Neuroblastoma natural history: Difference between revisions

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{{CMG}} {{AE}}{{ZAS}}{{HL}}
{{CMG}} {{AE}}{{ZAS}}{{HL}}
==Overview==
==Overview==
Neuroblastoma may progress to develop fatigue, loss of appetite, joint pain and fever if left untreated. There is gradual development of site specific symptoms as the tumor size gradually increases. Complications of neuroblastoma include; persistent refractory diarrhea, horner's syndrome, hypertension, transverse myelopathy, anemia and suppressed immunity. The prognosis of neuroblastoma is generally regarded as poor, depending on the tumor extent at the time of diagnosis. The other prognostic factors for nuroblastoma include; patient's age, tumor stage and grade, genetic mutations and response to treatment.
Neuroblastoma may progress to develop [[fatigue]], [[loss of appetite]], [[joint pain]] and [[fever]] if left untreated. There is gradual [[development]] of site specific [[Symptom|symptoms]] as the [[tumor]] size gradually increases. [[Complication (medicine)|Complications]] of neuroblastoma include persistent refractory [[diarrhea]], [[horner's syndrome]], [[hypertension]], [[Transverse myelitis|transverse myelopathy]], [[anemia]] and [[Immunodeficiency|suppressed immunity]]. The [[prognosis]] of neuroblastoma is generally regarded as poor, depending on the [[tumor]] extent at the time of [[diagnosis]]. The other [[Prognosis|prognostic]] factors for nuroblastoma include patient's [[age]], [[tumor]] stage and grade, [[genetic mutations]] and response to treatment.


==Natural History==
==Natural History==
* Neuroblastoma patients may initially present with vague symptoms making the diagnosis of such patients difficult.<ref>{{Cite journal
* Neuroblastoma [[Patient|patients]] may initially present with vague [[Symptom|symptoms]] making the [[diagnosis]] of such [[Patient|patients]] difficult.<ref>{{Cite journal
  | author = [[L. M. Wilson]] & [[G. J. Draper]]
  | author = [[L. M. Wilson]] & [[G. J. Draper]]
  | title = Neuroblastoma, its natural history and prognosis: a study of 487 cases
  | title = Neuroblastoma, its natural history and prognosis: a study of 487 cases
Line 28: Line 28:
  | pmid = 21922650
  | pmid = 21922650
}}</ref>
}}</ref>
* If left untreated, patients with neuroblastoma may progress to develop [[fatigue]], [[loss of appetite]], [[joint pain]], and [[fever]].
* If left untreated, [[Patient|patients]] with neuroblastoma may progress to develop [[fatigue]], [[loss of appetite]], [[joint pain]], and [[fever]].
* Gradual development of site specific symptoms may occur as the tumor size gradually increases.<ref>{{Cite journal
* Gradual development of site specific [[Symptom|symptoms]] may occur as the [[tumor]] size gradually increases.<ref>{{Cite journal
  | author = [[C. S. Alvarado]], [[W. B. London]], [[A. T. Look]], [[G. M. Brodeur]], [[D. H. Altmiller]], [[P. S. Thorner]], [[V. V. Joshi]], [[S. T. Rowe]], [[M. B. Nash]], [[E. I. Smith]], [[R. P. Castleberry]] & [[S. L. Cohn]]
  | author = [[C. S. Alvarado]], [[W. B. London]], [[A. T. Look]], [[G. M. Brodeur]], [[D. H. Altmiller]], [[P. S. Thorner]], [[V. V. Joshi]], [[S. T. Rowe]], [[M. B. Nash]], [[E. I. Smith]], [[R. P. Castleberry]] & [[S. L. Cohn]]
  | title = Natural history and biology of stage A neuroblastoma: a Pediatric Oncology Group Study
  | title = Natural history and biology of stage A neuroblastoma: a Pediatric Oncology Group Study
Line 42: Line 42:


==Complications==
==Complications==
* Complications of neuroblastoma may include:<ref>{{Cite journal
* [[Complication (medicine)|Complications]] of neuroblastoma may include:<ref>{{Cite journal
  | author = [[Nadja C. Colon]] & [[Dai H. Chung]]
  | author = [[Nadja C. Colon]] & [[Dai H. Chung]]
  | title = Neuroblastoma
  | title = Neuroblastoma
Line 53: Line 53:
  | doi = 10.1016/j.yapd.2011.03.011
  | doi = 10.1016/j.yapd.2011.03.011
  | pmid = 21736987
  | pmid = 21736987
}}</ref><ref>{{Cite journal
| author = [[John M. Maris]]
| title = Recent advances in neuroblastoma
| journal = [[The New England journal of medicine]]
| volume = 362
| issue = 23
| pages = 2202–2211
| year = 2010
| month = June
| doi = 10.1056/NEJMra0804577
| pmid = 20558371
}}</ref><ref>{{Cite journal
| author = [[Michal Sieniawski]], [[Jeremy Franklin]], [[Lucia Nogova]], [[Jan-Peter Glossmann]], [[Thomas Schober]], [[Hiltrud Nisters-Backes]], [[Volker Diehl]] & [[Andreas Josting]]
| title = Outcome of patients experiencing progression or relapse after primary treatment with two cycles of chemotherapy and radiotherapy for early-stage favorable Hodgkin's lymphoma
| journal = [[Journal of clinical oncology : official journal of the American Society of Clinical Oncology]]
| volume = 25
| issue = 15
| pages = 2000–2005
| year = 2007
| month = May
| doi = 10.1200/JCO.2006.10.1386
| pmid = 17420510
}}</ref>
}}</ref>
:* Persistent refractory diarrhea (due to vasoactive intestinal peptide secretion)
:* Persistent refractory [[diarrhea]] (due to [[Vasoactive intestinal peptide|vasoactive intestinal polypeptide]] secretion)
:* Horner's syndrome (due to cervical sympathetic chain compression)
:* [[Horner's syndrome]] (due to [[cervical sympathetic chain]] compression)
:* Opsoclonus myoclonus syndrome and ataxia (due to a paraneoplastic syndrome)
:* [[Opsoclonus myoclonus syndrome]] and [[ataxia]] (due to a [[paraneoplastic syndrome]])
:* Hypertension (due to either catecholamine secretion or renal artery compression)
:* [[Hypertension]] (due to either [[catecholamine]] secretion or [[renal artery]] compression)
:* Transverse myelopathy (due to tumor spinal cord compression)
:* [[Transverse myelitis|Transverse myelopathy]] (due to [[tumor]] [[spinal cord]] compression)
:* Anemia and suppressed immunity (due to bone marrow metastasis)
:* [[Anemia]] and [[Immunodeficiency|suppressed immunity]] (due to [[bone marrow]] [[metastasis]])


==Prognosis==
==Prognosis==
* Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. However, the prognosis of neuroblastoma is generally regarded as poor.
* Depending on the extent of the [[tumor]] at the time of [[diagnosis]], the [[prognosis]] may vary. However, the [[prognosis]] of neuroblastoma is generally regarded as poor.<ref>{{Cite journal
* INSS '''stage 1''', '''stage 2''', and '''stage 4S''' neuroblastomas  are associated with a 3 year survival rate of 75-90%.
| author = [[Julie R. Park]], [[Angelika Eggert]] & [[Huib Caron]]
* INSS '''stage 3''' neuroblastoma is associated with a 3 year survival rate of 80-90% among patients '''younger''' than 1 year of age.
| title = Neuroblastoma: biology, prognosis, and treatment
* INSS '''stage 3''' neuroblastoma is associated with a 3 year survival rate of 50% among patients '''older''' than 1 year of age.
| journal = [[Pediatric clinics of North America]]
* INSS '''stage 4''' neuroblastoma is associated with a 3 year survival rate of 60-75% among patients '''younger''' than 1 year of age.
| volume = 55
* INSS '''stage 4''' neuroblastoma is associated with a 3 year survival rate of 15% among patients '''older''' than 1 year of age.
| issue = 1
* The table below lists the prognostic factors for neuroblastoma patients:<ref name="radio">Neuroblastoma. Radiopaedia(2015) http://radiopaedia.org/articles/neuroblastoma Accessed on October, 5 2015</ref><ref name="gov"> Neuroblastoma Treatment for health professionals. National Cancer Institute (2015) http://www.cancer.gov/types/neuroblastoma/hp/neuroblastoma-treatment-pdq#link/_534_toc Accessed on October, 7 2015</ref><ref name="patho"> Neuroblastoma. Libre Pathology(2015) http://librepathology.org/wiki/index.php/Adrenal_gland#Neuroblastoma Accessed on October, 5 2015</ref><ref>{{Cite journal
| pages = 97–120
| year = 2008
| month = February
| doi = 10.1016/j.pcl.2007.10.014
| pmid = 18242317
}}</ref><ref>{{Cite journal
| author = [[L. M. Wilson]] & [[G. J. Draper]]
| title = Neuroblastoma, its natural history and prognosis: a study of 487 cases
| journal = [[British medical journal]]
| volume = 3
| issue = 5926
| pages = 301–307
| year = 1974
| month = August
| pmid = 4414795
}}</ref><ref>{{Cite journal
| author = [[Maya Suzuki]], [[Brian H. Kushner]], [[Kim Kramer]], [[Ellen M. Basu]], [[Stephen S. Roberts]], [[William J. Hammond]], [[Michael P. LaQuaglia]], [[Suzanne L. Wolden]], [[Nai-Kong V. Cheung]] & [[Shakeel Modak]]
| title = Treatment and outcome of adult-onset neuroblastoma
| journal = [[International journal of cancer]]
| volume = 143
| issue = 5
| pages = 1249–1258
| year = 2018
| month = September
| doi = 10.1002/ijc.31399
| pmid = 29574715
}}</ref><ref>{{Cite journal
| author = [[Nermine O. Basta]], [[Gail C. Halliday]], [[Guy Makin]], [[Jillian Birch]], [[Richard Feltbower]], [[Nick Bown]], [[Martin Elliott]], [[Lucas Moreno]], [[Giuseppe Barone]], [[Andrew Dj Pearson]], [[Peter W. James]], [[Deborah A. Tweddle]] & [[Richard Jq McNally]]
| title = Factors associated with recurrence and survival length following relapse in patients with neuroblastoma
| journal = [[British journal of cancer]]
| volume = 115
| issue = 9
| pages = 1048–1057
| year = 2016
| month = October
| doi = 10.1038/bjc.2016.302
| pmid = 27701387
}}</ref>
* INSS '''stage 1''', '''stage 2''', and '''stage 4S''' neuroblastomas  are associated with a 3 year [[survival rate]] of 75-90%.
* INSS '''stage 3''' neuroblastoma is associated with a 3 year [[survival rate]] of 80-90% among patients '''younger''' than 1 year of [[age]].
* INSS '''stage 3''' neuroblastoma is associated with a 3 year [[survival rate]] of 50% among patients '''older''' than 1 year of [[age]].
* INSS '''stage 4''' neuroblastoma is associated with a 3 year [[survival rate]] of 60-75% among patients '''younger''' than 1 year of [[age]].
* INSS '''stage 4''' neuroblastoma is associated with a 3 year [[survival rate]] of 15% among patients '''older''' than 1 year of [[age]].
* The table below lists the [[Prognosis|prognostic]] factors for neuroblastoma [[Patient|patients]]:<ref name="radio">Neuroblastoma. Radiopaedia(2015) http://radiopaedia.org/articles/neuroblastoma Accessed on October, 5 2015</ref><ref name="gov">Neuroblastoma Treatment for health professionals. National Cancer Institute (2015) http://www.cancer.gov/types/neuroblastoma/hp/neuroblastoma-treatment-pdq#link/_534_toc Accessed on October, 7 2015</ref><ref name="patho">Neuroblastoma. Libre Pathology(2015) http://librepathology.org/wiki/index.php/Adrenal_gland#Neuroblastoma Accessed on October, 5 2015</ref><ref>{{Cite journal
  | author = [[G. Hale]], [[M. J. Gula]] & [[J. Blatt]]
  | author = [[G. Hale]], [[M. J. Gula]] & [[J. Blatt]]
  | title = Impact of gender on the natural history of neuroblastoma
  | title = Impact of gender on the natural history of neuroblastoma
Line 80: Line 145:
}}</ref>
}}</ref>
{| style="border: 0px; font-size: 90%; margin: 3px; width: 1100px"
{| style="border: 0px; font-size: 90%; margin: 3px; width: 1100px"
|valign=top|
| valign="top" |
|+
|+
! style="background: #4479BA; width: 200px; color: #FFFFFF;"|'''Prognostic Factor'''
! style="background: #4479BA; width: 200px; color: #FFFFFF;" |'''Prognostic Factor'''


! style="background: #4479BA; width: 600px; color: #FFFFFF;"|'''Description'''
! style="background: #4479BA; width: 600px; color: #FFFFFF;" |'''Description'''


|-
|-


| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center | '''Patient's Age'''|| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" | '''Patient's Age'''|| style="padding: 5px 5px; background: #F5F5F5;" |
:Patients older than 18 months of age are associated with poor prognosis.
:[[Patient|Patients]] older than 18 months of age are associated with poor [[prognosis]].


|-
|-


| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center| '''Tumor Stage'''|| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" | '''Tumor Stage'''|| style="padding: 5px 5px; background: #F5F5F5;" |
:Advanced INSS stages of neuroblastoma are associated with poor prognosis.
:Advanced INSS stages of neuroblastoma are associated with poor [[prognosis]].


|-
|-


| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center| '''Tumor Grade'''|| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" | '''Tumor Grade'''|| style="padding: 5px 5px; background: #F5F5F5;" |
:An unfavorable Shimada histology index is associated with poor prognosis.
:An unfavorable Shimada [[histology]] index is associated with poor [[prognosis]].


|-
|-


| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center| '''Schwannnian Stroma'''|| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" | '''Schwannnian Stroma'''|| style="padding: 5px 5px; background: #F5F5F5;" |
:Reduced schwannian [[stroma]] content on [[histological]] analysis is associated with poor prognosis.
:Reduced schwannian [[stroma]] content on [[histological]] analysis is associated with poor [[prognosis]].
|-
|-


| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center| '''Mitotic-karyorrhectic Index'''|| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" | '''Mitotic-karyorrhectic Index'''|| style="padding: 5px 5px; background: #F5F5F5;" |
:A high mitotic-karyorrhectic index is associated with poor prognosis.
:A high mitotic-karyorrhectic index is associated with poor [[prognosis]].


|-
|-


| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center| '''Genetics Mutations'''|| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" | '''[[Genetic mutations|Genetic Mutations]]'''|| style="padding: 5px 5px; background: #F5F5F5;" |
:Chromosome 1p deletion, [[chromosome]] 11q deletion, and ''N-MYC'' oncogene amplification are associated with poor prognosis.
:Chromosome 1p deletion, [[chromosome]] 11q deletion, and ''N-MYC'' [[oncogene]] amplification are associated with poor [[prognosis]].
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center| '''Response to Treatment'''|| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" | '''Response to Treatment'''|| style="padding: 5px 5px; background: #F5F5F5;" |
:Patients whose neuroblastoma responds to treatment and goes into complete remission have a better prognosis than people whose cancer does not respond to the initial treatment.
:[[Patient|Patients]] whose neuroblastoma responds to treatment and goes into complete [[Remission (medicine)|remission]] have a better [[prognosis]] than people whose [[cancer]] does not respond to the initial treatment.
|}
|}


Latest revision as of 15:40, 7 March 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Zahir Ali Shaikh, MD[2]Haytham Allaham, M.D. [3]

Overview

Neuroblastoma may progress to develop fatigue, loss of appetite, joint pain and fever if left untreated. There is gradual development of site specific symptoms as the tumor size gradually increases. Complications of neuroblastoma include persistent refractory diarrhea, horner's syndrome, hypertension, transverse myelopathy, anemia and suppressed immunity. The prognosis of neuroblastoma is generally regarded as poor, depending on the tumor extent at the time of diagnosis. The other prognostic factors for nuroblastoma include patient's age, tumor stage and grade, genetic mutations and response to treatment.

Natural History

Complications

Prognosis

  • Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. However, the prognosis of neuroblastoma is generally regarded as poor.[7][8][9][10]
  • INSS stage 1, stage 2, and stage 4S neuroblastomas are associated with a 3 year survival rate of 75-90%.
  • INSS stage 3 neuroblastoma is associated with a 3 year survival rate of 80-90% among patients younger than 1 year of age.
  • INSS stage 3 neuroblastoma is associated with a 3 year survival rate of 50% among patients older than 1 year of age.
  • INSS stage 4 neuroblastoma is associated with a 3 year survival rate of 60-75% among patients younger than 1 year of age.
  • INSS stage 4 neuroblastoma is associated with a 3 year survival rate of 15% among patients older than 1 year of age.
  • The table below lists the prognostic factors for neuroblastoma patients:[11][12][13][14]
Prognostic Factor Description
Patient's Age
Patients older than 18 months of age are associated with poor prognosis.
Tumor Stage
Advanced INSS stages of neuroblastoma are associated with poor prognosis.
Tumor Grade
An unfavorable Shimada histology index is associated with poor prognosis.
Schwannnian Stroma
Reduced schwannian stroma content on histological analysis is associated with poor prognosis.
Mitotic-karyorrhectic Index
A high mitotic-karyorrhectic index is associated with poor prognosis.
Genetic Mutations
Chromosome 1p deletion, chromosome 11q deletion, and N-MYC oncogene amplification are associated with poor prognosis.
Response to Treatment
Patients whose neuroblastoma responds to treatment and goes into complete remission have a better prognosis than people whose cancer does not respond to the initial treatment.

References

  1. ↑ L. M. Wilson & G. J. Draper (1974). "Neuroblastoma, its natural history and prognosis: a study of 487 cases". British medical journal. 3 (5926): 301–307. PMID 4414795. Unknown parameter |month= ignored (help)
  2. ↑ Somruetai Shuangshoti, Shanop Shuangshoti, Issarang Nuchprayoon, Somjai Kanjanapongkul, Paula Marrano, Meredith S. Irwin & Paul S. Thorner (2012). "Natural course of low risk neuroblastoma". Pediatric blood & cancer. 58 (5): 690–694. doi:10.1002/pbc.23325. PMID 21922650. Unknown parameter |month= ignored (help)
  3. ↑ C. S. Alvarado, W. B. London, A. T. Look, G. M. Brodeur, D. H. Altmiller, P. S. Thorner, V. V. Joshi, S. T. Rowe, M. B. Nash, E. I. Smith, R. P. Castleberry & S. L. Cohn (2000). "Natural history and biology of stage A neuroblastoma: a Pediatric Oncology Group Study". Journal of pediatric hematology/oncology. 22 (3): 197–205. PMID 10864050. Unknown parameter |month= ignored (help)
  4. ↑ Nadja C. Colon & Dai H. Chung (2011). "Neuroblastoma". Advances in pediatrics. 58 (1): 297–311. doi:10.1016/j.yapd.2011.03.011. PMID 21736987.
  5. ↑ John M. Maris (2010). "Recent advances in neuroblastoma". The New England journal of medicine. 362 (23): 2202–2211. doi:10.1056/NEJMra0804577. PMID 20558371. Unknown parameter |month= ignored (help)
  6. ↑ Michal Sieniawski, Jeremy Franklin, Lucia Nogova, Jan-Peter Glossmann, Thomas Schober, Hiltrud Nisters-Backes, Volker Diehl & Andreas Josting (2007). "Outcome of patients experiencing progression or relapse after primary treatment with two cycles of chemotherapy and radiotherapy for early-stage favorable Hodgkin's lymphoma". Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 25 (15): 2000–2005. doi:10.1200/JCO.2006.10.1386. PMID 17420510. Unknown parameter |month= ignored (help)
  7. ↑ Julie R. Park, Angelika Eggert & Huib Caron (2008). "Neuroblastoma: biology, prognosis, and treatment". Pediatric clinics of North America. 55 (1): 97–120. doi:10.1016/j.pcl.2007.10.014. PMID 18242317. Unknown parameter |month= ignored (help)
  8. ↑ L. M. Wilson & G. J. Draper (1974). "Neuroblastoma, its natural history and prognosis: a study of 487 cases". British medical journal. 3 (5926): 301–307. PMID 4414795. Unknown parameter |month= ignored (help)
  9. ↑ Maya Suzuki, Brian H. Kushner, Kim Kramer, Ellen M. Basu, Stephen S. Roberts, William J. Hammond, Michael P. LaQuaglia, Suzanne L. Wolden, Nai-Kong V. Cheung & Shakeel Modak (2018). "Treatment and outcome of adult-onset neuroblastoma". International journal of cancer. 143 (5): 1249–1258. doi:10.1002/ijc.31399. PMID 29574715. Unknown parameter |month= ignored (help)
  10. ↑ Nermine O. Basta, Gail C. Halliday, Guy Makin, Jillian Birch, Richard Feltbower, Nick Bown, Martin Elliott, Lucas Moreno, Giuseppe Barone, Andrew Dj Pearson, Peter W. James, Deborah A. Tweddle & Richard Jq McNally (2016). "Factors associated with recurrence and survival length following relapse in patients with neuroblastoma". British journal of cancer. 115 (9): 1048–1057. doi:10.1038/bjc.2016.302. PMID 27701387. Unknown parameter |month= ignored (help)
  11. ↑ Neuroblastoma. Radiopaedia(2015) http://radiopaedia.org/articles/neuroblastoma Accessed on October, 5 2015
  12. ↑ Neuroblastoma Treatment for health professionals. National Cancer Institute (2015) http://www.cancer.gov/types/neuroblastoma/hp/neuroblastoma-treatment-pdq#link/_534_toc Accessed on October, 7 2015
  13. ↑ Neuroblastoma. Libre Pathology(2015) http://librepathology.org/wiki/index.php/Adrenal_gland#Neuroblastoma Accessed on October, 5 2015
  14. ↑ G. Hale, M. J. Gula & J. Blatt (1994). "Impact of gender on the natural history of neuroblastoma". Pediatric hematology and oncology. 11 (1): 91–97. PMID 8155504. Unknown parameter |month= ignored (help)

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