Department of Pediatric Surgery, Zhongshan City People's Hospital, No. 2 Sunwen East Road, Guangdong, Zhongshan, 528400, People's Republic of China.
BMC Pediatr. 2024 Mar 7;24(1):162. doi: 10.1186/s12887-024-04570-z.
To investigate clinical characteristics, prognoses, and impacts of treatments on prognoses of neuroblastoma patients with bone or liver metastasis.
This retrospective cohort study extracted data from the Surveillance, Epidemiology, and End Results (SEER) database 2010-2019. The outcomes were 3-year cancer-specific survival (CSS) and 5-year CSS. Multivariable COX risk proportional models were established to assess the association between metastasis types and CSS. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated.
Totally 425 patients with metastatic neuroblastoma were eligible for 3-year CSS analysis and 320 for 5-year CSS analysis. For 3-year follow-up, 62 (14.59%) patients had liver metastasis alone, 289 (0.68%) had bone metastasis alone, and 74 (17.41%) had both liver and bone metastasis. For 5-year follow-up, 44 (13.75%) patients had liver metastasis alone, 223 (69.69%) had bone metastasis alone, and 53 (16.56%) had both liver and bone metastasis. Significant differences were observed in age, tumor size, surgery for the primary site, chemotherapy, radiation, brain metastasis, lung metastasis, and vital status between patients with liver metastasis alone, bone metastasis alone, and both liver and bone metastasis (all P < 0.05). Compared with patients with liver metastasis alone, patients with bone metastasis alone (HR = 2.30, 95%CI: 1.10-4.82, P = 0.028) or both (HR = 2.35, 95%CI: 1.06-5.20, P = 0.035) had significantly poorer 3-year CSS; patients with bone metastasis alone (HR = 2.32, 95%CI: 1.14-4.70, P = 0.020) or both liver and bone metastasis (HR = 2.33, 95%CI: 1.07-5.07, P = 0.032) exhibited significantly worse 5-year CSS than those with liver metastasis alone. In patients with bone metastasis, those with chemotherapy had significantly better 3-year CSS than those without (HR = 0.24, 95%CI: 0.07-0.75, P = 0.014). Among patients with liver metastasis, receiving radiation was associated with significantly worse 3-year CSS (HR = 2.00, 95%CI: 1.05-3.81, P = 0.035).
Compared with patients with liver metastasis alone, those with bone metastasis alone or both had poorer 3- and 5-year CSS. For patients with bone metastasis, undergoing chemotherapy was associated with better 3-year CSS. For patients with liver metastasis, receiving radiation was associated with worse 3-year CSS.
本研究旨在探究伴有骨或肝转移的神经母细胞瘤患者的临床特征、预后及治疗对预后的影响。
本回顾性队列研究从 2010 年至 2019 年的监测、流行病学和最终结果（SEER）数据库中提取数据。主要结局为 3 年癌症特异性生存率（CSS）和 5 年 CSS。多变量 COX 风险比例模型用于评估转移类型与 CSS 之间的关系。估计风险比（HR）和 95%置信区间（CI）。
共纳入 425 例有远处转移的神经母细胞瘤患者，符合 3 年 CSS 分析条件；320 例患者符合 5 年 CSS 分析条件。在 3 年随访中，62 例（14.59%）患者仅有肝转移，289 例（0.68%）仅有骨转移，74 例（17.41%）同时有肝和骨转移。在 5 年随访中，44 例（13.75%）患者仅有肝转移，223 例（69.69%）仅有骨转移，53 例（16.56%）同时有肝和骨转移。在肝转移、骨转移和肝骨同时转移的患者中，年龄、肿瘤大小、原发灶手术、化疗、放疗、脑转移、肺转移和生存状态等方面均存在显著差异（均 P < 0.05）。与仅有肝转移的患者相比，仅有骨转移（HR=2.30，95%CI：1.10-4.82，P=0.028）或同时有肝骨转移（HR=2.35，95%CI：1.06-5.20，P=0.035）的患者 3 年 CSS 更差；仅有骨转移（HR=2.32，95%CI：1.14-4.70，P=0.020）或同时有肝骨转移（HR=2.33，95%CI：1.07-5.07，P=0.032）的患者 5 年 CSS 更差。在骨转移患者中，接受化疗的患者 3 年 CSS 显著优于未接受化疗的患者（HR=0.24，95%CI：0.07-0.75，P=0.014）。在肝转移患者中，接受放疗与 3 年 CSS 更差显著相关（HR=2.00，95%CI：1.05-3.81，P=0.035）。
与仅有肝转移的患者相比，仅有骨转移或同时有肝骨转移的患者 3 年和 5 年 CSS 更差。对于骨转移患者，接受化疗与 3 年 CSS 改善相关。对于肝转移患者，接受放疗与 3 年 CSS 更差相关。
