surgery improved the long-term survival of the neuroblastoma patients, while chemotherapy and radiotherapy exerted an unfavorable impact on patient outcome. These results provide an important reference for the clinical treatment of neuroblastoma.

Eflornithine as Postimmunotherapy Maintenance in High-Risk Neuroblastoma: Externally Controlled, Propensity Score–Matched Survival Outcome Comparisons

“…Because PSM can address potential sources of bias, its use in evaluating a variety of diseases that includes pediatric cancers has risen, and it is being increasingly considered by regulatory agencies. [25][26][27][28][32][33][34] Our analysis followed recommended PSM reporting guidelines 27 and achieved balance across all 11 baseline characteristics incorporated in the model.…”

Nonspecific Gastrointestinal Symptoms as the First Sign of Ganglioneuroblastoma Intermixed—Case Report and Literature Review

“…Prognostic factors such as age older than 18 months, histopathology, and MYCN in amplification pediatric patients are stratified into different risk groups, and on these depend the further proceedings. The low-risk group is mainly treated with surgery; the intermediate-risk group requires surgical management with moderate-intensity chemotherapy; and the high-risk group is treated with a variety of methods, including surgery, chemotherapy, radiotherapy, autologous hematopoietic stem cells, and immunotherapy [ 55 ]. In our case, based on the suspicion of metastasis on the CT scan and the child’s age of more than 18 months, the patient was classified as HR-NBL.…”

“…Compared with standard regimens, a rapid induction regimen with an increased dose intensity seemed to improve the 5-year (30.2% vs. 18.2%) event-free survival of patients. Nevertheless, this method of treatment is associated not only with more infectious complications and longer hospital stays but also with late complications, including growth failure, renal dysfunctions, hypothyroidism, hearing impairment, orthopedic impairment, and secondary malignancies [ 55 ]. Radiotherapy can also be used in the treatment of HR-NB, mainly to consolidate the locoregional control of residual and relapsed tumors or to treat resistant metastatic tumors.…”

Effects of barakol from Cassia siamea on neuroblastoma SH-SY5Y cell line: A potential combined therapy with doxorubicin

“…Neuroblastoma is one of the most common solid cancers found in early childhood [ 1 ]. The management of neuroblastoma is challenging for cancer specialists [ 2 ].…”