Clinical Characteristics And Prognosis Of 82 Children With Neuroblastoma

Neuroblastoma(NB)is the common extracranial solid malignan tumor in children.It occurs mainly in children under 5 year of age and happens at the adrenal medulla and anywhere in the sympathetic nerve system.It has extensive tumor heterogeneity,and its prognosis is very different.In recent years,with the development of children's oncology and in-depth study,the prognosis of children in low and mediate-risk group is improved.To the children in high-risk groups,although they receive multi-modality treatment,it often leads to death due to recurrence or metastasis.So improving the survival of children in high-risk group is urgent for international children's oncology group.Objective:To summarize the clinical characteristics,clinical manifestation,auxiliary examination,treatment and prognostic situation of children with NB,with the purpose of analyzing the clinical characteristics,prognosis and evaluating the therapeutic effect of German NB 97 improvement chemotherapy regimens.Methods:Collecting the clinical data on 82 children with neuroblastoma in Department of Pediatric Oncology,the First Hospital of Jilin University from November 2008 to June 2016,including age,sex,initial symptoms,primary tumor site,family background,pathological type,auxiliary examination,INSS stages,treatment and prognosis,and summarizing clinical characteristics,treatment and prognostic features of NB in children.Results:Among the 82 children with neuroblastoma,42 children(51.2%)were male,40 children(48.8%)were female.There were 17 cases(14.6%)aged 0-1year,60 cases(73.2%)aged 1-5 year.Among them there were 37 children(45.1%)whose tumors were located in the adrenal gland,including 23 cases(28.0%)in left adrenal gland,14 cases(17.1%)in the right.47 cases(57.3%)had metastasis at diagnosis and the mian metatases were bone marrow,bone and lymph nodes.49 children(59.8%)were from rural families.24 children(29.3%)showed unexplained fever at the beginning,which was low and moderate fever and was ineffective with anti-infection treatment.The survival time of the 82 children with NB in this group was 0.5 to 108 months,and median survival time was 39.5 months.1,3,5-year survival rate was 91.5%,70.8%,62.7%.The 5 year survival rate were 100% in stage ?and ? neuroblastoma children,56.2% in stage ? and ? children.The prognostic factors were onset age,the primary site,INSS stage,pathological type and serum NSE and LDH.During the follow-up,26 cases(31.7%)were found to have light and moderate hematuria,and 4 cases(4.9%)had proteinuria.Conclusion:1.90% of children wih NB are under 5 years old,and the adrenal gland is the main pathogenic site.2.It is necessary to pay attention to the possibility of NB when there is unexplained fever in children under 5 years old and this fever cannot be explained by conventional infection.3.Children with NB from rural familes are higher than that in cities and towns,whether it is related to long-term low dose pesticide exposure of pregnant womwn.4.Most children with NB are in stage ? and ? at diagnosis,and have poor prognosis,especially in stage ?.Although those children receive multi-modality treatment,the prognosis is poorer than children in stage ?and ?.5.The prognostic factors are onset age,the primary site,INSS stage,pathological type,serum NSE and LDH.