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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Sociedade de Pediatria de São Paulo
2025-07-01
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| Series: | Revista Paulista de Pediatria |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822025000100435&lng=en&tlng=en |
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| author | 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 |
| author_facet | 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 |
| author_sort | Roberta Gomes Ribeiro Gonçalves Pinto |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-585cf84cdc5a40bcacd5bcd5791aeadd |
| institution | DOAJ |
| issn | 1984-0462 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Sociedade de Pediatria de São Paulo |
| record_format | Article |
| series | Revista Paulista de Pediatria |
| spelling | doaj-art-585cf84cdc5a40bcacd5bcd5791aeadd2025-08-20T03:08:44ZengSociedade de Pediatria de São PauloRevista Paulista de Pediatria1984-04622025-07-014310.1590/1984-0462/2025/43/2024200Prognostic factors of neuroblastoma in limited-resource settingsRoberta Gomes Ribeiro Gonçalves Pintohttps://orcid.org/0009-0004-2677-8010Mecneide Mendes Linshttps://orcid.org/0000-0002-9155-5030Kaline Maria Maciel de Oliveira Pereirahttps://orcid.org/0000-0002-7549-1495Ticiana Ester Mattos Pascoal Meirahttps://orcid.org/0009-0001-1236-7913Eduarda Coutinho Albuquerque Neiva Coêlhohttps://orcid.org/0000-0002-6903-1337Alice Rodrigues Barbosa de Moraeshttps://orcid.org/0000-0003-2142-9773Marina Lundgren de Melo Batistahttps://orcid.org/0000-0002-8655-0817Leticia Ribeiro Maciel Pereirahttps://orcid.org/0009-0005-4626-4743Maria Júlia Gonçalves de Mellohttps://orcid.org/0000-0003-4645-8343ABSTRACT 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822025000100435&lng=en&tlng=enNeuroblastomaOncologyPrognosisN-MYC proto-oncogene proteinL-Lactate dehydrogenase |
| spellingShingle | 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 Prognostic factors of neuroblastoma in limited-resource settings Revista Paulista de Pediatria Neuroblastoma Oncology Prognosis N-MYC proto-oncogene protein L-Lactate dehydrogenase |
| title | Prognostic factors of neuroblastoma in limited-resource settings |
| title_full | Prognostic factors of neuroblastoma in limited-resource settings |
| title_fullStr | Prognostic factors of neuroblastoma in limited-resource settings |
| title_full_unstemmed | Prognostic factors of neuroblastoma in limited-resource settings |
| title_short | Prognostic factors of neuroblastoma in limited-resource settings |
| title_sort | prognostic factors of neuroblastoma in limited resource settings |
| topic | Neuroblastoma Oncology Prognosis N-MYC proto-oncogene protein L-Lactate dehydrogenase |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822025000100435&lng=en&tlng=en |
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