Neuroblastomas treated at the four major child oncologic clinics in Denmark 1943–1980: An evaluation of 180 cases

Abstract

One hundred and eighty cases of neuroblastomas from the four child oncology clinics are reviewed. The overall cure rate was 24%. During the 38-year period, there was a significant increase in survival from 0% during the period of 1943-1950 to 32% during the period of 1971-1980. This improved survival rate is most likely a result of adjuvant chemotherapy. Forty percent of the patients appear chronically ill, which reflects the fact that nearly 60% have metastases when they are first seen. In localized disease (stages I-II), the prognosis was favourable (cure rate 69%), while the prognosis for disseminated disease (stage III-IV) was poor (cure rate 5%). A favourable outcome was seen in patients under 1 year (survival rate 46%), and in patients with primary tumours located in the neck or mediastinum (survival rate 48%). When related to stage, however, the survival rates for the former tumours were not significantly better in patients below 1 year or in patients with cervical or thoracic tumours. As is the case in other studies, we found that survival is significantly poorer in males.

Trends of survival in neuroblastoma and independent risk factors for survival at a single institution

“…The survival rates by Evans stage were also similar to ours. The survival in a hospital-based study in Denmark [40] seemed a little lower than ours. The 10-year survival rate in the years 1971-80 was 32%.…”

Epidemiological investigations on neuroblastomas in Denmark 1943-1980

“…Neuroblastoma cases with spontaneous cure or cure obtained in other hospitals than those investigated might have escaped ascertainment in this study; however, the rate of spontaneous regression or maturation of clinically overt disease has been estimated to be 8 per cent of cases (Evans et al, 1976), and this frequency obviously cannot influence the present estimates of the true trends in incidence significantly. The observation of a continuing rise in incidence in recent years despite the lack of noteworthy improvement in diagnosis, and despite no further centralization of treatment (Carlsen et al, 1985), support the conjecture that the rise in incidence is real. It is therefore believed that the present estimates reflect the true trends in incidence of childhood neuroblastoma in Denmark during the period 1943-80.…”

“…However, no specific risk factors were revealed. Children born to mothers over 34 years have the lowest incidence during the first year of life, suggesting that a possible hereditary mutation may play its role later in life, but these considerations are speculative, since most neuroblastomas are most likely congenital (Birch et al, 1980;Carlsen et al, 1985;Wilson & Draper, 1974).…”

Prognostic factors in metastatic neuroblastoma in patients over 1 year of age treated with high-dose chemotherapy and stem cell transplantation: a multivariate analysis in 218 patients treated in a single institution

“…Following HDC and SCT for this population of 218 patients, the probability of disease-free survival 5 years post-diagnosis was 29% (23-36) and overall survival was 31% (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38). The median observation time of the entire popoulation was 120 months (26-231), with 99 months (27-212) for patients treated with busulfan-melphalan and 155 months (26-231) for those treated with other combinations.…”

“…Some studies including all stages of neuroblastoma have previously suggested that the prognosis of neuroblastoma is better in females. 31 The excess of male patients suffering from stage IV disease could be an explanation. Nevertheless, a sex ratio close to 1.5 is found in other large series of stage IV patients and especially those in the large series of the EBMT Solid Tumor Working Party.…”