Desandes Emmanuel, Guissou Sandra, Ducassou Stéphane, Lacour Brigitte
CHU Nancy, Registre National des Cancers de l'Enfant, Registre National des Tumeurs Solides de l'Enfant, Faculté de médecine, Vandoeuvre-lès-Nancy F-54500, France.
Université Paris-Sorbonne, CRESS équipe 7, Inserm UMRS-1153, Paris, F-75006, France.
Pediatr Blood Cancer. 2016 Aug;63(8):1375-80. doi: 10.1002/pbc.26006. Epub 2016 Apr 19.
Solid tumors are uncommon in the neonatal period but represent an important cause of mortality and morbidity.
Using the French National Registry of Childhood Solid Tumors database, all children, from birth to 28 days of age inclusive, with a primary malignant solid tumor diagnosed between 2000 and 2009 in mainland France were identified. Tumors were classified according to the third version of the International Classification of Childhood Cancer.
Of total 285 solid tumors over 10 years, the most common cancer was neuroblastoma (47%), followed by germ cell tumors (29%), central nervous system tumors (10%), and soft tissue sarcomas (8%). The annual incidence was 36.6 per million live births. No statistically significant change in time trends of incidence was observed during 2000-2009. Routine ultrasonography during pregnancy established the diagnosis in 52% of cases. Thirteen neonates (4.5%) had congenital abnormalities associated with their tumors. For all solid tumors combined, overall survival was 84.2% (95% CI, 79.4-87.9) at 1 year and 83.8% (95% CI, 79.0-87.6) at 5 years. More favorable prognosis was significantly associated with neonates treated by surgery (65% of cases) compared to those without tumor excision. However, perioperative and postoperative mortality was 8%.
Because of their relative rarity, there is a paucity of objective information on the epidemiology, optimal treatment, and long-term outcome of neonatal solid tumors. But to obtain a clearer picture of the epidemiology of neonatal tumors, it is essential to have some recommendations on the methodological approach used to study them.
实体瘤在新生儿期并不常见，但却是导致死亡和发病的重要原因。
利用法国国家儿童实体瘤登记数据库，确定了2000年至2009年在法国本土出生至28天（含28天）的所有被诊断为原发性恶性实体瘤的儿童。肿瘤根据《国际儿童癌症分类》第三版进行分类。
在10年期间共285例实体瘤中，最常见的癌症是神经母细胞瘤（47%），其次是生殖细胞肿瘤（29%）、中枢神经系统肿瘤（10%）和软组织肉瘤（8%）。年发病率为每百万活产36.6例。2000年至2009年期间未观察到发病率随时间变化的统计学显著变化。孕期常规超声检查确诊了52%的病例。13名新生儿（4.5%）的肿瘤伴有先天性异常。对于所有实体瘤合并病例，1年总生存率为84.2%（95%CI，79.4 - 87.9），5年总生存率为83.8%（95%CI，79.0 - 87.6）。与未进行肿瘤切除的新生儿相比，接受手术治疗的新生儿（65%的病例）预后明显更有利。然而，围手术期和术后死亡率为8%。
由于新生儿实体瘤相对罕见，关于其流行病学、最佳治疗方法和长期预后的客观信息匮乏。但为了更清楚地了解新生儿肿瘤的流行病学，对用于研究它们的方法学方法提出一些建议至关重要。
