Neuroblastoma natural history: Difference between revisions

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  | doi = 10.1016/j.pcl.2007.10.014
  | doi = 10.1016/j.pcl.2007.10.014
  | pmid = 18242317
  | 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>
* INSS '''stage 1''', '''stage 2''', and '''stage 4S''' neuroblastomas  are associated with a 3 year survival rate of 75-90%.
* INSS '''stage 1''', '''stage 2''', and '''stage 4S''' neuroblastomas  are associated with a 3 year survival rate of 75-90%.

Revision as of 15:31, 18 February 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

  • Neuroblastoma patients may initially present with vague symptoms making the diagnosis of such patients difficult.[1][2]
  • If left untreated, 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.[3]

Complications

  • Complications of neuroblastoma may include:[4][5][6]
  • Persistent refractory diarrhea (due to vasoactive intestinal peptide secretion)
  • Horner's syndrome (due to cervical sympathetic chain compression)
  • Opsoclonus myoclonus syndrome and ataxia (due to a paraneoplastic syndrome)
  • Hypertension (due to either catecholamine secretion or renal artery compression)
  • Transverse myelopathy (due to tumor spinal cord compression)
  • Anemia and suppressed immunity (due to bone marrow metastasis)

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]
  • 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:[9][10][11][12]
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.
Genetics 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. ↑ Neuroblastoma. Radiopaedia(2015) http://radiopaedia.org/articles/neuroblastoma Accessed on October, 5 2015
  10. ↑ 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
  11. ↑ Neuroblastoma. Libre Pathology(2015) http://librepathology.org/wiki/index.php/Adrenal_gland#Neuroblastoma Accessed on October, 5 2015
  12. ↑ 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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