Recent advances in neuroblastoma.

Neuroblastoma is one of the commoner tumors of infancy and childhood. There is great variation in the histological picture and even within one tumor. One unique feature is the apparently high rate of spontaneous regression, particularly during the first year of life. There is also a tendency for neuroblastoma to mature to the more benign ganglioneuroma and recent in vitro studies suggest that a serum factor may influence this process. Approximately 90 percent of patients with neuroblastoma excrete abnormally high quantities of various catecholamines, thus providing a useful diagnostic tool and a means for evaluating the effect of therapy. Treatment requires a multidisciplinary team approach involving a surgeon, radiotherapist and chemotherapist. Prognosis is influenced by a number of host factors and the most important of these seem to be the patient's age at diagnosis and the extent of the disease, although some children with widespread disease appear to have a particularly good prognosis. It is difficult to evaluate the influence of chemotherapy on survival in patients with neuroblastoma but it has not been of great significance. The unique biologic characteristics of this tumor require further study in the hope of providing more effective therapy.