Publication: Neuroblastoma. A study of the clinicopathological features influencing prognosis based on the analysis of 54 cases
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Date
1994
Authors
Valera-Durán, J. ; Böhm, N. ; Díaz-Flores, Lucio ; Ramon y Cajal-Junquera, S. ; Toro Rojas, M. ; Valera-Nuñez, R.
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Publisher
Murcia : F. Hernández
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DOI
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info:eu-repo/semantics/article
Description
Abstract
The retrospective analysis of 54 cases of
neuroblastoma taken from the files of the Department of
Pathology, University of Santiago Hospital, Spain, and
the Ludwig-Aschoff Institute of Pathology, University of
Freiburg, Germany confirmed the validity and
significance of various clinical and histopathological
features when trying to establish the prognosis and the
proper therapeutic approach in a given case of
neuroblastoma. When the age of the patients was
compared to survival it was shown that all but three of
the patients older than 2 years of age had died from
tumor within ten months. In contrast, there was a 37.5%
five-year survival rate among patients who were 24
months of age or younger at the time of diagnosis and
treatment. The primary tulnor was located in the adrenal
gland in 27 cases (50%), in 9 cases (17%) the tumor was
retroperitoneal but extra-adrenal, and in the remaining
18 patients (33%) the tumor arose from the paravertebral
sympathetic ganglia. Adrenal primaries behaved in an
extremely aggresive manner as all but three patients with
tilmors at this location were dead within 18 months.
Retroperitoneal extra-adrenal neuroblastomas followed
an almost equally poor outcome with only one five-year
survivor ( 1 1 %). In contrast, 49% of the patients with
paravertebral neuroblastoma had survived five years and
a further 33% were alive with shorter follow-up.
According to histological criteria, there were 6 grade I
turnors, 15 grade I1 and 33 grade 111 tumors in our series.
All grade I tumors were clinical stage 1 at diagnosis and
all are alive 2 to 3 112 years later. Grade I1 tumors were
clinical stage 2, 3 or 4 and showed a 46% five-year
survival. With the exception of three patients with
paravertebral tumors, all patients with grade 111
neuroblastoma were clinical stage 3 or 4 when initially
Offprint requests to: Dr. Juan Varela-Duran, Departamento de Anatomia
Patologica, Hospital General de Galicia, C/ Galeras s/n, 15702 Santiago
de Cornpostela, Spain
seen and all were dead from tumor within ten months,
with a five-year survival of 9%. It is concluded that the
age at diagnosis, location of the primary tumor and
histological differentiation, all of which are interrelated,
are the most reliable clinicopathological features
affecting prognosis and therapy in neuroblastoma.
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