Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A randomized study was conducted to determine the effect of cyclophosphamide on the rate of recurrence and metastases in children with localized and regional neuroblastoma. One hundred and thirty-four patients were entered and 113 were suitable for analysis. All patients had surgical resection of the primary tumor when possible, postoperative irradiation to the tumor bed when indicated for gross residual disease, and 49/113 received cyclophosphamide, 10 mg/kg/day orally for 7-10 days every 28 days for 1 year. A difference was found in the rate of metastases between the patients who did and did not receive chemotherapy; the overall survival of about 80% in both groups was better than anticipated. All relapses occurred during the first year; there were none in 27 Stage I patients, 8/52 in Stage II and 13/34 in Stage III. Toxicity was minimal, with only two patients developing hemorrhagic cystitis that prevented continued therapy.
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PMID:Cyclophoshamide treatment of patients with localized and regional neuroblastoma: A randomized study. 78 89

A randomized study was designed to determine the effect of intermittent oral cyclophosphamide on the rate of metastases in children with localized and regional neuroblastoma. Secondary objectives of the study were to determine the value of the proposed staging system, to measure the influence of the peripheral lymphocyte count on prognosis, and to study the effect of the primary tumor site and regional node involvement. Since there was no difference in survival in the two groups of patients, whether or not they received chemotherapy, all 113 children were treated as a single group for the analysis of the secondary objectives. The proposed staging served as a good indicator of prognosis with a significant difference in survival seen between each of three stages. It was not possible to detect a significant influence by the three other prognostic variables studied, peripheral lymphocytes, primary site and regional node involvement. Small numbers in the various subgroups studied may account for the failure of differences to achieve statistical significance.
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PMID:Factors influencing survival of children with nonmetastatic neuroblastoma. 78 90

Four major staging systems have been used to estimate the prognosis for children with local and regional neuroblastoma (NBL). Data obtained at diagnosis for 251 neuroblastoma patients from two Childrens Cancer Study Group (CCSG) studies were analyzed according to staging systems of the CCSG, St Jude Children's Research Hospital, the Pediatric Oncology Group (POG), and the Union Internationale Contre le Cancer (UICC) tumor-nodes-metastasis (TNM) system. The most significant variables were found to be age, tumor stage, extent of tumor removal, transgression of the midline by tumor infiltration, and site of primary tumor. Involvement of lymph nodes per se was not a bad prognostic sign unless associated with extension beyond the midline, the latter being the single most important prognostic variable. All four staging systems had value for prognostication and all identified with accuracy the low stage patient (stage I, stage A) who fares well (greater than or equal to 87% survival). The CCSG definition of stages II and III disease discriminated prognostic groups best among the remaining patients, and was able to identify the child with local-regional NBL with poor survival. The estimated 5-year survival rates for children with regional tumor (stage III, IIIA[N]), according to the four systems were 44%, 74%, 74%, and 74% for the CCSG, St Jude, POG, and UICC methods, respectively. We conclude that all four staging systems effectively define good-prognosis patients with localized disease but that the CCSG staging system most accurately identifies patients with regional tumor who have a poor outcome.
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PMID:A comparison of four staging systems for localized and regional neuroblastoma: a report from the Childrens Cancer Study Group. 198 68