Τίτλος:
Survival patterns of childhood neuroblastoma: an analysis of clinical data from Southern-Eastern European countries.
Περίληψη:
The prognosis of children with neuroblastoma (NBL) can be dismal with significant variations depending on the stage and biology of the tumor. We assessed the event-free (EFS) and overall (OS) survival using harmonized data from three Southern-Eastern European (SEE) countries. Data for 520 incident NBL cases (2009-2018) were collected from Greece, Slovenia and Russia. Kaplan-Meier curves were fitted, and EFS/OS were derived from Cox proportional models by study variables including the protocol-based risk-group (low/observation, intermediate, high). Over one-third of cases were coded in the high-risk group, of which 23 children (4.4%) received treatment with anti-ganglioside 2 (GD2) mAb. Survival rates were inferior in older (OS 5-year; 1.5-4.9 years: 61%; EFS 5-year; 1.5-4.9 years: 48%) compared to children younger than 1.5 years (OS 5-year; <1.5 years: 91%; EFS 5-year; <1.5 years: 78%). Predictors of poor OS included stage 4 (hazard ratio, HROS: 18.12, 95% confidence intervals, CI: 3.47-94.54), N-myc amplification (HROS: 2.16, 95% CI: 1.40-3.34), no surgical excision (HROS: 3.27, 95% CI: 1.91-5.61) and relapse/progression (HROS: 5.46, 95% CI: 3.23-9.24). Similar unfavorable EFS was found for the same subsets of patients. By contrast, treatment with anti-GD2 antibody in high-risk patients was associated with decreased risk of death or unfavorable events (HROS: 0.11, 95% CI: 0.02-0.79; HREFS: 0.19, 95% CI: 0.07-0.52). Our results confirm the outstanding prognosis of the early NBL stages, especially in children <1.5 years, and the improved outcomes of the anti-GD2 treatment in high-risk patients. Ongoing high-quality clinical cancer registration is needed to ensure comparability of survival across Europe and refine our understanding of the NBL biology.
Συγγραφείς:
Karalexi, Maria A.
Servitzoglou, Marina
Papadakis, Vassilios
Kachanov, Denis
Česen Mazič, Maja
Baka, Margaret
Moschovi, Maria
Kourti, Maria
Polychronopoulou, Sofia
Stiakaki, Eftichia
Hatzipantelis, Emmanuel
Dana, Helen
Stefanaki, Kalliopi
Malama, Astero
Themistocleous, Marios S.
Strantzia, Katerina
Shamanskaya, Tatyana
Bouka, Panagiota
Panagopoulou, Paraskevi
Kantzanou, Maria
Ntzani, Evangelia
Dessypris, Nick
Petridou, Eleni Th
Περιοδικό:
European Journal of Cancer Prevention: The Official Journal of the European Cancer Prevention Organisation (ECP)
DOI:
10.1097/CEJ.0000000000000614
