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Query: UMLS:C0027819 (neuroblastoma)
 27,800 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Neuroblastoma IV-S (IV-Special) stage has been reviewed according to the current concepts as stated by Evans et al. Biological and clinical features of such a stage of disease are presented. These data suggest that the occurrence of different sites of involvement can be observed in addition to those definided previously. General views of treatment also described.
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PMID:[Stage IV-S neuroblastoma]. 653 Dec 45

The purpose of the present study was to analyze the clinical pattern of neuroblastoma, the development of therapy, therapeutic results and the effect of neuroblastoma treated in childhood on the patient's later life. A retrospective series of 88 patient under 15 with primary neuroblastoma from years 1951-1978 was analyzed. The material was divided into two groups: patients admitted in 1951-1964 and those admitted in 1965-1978. Thirty three of the children (37.5%) were treated in 1951-1964 and 55 (62.5%) in 1965-1978. No statistical differences were seen between the therapeutic groups regarding age and sex distribution, site of the primary tumor and the histological and stage distribution. The mean age of all the patients on admission was 3.2 years (range 0-14.6 years). The age distribution was as follows: 24 (27.3%) 12 months, 18 (20.5%) 12-24 months and 46 (52.3%) over 24 months. There were 45 (51.1%) boys and 43 (48.9%) girls. All the histological specimens were reexamined. On the basis of histological differentiation, the series contained 67 (76.1%) neuroblastomas and 21 (23.9%) ganglioneuroblastomas. The localization of the primary tumors was the following: neck one (1.1%), mediastinum 17 (19.3%), elsewhere in the thorax 9 (10.2%), abdomen 15 (17.0%), pelvis 6 (8.8%), adrenal glands 31 (35.2%), dumbbell tumors 9 (10.2%). The stage distribution (Evans et al., 1971) was: stage I 6 (6.8%), stage II 20 (22.7%), stage III 36 (40.9%), stage IV 20 (22.7%) and stage IV-S 6 (6.8%). The diagnostic studies performed were chest roentgenography on 97.7%, skull roentgenography on 62.5%, pelvic roentgenography on 18.2%, spinal roentgenography on 23.8%, roentgenography of the long bones on 53.4%, and urography on 59.1% of the total. A bone marrow study was made on 36.4% of the cases. 24-hour urinary excretion of VMA was determined at the beginning of therapy for 78.2% and of HVA for 38.2% of the patients of the latter treatment group. The commonest general symptoms were anemia (34.1% of all patients), vague pyrexia (25.0%), lack of appetite, weight loss (18.2%) and poor general condition (15.9%). General symptoms were commonest in patients in stages IV and III (75.0 and 72.2%) and least frequent in stage I patients (16.7%). The average duration of the general symptoms in the survivors was 1.9 months and in the patients who died 1.7 months.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Neuroblastoma in 88 children. Clinical features, prognostic factors, results and late effects of therapy. 667 Aug 48

Between 1949 and 1978, 119 children with the diagnosis of neuroblastoma or ganglioneuroblastoma were treated at the Washington University Medical Center. Of these, 50 (41%) were alive and disease-free 3 or more years after diagnosis. Important prognostic variables included stage of tumor (Evans staging), histology, age at diagnosis, and site of primary tumor. A stepwise logistic regression analysis of these data has shown that, in order of significance, stage, histology and age at diagnosis are independent prognostic variables. Sex of the patient and nodal status at diagnosis (where known) were not significant prognostic variables. No effects of individual treatment modalities could be detected. This study confirms the overwhelming influence of factors unrelated to treatment in determining the prognosis of neuroblastoma.
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PMID:An analysis of neuroblastoma at a single institution. 670 95

From 1970 to 1982 11 infants with Evans stage IV neuroblastoma who were 11 months of age or less at diagnosis were treated. All but one were treated with intensive multiagent chemotherapy; eight had attempted surgical resection; only one received radiotherapy to the primary tumor. Ten of the 11 infants remain free of disease from 2 1/2 to 13 years (median, four years). Multiagent chemotherapy has clearly improved the outcome for infants with stage IV neuroblastoma.
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PMID:Improved prognosis for infants with stage IV neuroblastoma. 673 20

We studied the relation between the DNA content of neuroblastoma cells and the response to therapy in 35 infants under one year of age with a diagnosis of neuroblastoma. Using flow cytometric techniques, we found that in 27 cases the primary malignant stem line consisted of neuroblasts with hyperdiploid DNA content, ranging from 1.07 to 2.42 times the finding in normal diploid cells. All remaining cases had diploid stem lines. Diploidy was more common in infants with clinical Stage D neuroblastoma (metastases beyond regional lymph nodes) than in those with other, less advanced stages: 6 of 10 as compared with 2 of 25 (P = 0.003). Of 17 evaluable patients with unresectable hyperdiploid tumors, 15 had complete responses and two had partial responses to cyclophosphamide and doxorubicin; six others with diploid tumors did not respond (P = 0.00001). We also found that each of the four infants with Evans' Stage IV-S neuroblastoma, an unusual form of disseminated neuroblastoma with a relatively good prognosis, had hyperdiploid tumor cells of clonal origin. We conclude that in neuroblastoma of infants, hyperdiploidy of tumor cells is associated with a better response to chemotherapy than is diploidy.
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PMID:Cellular DNA content as a predictor of response to chemotherapy in infants with unresectable neuroblastoma. 673 17

Data relative to the prognostic and therapeutic significance of lymph node metastases in regionally confined neuroblastoma (Evans stages II-III) are scant. We have analyzed lymph node status in order to assess the significance of nodal involvement. Disease-free survival (minimum follow-up of 2 years) was 84% (21/25) among node-positive patients compared with 95% (18/19) for node-negative patients (P greater than 0.1, two-tailed test). These results contrast with the results from two other centers in which lymph node involvement was a significant adverse prognostic indicator. The use of intensive multimodal therapy including surgical resection of the primary tumor, wide-field radiation therapy to the tumor bed and regional lymph nodes, and chemotherapy may have accounted for the better survival in our node-positive patients.
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PMID:Influence of local-regional lymph node metastases on prognosis in neuroblastoma. 674 57

Thirty-three children with Evans stage IV neuroblastoma were treated with an intensive chemotherapy regimen reported by Helson to be highly effective. The purpose of the study was to determine whether the toxic regimen was manageable by different investigators and to increase the sample of patients. Remission induction therapy consisted of courses repeated every four weeks: Cyclophosphamide (CTX) 80 mg/kg IV, with IV fluids, and furosemide on days 1 and 2; vincristine (VCR) 0.03 mg/kg IV 12 hours after cyclophosphamide; trifluoro-methyl-2-deoxyridine (F3TdR) 45 mg/kg IV push, and papaverine (PAP) 45 mg/kg (12-hour infusion) under cardiac monitoring on days 3 and 4. Initially during maintenance, courses of therapy were reduced to two days. Because this was found to be ineffective therapy, the courses were extended to four days. Some of the patients who achieved response were removed from the protocol and placed on different maintenance therapy. Seventeen of 21 children newly diagnosed and 6/12 children previously treated for metastatic neuroblastoma achieved partial or complete remission. Eight of 16 newly diagnosed patients achieving response are still alive, six without evidence of disease for periods of time ranging from 20 to 41 months. The median of the administered drug dosages was 100% of the recommended dosages. Seventy percent of the 229 courses given were initiated at correct interval. Therapy had to be delayed on the others because of toxicity. The value of the four-drug combination is limited because of side effects related to myelosuppression which resulted in severe complications and frequent hospitalizations.
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PMID:Intensive chemotherapy for metastatic neuroblastoma: a Southwest Oncology Group study. 678 Jul 76

From 1957 to 1980, 170 neuroblastoma were surgically approached: 3 cervical, 11 thoracic, 147 abdominal, 5 pelvic. The surgical data gathered from this large series leads us to assess that there are great differences between lateral and median neuroblastoma. Lateral ones can be surgically removed without major risk. Median ones arising from sympathetic nerves which depend on the aorta or on the visceral arteries (coeliac or mesenteric) cannot be removed totally without life-threatening risk. These data do not agree with Evans and d'Angio staging. Indeed, stage I and II are only observed in neuroblastomas developed on the lateral nerves of the sympathetic chain and can be removed. Stage III tumors can also be removed surgically when arising from a lateral site, even if they cross the median line. On the contrary all median perivascular neuroblastomas are to be staged III: total removal is not possible and the surgical risk is too high when compared with efficiency of chemotherapy. A special type, the distal perivascular neuroblastoma, is pointed out (5 cases). It is very important to precise exactly the initial localization of neuroblastoma, whatever be their metastatic extension. The new technics of investigation (C.T., ultrasonography, but also plain film and front and lateral views of intravenous pyelogram) allow to define precisely the median or lateral site of the tumor and also to choose between a non-surgical (median) or a surgical (lateral) treatment. This distinction seems in correlation with the two different ways of pathway of the embryonic neuroblast cells.
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PMID:[The place of surgery in the treatment of neuroblastoma]. 685 Sep 52

Therapy was designed to achieve a high cure rate and to prevent serious therapeutic side effects for 11 infants younger than one year old with neuroblastoma who had a favorable prognosis (Evans Stages I, II, III, and IV-S). It consisted of surgery alone if the tumor was totally removed (one infant) and of surgery and low doses of cytoxan and vincristine for a period of 1 year if the tumor was incompletely removed (seven infants). In addition, radiation therapy was applied to unresected dumbbell tumors (three infants). All infants are alive without evidence of disease with the exception of one who died in an accident. The follow-up time varies from 2-8 years. The drug combination prevented recurrences in two infants whose tumor was reduced by surgery to less than 10% of the original size. In five infants, chemotherapy reduced the size of large residual tumor masses. Two of these masses were subsequently removed. The tumors of the three other infants recurred while on chemotherapy and were successfully eradicated by surgery or radiation therapy. Two infants were not treated according to this therapeutic plan. Although they had small residual masses after surgery, no chemotherapy was given. They are alive without recurrence of the disease 2 years or more after diagnosis. In summary, cure was achieved in these infants without intensive chemotherapy.
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PMID:Neuroblastoma: therapy for infants with good prognosis. 685 97

Results of surgical treatment of 29 neuroblastoma patients between 1968 and 1980 are presented. 13 of these children have remained free from relapses and complaints for more than 2 years. Despite the progress in (immuno)chemotherapy and (immuno)radiotherapy the prognosis depends on the kind of surgery performed, also and especially in stages III and IV (after Evans). Among the author's own patients it became evident that both the survival rate and the survival period were increased in the prognostically unfavourable cases by subtotal resection. No representative collective statistics are known and it will probably take quite some time before these can be compiled, since it is extremely difficult to evaluate the disease pattern. However, it appears meaningful to establish postoperative prognosis in accordance with the possibilities of surgical procedure. Hence we are offering a classification of postoperative prognoses which, in our opinion, is superior to that proposed by Evans.
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PMID:[The significance of the surgical treatment of neuroblastoma]. 715 76


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