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Factors of Recurrence After Complete Response in Children with Neuroblastoma: A 16-Year Retrospective Study of 179 Cases

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收录情况: ◇ SCIE ◇ 预警期刊

机构: [1]Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, People’s Republic of China
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关键词: age MYCN amplification histology recurrence-free survival serum lactate dehydrogenase serum neuron-specific enolase

摘要:
Background: It is not clear which known adverse prognostic factors of neuroblastoma are closely associated with tumor recurrence after complete response. We analyzed the factors for post-remission recurrence in children with neuroblastoma through a retrospective study. Methods: A total of 179 children with neuroblastoma who achieved initial complete response were included in this study. Kaplan-Meier method and multivariate Cox regression model were used to assess the factors that may have impact on tumor recurrence after complete response. Results: The 5-year overall survival rates of the entire cohort (n = 179), recurrence group (n = 86) and non-recurrence group (n = 93) were 81.9%, 66.2%, and 98.7%, respectively. The 5-year recurrence-free survival (RFS) rates of the entire cohort and the high-risk cohort were 47.3% and 31.2%, respectively. RFSs were significantly reduced in children with age >18 months, INSS stage 4, unfavorable histology, bone marrow metastasis, osseous metastasis, serum NSE level >100 ng/mL, and serum LDH level >1400 U/L (P < 0.05). The independent risk factors for post-remission recurrence in the entire cohort were age >18 months, unfavorable histology, and serum LDH level >1400 U/L (P < 0.05). In the high-risk cohort, the independent risk factor for recurrence was serum LDH >1400 U/L (P < 0.05). Based on a new recurrence risk stratification, the 5-year RFSs of the children were 93.5%, 66.4%, and 22.5% in the low-risk, intermediate-risk, and high-risk groups, respectively. The area under the ROC curve of the new stratification was 0.773 (95% CI: 0.704-0.842). Conclusion: Age >18 months, unfavorable histology, and serum LDH level >1400 U/L are independent risk factors for post-remission recurrence in children with neuroblastoma. A newly established recurrence risk stratification has diagnostic advantages in predicting risk of recurrence, which is especially suitable for low-and middle-income countries or regions.

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出版当年[2021]版:
大类 | 3 区 医学
小类 | 4 区 肿瘤学
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 肿瘤学
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出版当年[2020]版:
Q3 ONCOLOGY
最新[2023]版:
Q3 ONCOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2020版] 出版当年五年平均 出版前一年[2019版] 出版后一年[2021版]

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第一作者机构: [1]Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, People’s Republic of China
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通讯机构: [1]Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, People’s Republic of China [*1]Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, People’s Republic of China
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