Metastatic sites in stage IV and IVS neuroblastoma correlate with age, tumor biology, and survival
Metastatic sites in stage IV and IVS neuroblastoma correlate with age, tumor biology, and survival
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DOI：
10.1097/00043426-199905000-00005
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发表时间：
1999-05-01
影响因子：
1.2
通讯作者：
Matthay, KK
中科院分区：
文献类型：
--
作者：
DuBois, SG;Kalika, Y;Matthay, KK
目的：本研究的目的是确定神经母细胞瘤中转移部位的发生率，以及转移部位与年龄、肿瘤生物学和生存相关的程度。患者和方法：对儿童癌症组方案3881和3891登记的648例TV和TVS期神经母细胞瘤患者进行分析。转移部位数据由治疗机构提供，并对中枢神经系统（CNS）、颅内、肺部或“其他”转移的患者进行了研究。结果：诊断时转移部位的发生率为骨髓70.5%，骨55.7%，淋巴结30.9%，肝脏29.6%，颅内及眶部18.2%，肺3.3%，中枢神经系统0.6%。无事件生存期（EFS）在骨、骨髓、中枢神经系统、颅内/眶、肺和胸膜转移患者中降低，而在肝脏和皮肤转移患者中提高。在婴儿中，MYCN扩增和不利的岛田组织病理学与骨、颅内或眼眶转移的频率增加相关。在老年患者中，MYCN扩增与颅内或眼眶、肝脏和肺部转移的频率增加相关。多因素分析显示，转移部位并不是一个独立的预后因素。结论：神经母细胞瘤的转移模式随年龄而异，并与肿瘤生物学特征和EFS相关。这些相关性可能反映了宿主或肿瘤生物学特征随年龄的变化，从而导致转移能力或肿瘤对特定部位的亲和力的差异。
Purpose: The goal of this study was to determine the incidence of metastatic sites in neuroblastoma and the extent to which metastatic sites correlate with age, tumor biology, and survival.Patients and Methods: All 648 patients with stage TV and TVS neuroblastoma registered on Children's Cancer Group protocols 3881 and 3891 were analyzed. Metastatic site data were provided by treating institutions and reviewed in patients with central nervous system (CNS), intracranial, lung, or "other" metastases.Results: The incidence of metastatic sites at diagnosis was 70.5% in bone marrow, 55.7% in bone, 30.9% in lymph nodes, 29.6% in liver, 18.2% in intracranial and orbital sites, 3.3% in lung, and 0.6% in CNS. Event-free survival (EFS) was decreased in patients with bone, bone marrow, CNS, intracranial/orbital, lung, and pleural metastases, and improved in those with liver and skin metastases. In infants, MYCN amplification and unfavorable Shimada histopathology correlated with increased frequencies of bone and intracranial or orbital metastases. In older patients, MYCN amplification correlated with increased frequencies of intracranial or orbital, liver, and lung metastases. Multivariate analysis revealed that metastatic site is not an independent prognostic factor.Conclusions: Metastatic pattern in neuroblastoma differs with age and correlates with tumor biological features and EFS. These correlations could reflect changes in host or tumor biological features with age resulting in differences in metastatic capacity or tumor affinity for specific sites.