Abstract
IntroductionNeuroblastoma is one of the most common extracranial solid tumors in children, which accounts for about 7–10% in children’s tumors. The prognosis group of patients with neuroblastoma could not only improve the efficacy of high-risk patients, but also reduce the effects of drug complications for surviving patients.Material and MethodsPatients diagnosed with neuroblastoma between 1986 and 2012 were selected form the TARGET database. The nomogram was built with potential risk factors based on COX regression analysis. The precision of the 3-year and 5-year survival of the nomograms was evaluated by the area under receiver operating characteristic (ROC) curve (AUC).ResultsA total of 757 child neuroblastoma patients were selected from the TARGET database. Univariate analysis showed that age of diagnosis (>520 day), race of American Indian or Alaska Native, stage 4 in International Neuroblastoma Staging System (INSS), MYCN status, DNA ploidy, and high mitosis-karyorrhexis index were associated with overall survival (OS). Multivariate analysis showed age of diagnosis (>520 day), stage 4 in INSS and DNA ploidy were independent risk factors of OS. The concordance index (C-index) of the nomogram was 0.704 (95% CI [0.686–0.722]) in the training cohort while the C-index in the validation cohort was 0.672 (95% CI [0.644–0.700]). AUC values of ROC curves for 3-year OS and 5-year OS in the training cohort were 0.732 and 0.772, respectively. The nomogram performed better compared with INSS staging system, tumor histology and children’s oncology group (COG) risk group with C-indexes of 0.662 (95% CI [0.648–0.676]), 0.637 (95% CI [0.622–0.652]) and 0.651 (95% CI [0.637–0.665]), respectively.ConclusionsThe nomogram showed stronger predictive power than the INSS staging system, tumor histology and COG risk group. Precise estimates of the prognosis of childhood neuroblastoma might help doctors make better treatment decisions.
Highlights
Neuroblastoma is one of the most common extracranial solid tumors in children, which accounts for about 7–10% in children’s tumors
Optimal cutoff value of age of diagnosis was 520 days. 70% of all patients were randomly selected to form the training cohort for the construction of nomogram while the rest 30% patients served as the validation cohort
Race, International Neuroblastoma Staging System (INSS) staging system, MYCN, DNA ploidy status, mitosis-karyorrhexis index (MKI), and calculated risk scores were associated with overall survival
Summary
Neuroblastoma is one of the most common extracranial solid tumors in children, which accounts for about 7–10% in children’s tumors. The prognosis group of patients with neuroblastoma could improve the efficacy of high-risk patients, and reduce the effects of drug complications for surviving patients. The nomogram performed better compared with INSS staging system, tumor histology and children’s oncology group (COG) risk group with C-indexes of 0.662 (95% CI [0.648–0.676]), 0.637 (95% CI [0.622–0.652]) and 0.651 (95% CI [0.637–0.665]), respectively. Conclusions: The nomogram showed stronger predictive power than the INSS staging system, tumor histology and COG risk group. The prognosis group of patients with neuroblastoma was classify in to high-risk patients and low-risk patients, which could improve the efficacy of high-risk patients, and reduce the effects of drug complications for surviving patients. It is necessary to analyze the prognosis of patients with neuroblastoma
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