High Survival With Surgery in Low-Risk Neuroblastoma
(HealthDay News) – Surgery alone results in high five-year event-free and overall survival (EFS and OS) rates for patients with low-risk stage 2a and 2b neuroblastoma (NBL).
To investigate whether surgery alone would achieve three-year OS of ≥95%, Douglas R. Strother, MD, of the University of Calgary in Canada, and colleagues conducted a study involving 915 patients (<22 years) with asymptomatic International Neuroblastoma Staging System stages 2a and 2b NBL who had undergone maximally safe resection of tumor. Patients who had or who were at risk for developing symptomatic disease, those with <50% tumor resection at diagnosis, or those with unresectable progressive disease following surgery, were treated with chemotherapy.
The researchers found that the five-year EFS was 89%, and five-year OS was 97%. Five-year EFS was 87% and OS was 96% for patients with asymptomatic stage 2a or 2b disease. OS was significantly lower for stage 2b patients with unfavorable histology, diploid tumors, or who were aged >18 months. The five-year OS rates were 99 and 91% for those with stage 1 and 4s NBL, respectively. Five-year OS was 98% for patients who required chemotherapy at diagnosis. Recurrence or disease progression was experienced by 11.1% of patients observed after surgery.
"Excellent survival rates can be achieved in asymptomatic low-risk patients with stages 2a and 2b NBL after surgery alone," the authors write. "Immediate use of chemotherapy may be restricted to a minority of patients with low-risk NBL."