Prognostic factors including neoadjuvant chemotherapy in Mexican children with neuroblastoma.

INTRODUCTION: There are several prognostic factors in children with neuroblastoma that have been outlined in the international literature. MATERIAL AND METHODS: A retrospective study was carried out analysing the medical records of patients with the pathological diagnosis of neuroblastoma seen at the Department of Oncology from the Instituto Nacional de Pediatriá (Mexico) between January 1984 to January 1997. A total of 32 clinical prognostic factors were assess in our population. RESULTS: Fifty five patients whose age ranged from 1 to 168 months old, mean of 35 months were included. Out of 32 prognostic factors only 6 including sex (p= 0.0039), metastatic disease to bone (p= 0.003), bone marrow involvement (p= 0.0027), staging system (p= 0.000015), surgical treatment (p 0,0022) and neoadjuvant chemotherapy (p.005) were the most significant. CONCLUSIONS: It was concluded that besides the prognostic factors outlined, neoadjuvant chemotherapy is of utmost importance. It decreases tumor volume and allows surgery to be more successful, therefore believing that this variable represents a specific prognostic factor in cases of advanced neuroblastoma.

Prognostic factors including neoadjuvant chemotherapy in Mexican children with neuroblastoma

Introducción. Existen diferentes factores pronósticos en los niños con neuroblastoma, estos factores tienen diferente peso específico de acuerdo a la literatura internacional. Material y métodos. Se realizó un estudio retrospectivo, analizando los expedientes clínicos de los pacientes con el diagnóstico de neuroblastoma, tratados en el Instituto Nacional de Pediatría (México) de enero de 1984 a enero de 1997. Se analizaron un total de 32 factores pronósticos clínicos dentro de nuestra población. Resultados. Se incluyeron un total de 55 pacientes, con un rango de edad de 1 a 68 meses, con una media de 36 meses de edad. De los 32 factores pronósticos evaluados, únicamente 6 fueron significativos, los cuales incluyeron el sexo (p= 0,0039), enfermedad metastásica a hueso (p= 0,003), infiltración a médula ósea (p= 0,0027), estadificación (p= 0,000015), tratamiento quirúrgico (p= 0,0022) y el uso de quimioterapia neoadyuvante (p= 0,005). Conclusiones. En análisis de los resultados de los diferentes factores pronósticos nos permiten concluir que la quimioterapia neoadyuvante realiza un papel importante al permitir la disminución del volumen tumoral, lo que permite que la resección quirúrgica pueda ser completa. El resto de las variables que fueron significativas están asociadas directamente con la presencia de neuroblastoma en estadio avanzado

Introduction. There are several prognostic factors in children with neuroblastoma that have been outlined in the international literature. Material and methods. A retrospective study was carried out analysing the medical records of patients with the pathological diagnosis of neuroblastoma seen at the Department of Oncology from the Instituto Nacional de Pediatría (Mexico) between January 1984 to January 1997. A total of 32 clinical prognostic factors were assess in our population. Results. Fifty five patients whose age ranged from 1 to 168 months old, mean of 35 months were included. Out of 32 prognostic factors only 6 including sex (p= 0.0039), metastatic disease to bone (p= 0.003), bone marrow involvement (p= 0.0027), staging system (p= 0.000015), surgical treatment (p 0,0022) and neoadjuvant chemotherapy (p.005) were the most significant. Conclusions. It was concluded that besides the prognostic factors outlined, neoadjuvant chemotherapy is of utmost importance. It decreases tumor volume and allows surgery to be more successful, therefore believing that this variable represents a specific prognostic factor in cases of advanced neuroblastoma