[Neuroblastoma: biological markers, surgery, and clinical course].

INTRODUCTION

The treatment of neuroblastoma is basically chemotherapy, and surgery, in spite of advances, this kind of tumor is nowadays a surgical challenge.

PURPOSE

The aim of this study was to evaluate the impact of our therapy in this kind of pediatric tumors.

MATERIAL AND METHODS

32 consecutive patients with abdominal neuroblastoma, aged between 1 month and 10 years old, median age 3 years old, observed from 1993 through 1997 have been studied. Several parameters: age, ferritin, deletion of the chromosome 1p36, chromosomic ploidy, LDH, N-myc gene amplification and enolase neuron specific were studied and were related with the histology by Joshi and the International Neuroblastoma Staging System (INSS) in order to know the prognosis. All the patients were treated by means of chemotherapy and surgery, and some cases with radiotherapy and bone marrow transplantation.

RESULTS

Two patients presented the tumor in stage I (INSS) and three in stage II. All the patients had a total resection and they live free of disease. In the state III, two patients did not maintain the follow-up; five live with disease (two with QT without surgery yet, two local recurrences, and one metastasis), and four live free of disease. In the stage IV: five died, two live with disease (1 local recurrence and one metastasis), five live free of disease, and one did not maintain the follow-up. In the stage IV-S, the three patients live free of disease. The method of Kaplan-Meier at 5 years shows a mean of 49 months and a median of 60 months.

CONCLUSIONS

1. Of all the parameters studied, we consider the ones with biggest prognostic efficacy are, the age, the stage INSS, the histology Shimada and the N-myc amplification. 2. The total resection of the tumor keeps being essential for a more favourable prognostic.