PMID- 12173347
OWN - NLM
STAT- MEDLINE
DCOM- 20020830
LR  - 20190620
IS  - 0008-543X (Print)
IS  - 0008-543X (Linking)
VI  - 94
IP  - 10
DP  - 2002 May 15
TI  - Evolving significance of prognostic markers associated with treatment improvement 
      in patients with stage 4 neuroblastoma.
PG  - 2756-65
AB  - BACKGROUND: With recent improvements in the treatment and outcome of patients 
      with neuroblastoma (NB), the authors reassessed the prognostic importance of 
      clinical and biologic markers in patients with Stage 4 NB who were treated at the 
      Memorial Sloan-Kettering Cancer Center (MSKCC). METHODS: The authors analyzed 84 
      patients with Stage 4 NB who were treated on the N5, N6, or N7 protocols at MSKCC 
      from 1987 to 1999. The impact on survival of clinical factors (age, serum 
      ferritin, and lactate dehydrogenase [LDH] levels), histopathology (International 
      Neuroblastoma Pathology Classification [INPC]), and tumor biologic markers (MYCN; 
      ploidy; loss of heterozygosity [LOH] at 1p36, 1p22, 11q23, 14q12-q32, 9p21, and 
      19q13; and gain at 17q) were analyzed in univariate and multivariate models. 
      RESULTS: Forty-six of 84 patients were alive at the time of this report (55%), 
      with a median follow-up of 41 months from the time of diagnosis. In the 
      univariate analysis, there was no prognostic impact on survival by age, serum 
      ferritin and LDH levels, MYCN, 1p36 LOH, 14q32 LOH, or 17q gain. LOH at 11q23 was 
      associated significantly with superior progression free survival (P = 0.04) and 
      survival (P = 0.04) in the univariate analysis. In the multivariate analysis, it 
      was found that 11q23 status was the most significant variable associated with 
      overall survival (hazard ratio, 0.50; 95% confidence interval, 0.26-0.99). LOH at 
      11q23 and LOH at 1p22 were highly correlated (P = 0.02). It was found that 11q23 
      status and INPC score were the most significant variables associated with 
      progression free survival. CONCLUSIONS: Because patient survival improves with 
      more effective therapy, traditional prognostic markers, such as age, MYCN 
      amplification, and elevated serum LDH levels, have become less important for 
      patients with Stage 4 NB. In the current study, less common chromosomal 
      abnormalities (LOH at 1p22 and 11q23) appeared to assume new importance.
FAU - Mora, Jaume
AU  - Mora J
AD  - Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New 
      York, USA. jmora@hsjdbcn.org
FAU - Gerald, William L
AU  - Gerald WL
FAU - Qin, Jing
AU  - Qin J
FAU - Cheung, Nai-Kong V
AU  - Cheung NK
LA  - eng
GR  - CA61017/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Cancer
JT  - Cancer
JID - 0374236
RN  - 0 (Biomarkers, Tumor)
RN  - 9007-73-2 (Ferritins)
RN  - EC 1.1.1.27 (L-Lactate Dehydrogenase)
SB  - IM
MH  - Age Factors
MH  - Biomarkers, Tumor/analysis
MH  - Ferritins/blood
MH  - Follow-Up Studies
MH  - L-Lactate Dehydrogenase/blood
MH  - Loss of Heterozygosity
MH  - Neoplasm Staging
MH  - Neuroblastoma/*drug therapy/genetics/mortality/pathology
MH  - Ploidies
MH  - Prognosis
MH  - Treatment Outcome
EDAT- 2002/08/14 10:00
MHDA- 2002/08/31 10:01
CRDT- 2002/08/14 10:00
PHST- 2002/08/14 10:00 [pubmed]
PHST- 2002/08/31 10:01 [medline]
PHST- 2002/08/14 10:00 [entrez]
AID - 10.1002/cncr.10548 [doi]
PST - ppublish
SO  - Cancer. 2002 May 15;94(10):2756-65. doi: 10.1002/cncr.10548.