Mortality and morbidity of patients with neuroblastoma who survived for more than 10 years after treatment-Niigata Tumor Board Study

Purpose: To evaluate the utility of treatment strategies in neuroblastoma (NB), the survival of the NB patients was retrospectively examined. Methods: During the past 40 years from 1967 to 2006, 103 NB patients not detected by the mass screening program were treated. The patients were divided into 3 groups; the period of aggressive surgery (AS group: 43 patients) from 1967 to 1984, the period of aggressive chemotherapy (AC group: 40 patients), from 1985 to 1996, and the period of mega-chemotherapy with stem cell transplantation since 1997. The patients treated in the AC and the AS groups were examined. Results: The survival curve reached a nadir within 3 years in the AS group, whereas the second major drop of the survival curve was found in the AC group, which was owing to late mortality of 7 patients more than 10 years after the initiation of treatment. As a result, the overall survival in the AS and the AC groups were approximately 30.2% and 30.0% at 20 years after treatment, respectively. A different kind of strategy-related morbidity was found in 46% of EFS in both the AS and the AC groups. Conclusions: The effectiveness of a treatment strategy should therefore be assessed after several decades. (C) 2010 Elsevier Inc. All rights reserved.