Prognostic factors of neuroblastoma in limited-resource settings

Prognostic factors of neuroblastoma in limited-resource settings

ABSTRACT Objective: This study aimed to analyze survival and risk factors for death in children with neuroblastoma that may contribute to a viable risk classification for low-income countries. Methods: A historic cohort involving patients under 19 years of age with neuroblastoma was followed at...

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Main Authors: Roberta Gomes Ribeiro Gonçalves Pinto, Mecneide Mendes Lins, Kaline Maria Maciel de Oliveira Pereira, Ticiana Ester Mattos Pascoal Meira, Eduarda Coutinho Albuquerque Neiva Coêlho, Alice Rodrigues Barbosa de Moraes, Marina Lundgren de Melo Batista, Leticia Ribeiro Maciel Pereira, Maria Júlia Gonçalves de Mello
Format: Article
Language:English
Published: Sociedade de Pediatria de São Paulo 2025-07-01
Series:Revista Paulista de Pediatria
Subjects:
Neuroblastoma
Oncology
Prognosis
N-MYC proto-oncogene protein
L-Lactate dehydrogenase
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822025000100435&lng=en&tlng=en
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Summary:ABSTRACT Objective: This study aimed to analyze survival and risk factors for death in children with neuroblastoma that may contribute to a viable risk classification for low-income countries. Methods: A historic cohort involving patients under 19 years of age with neuroblastoma was followed at a reference center in Northeast Brazil between July 2005 and July 2020. Data on sociodemographic, were collected. The outcomes studied were recurrence, disease progression, and five-year mortality. Multivariate analysis of Cox proportional hazards for death was performed. Overall and eventfree survivals were evaluated using the Kaplan-Meier method and the comparison between the groups studied, by the log-rank test. Results: Patients (n=126) were predominantly female with a median age of 26.5 months. Most presented primary adrenal, tumor stage 4 according to the International Neuroblastoma Staging System, unfavorable histology, and median serum lactate dehydrogenase (LDH) levels of 640.5 U/L. LDH≥640.5 U/L (hazard ratio [HRa] 2.49; 95% confidence interval [CI] 1.57–3.95; p<0.001) and stage 4 (HRa 1.67; 95%CI 1.00–2.78; p=0.047) were identified as risk factors for death. The overall survival was 32.4%, showing distinct curves regarding LDH serum levels and staging (log-rank p<0.05); the event-free survival was 26.3%. Conclusions: Elevated LDH serum levels were a risk factor for five-year mortality, and can be utilized as a prognostic marker in resource-limited settings.
ISSN:1984-0462

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