Hassenbusch S, Kaizer H, White J J
J Pediatr Surg. 1976 Jun;11(3):287-97. doi: 10.1016/s0022-3468(76)80181-9.
Data of 101 patients with neuroblastic tumors from 1950 to1974 at The Johns Hopkins Hospital have been abstracted onto specially designed summary sheets, and subjected to multifactorial analysis. One-third of the 21 benign ganglioneuromas showed evidence for spontaneous maturation. The overall cure rate among the malignant tumors was 39%. Cures were higher with an extraabdominal primary, with more mature histologic differentiation, and if excision, even partial, was carried out. Neither radiotherapy nor evolving modalities of chemotherapy appear to have had benefit over this 25-yr period. An age at diagnosis less than 2 yr, and a less extensive clinical stage both were independent predictors of survival. The apparent effects of a favorable site of tumor origin, or more mature histologic differentiation were not of major impact in and of themselves, but correlated better with clinical stage. Two prognostic schemata, based on stage plus age, and stage plus histologic differentiation plus age respectively, proved to be 95% accurate in our experience. With more extensive evaluation and experience, either or both may be helpful in the management of malignant neuroblastic tumors, and assessment of therapeutic regimens.
对1950年至1974年间约翰霍普金斯医院收治的101例神经母细胞瘤患者的数据进行了整理，记录在专门设计的总结表上，并进行了多因素分析。21例良性神经节神经瘤中有三分之一显示出自发成熟的迹象。恶性肿瘤的总体治愈率为39%。腹外原发、组织学分化更成熟以及即使是部分切除的患者治愈率更高。在这25年期间，放疗和不断发展的化疗方式似乎都没有带来益处。诊断时年龄小于2岁以及临床分期较局限都是生存的独立预测因素。肿瘤起源部位良好或组织学分化更成熟的明显影响本身并不显著，但与临床分期的相关性更好。根据我们的经验，分别基于分期加年龄以及分期加组织学分化加年龄的两种预后方案准确率达95%。随着评估的更加广泛和经验的积累，其中一种或两种方案可能有助于恶性神经母细胞瘤的管理以及治疗方案的评估。
