Treatment and outcomes of high-risk neuroblastoma in Southeast Asia: a single-institution experience and review of the literature
Introduction: In Europe and North America, the majority of children with high-risk neuroblastoma survive the disease. Elsewhere, the treatment outcomes are poor. Methods: A retrospective review of children treated for high-risk neuroblastoma in a single institution in Singapore from 2007 to 2019 was...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer – Medknow Publications
2023-05-01
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| Series: | Singapore Medical Journal |
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| Online Access: | https://journals.lww.com/10.11622/smedj.2021164 |
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| author | Anselm Chi-Wai Lee Chan Hon Chui Robert Kwok Kim Shang Lee Chee Meng Fong Wilfred Hing-Sang Wong |
| author_facet | Anselm Chi-Wai Lee Chan Hon Chui Robert Kwok Kim Shang Lee Chee Meng Fong Wilfred Hing-Sang Wong |
| author_sort | Anselm Chi-Wai Lee |
| collection | DOAJ |
| description | Introduction:
In Europe and North America, the majority of children with high-risk neuroblastoma survive the disease. Elsewhere, the treatment outcomes are poor.
Methods:
A retrospective review of children treated for high-risk neuroblastoma in a single institution in Singapore from 2007 to 2019 was carried out. Treatment consisted of intensive chemotherapy, surgery aimed at gross total resection of residual disease after chemotherapy, consolidation with high-dose therapy followed by autologous stem cell rescue, and radiotherapy to the primary and metastatic sites followed by maintenance treatment with either cis-retinoic acid or anti-disialoganglioside monoclonal antibody therapy. Survival data were examined on certain clinical and laboratory factors.
Results:
There were 57 children (32 male) treated for high-risk neuroblastoma. Their mean age was 3.9 (range 0.7–14.9) years. The median follow-up time was 5.5 (range 1.8–13.0) years for the surviving patients. There were 31 survivors, with 27 patients surviving in first remission, and the five-year overall survival and event-free survival rates were 52.5% and 47.4%, respectively. On log-rank testing, only the group of 17 patients who were exclusively treated at our centre had a survival advantage. Their five-year overall survival rate compared to patients whose initial chemotherapy was done elsewhere was 81.6% versus 41.1% (P = 0.011), and that of event-free survival was 69.7% versus 36.1% (P = 0.032). Published treatment results were obtained from four countries in Southeast Asia with five-year overall survival rates from 13.5% to 28.2%.
Conclusion:
Intensified medical and surgical treatment for high-risk neuroblastoma proved to be effective, with superior survival rates compared to previous data from Southeast Asia. |
| format | Article |
| id | doaj-art-1323e177eed6407a9e2eba2c25774fbc |
| institution | Kabale University |
| issn | 0037-5675 2737-5935 |
| language | English |
| publishDate | 2023-05-01 |
| publisher | Wolters Kluwer – Medknow Publications |
| record_format | Article |
| series | Singapore Medical Journal |
| spelling | doaj-art-1323e177eed6407a9e2eba2c25774fbc2025-02-09T13:47:41ZengWolters Kluwer – Medknow PublicationsSingapore Medical Journal0037-56752737-59352023-05-0164531932510.11622/smedj.2021164Treatment and outcomes of high-risk neuroblastoma in Southeast Asia: a single-institution experience and review of the literatureAnselm Chi-Wai LeeChan Hon ChuiRobert KwokKim Shang LeeChee Meng FongWilfred Hing-Sang WongIntroduction: In Europe and North America, the majority of children with high-risk neuroblastoma survive the disease. Elsewhere, the treatment outcomes are poor. Methods: A retrospective review of children treated for high-risk neuroblastoma in a single institution in Singapore from 2007 to 2019 was carried out. Treatment consisted of intensive chemotherapy, surgery aimed at gross total resection of residual disease after chemotherapy, consolidation with high-dose therapy followed by autologous stem cell rescue, and radiotherapy to the primary and metastatic sites followed by maintenance treatment with either cis-retinoic acid or anti-disialoganglioside monoclonal antibody therapy. Survival data were examined on certain clinical and laboratory factors. Results: There were 57 children (32 male) treated for high-risk neuroblastoma. Their mean age was 3.9 (range 0.7–14.9) years. The median follow-up time was 5.5 (range 1.8–13.0) years for the surviving patients. There were 31 survivors, with 27 patients surviving in first remission, and the five-year overall survival and event-free survival rates were 52.5% and 47.4%, respectively. On log-rank testing, only the group of 17 patients who were exclusively treated at our centre had a survival advantage. Their five-year overall survival rate compared to patients whose initial chemotherapy was done elsewhere was 81.6% versus 41.1% (P = 0.011), and that of event-free survival was 69.7% versus 36.1% (P = 0.032). Published treatment results were obtained from four countries in Southeast Asia with five-year overall survival rates from 13.5% to 28.2%. Conclusion: Intensified medical and surgical treatment for high-risk neuroblastoma proved to be effective, with superior survival rates compared to previous data from Southeast Asia.https://journals.lww.com/10.11622/smedj.2021164chemotherapychildhaematopoietic stem cell transplantationneuroblastomasoutheast asia |
| spellingShingle | Anselm Chi-Wai Lee Chan Hon Chui Robert Kwok Kim Shang Lee Chee Meng Fong Wilfred Hing-Sang Wong Treatment and outcomes of high-risk neuroblastoma in Southeast Asia: a single-institution experience and review of the literature Singapore Medical Journal chemotherapy child haematopoietic stem cell transplantation neuroblastoma southeast asia |
| title | Treatment and outcomes of high-risk neuroblastoma in Southeast Asia: a single-institution experience and review of the literature |
| title_full | Treatment and outcomes of high-risk neuroblastoma in Southeast Asia: a single-institution experience and review of the literature |
| title_fullStr | Treatment and outcomes of high-risk neuroblastoma in Southeast Asia: a single-institution experience and review of the literature |
| title_full_unstemmed | Treatment and outcomes of high-risk neuroblastoma in Southeast Asia: a single-institution experience and review of the literature |
| title_short | Treatment and outcomes of high-risk neuroblastoma in Southeast Asia: a single-institution experience and review of the literature |
| title_sort | treatment and outcomes of high risk neuroblastoma in southeast asia a single institution experience and review of the literature |
| topic | chemotherapy child haematopoietic stem cell transplantation neuroblastoma southeast asia |
| url | https://journals.lww.com/10.11622/smedj.2021164 |
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