Clinical Characteristics and Survival Outcomes in Neuroblastoma With Bone Metastasis Based on SEER Database Analysis.

Bin He,Jianshui Mao,Leyi Huang

doi:10.3389/fonc.2021.677023

Abstract

PurposeClinical features and survival analysis of neuroblastoma (NB) are well explored. However, clinical research of NB patients with bone metastasis is rarely reported. Thus, the current study was performed to analyze the clinical features, survival outcome, and risk factors in those patients.Materials and MethodsWe reviewed the Surveillance, Epidemiology, and End Results (SEER) database to select cases diagnosed with NB with bone metastasis from 2010 to 2016. Overall survival (OS) and cancer-specific survival (CSS) were analyzed through univariate Cox regression analysis. Subsequently, we performed multivariate analysis to determine independent predictors of survival. The Kaplan–Meier method was applied to intuitively show differences in prognostic value between independent risk factors.ResultsWe finally identified 393 NB patients with bone metastasis who were selected for survival analysis. Nearly half of the patients (47.3%) were aged >3 years. The adrenal gland was the primary tumor site, accounting for approximately two thirds of cases (66.2%). The 5-year OS and CSS rates of all patients were 62.1% and 64.1%, respectively. The univariate analysis indicated that age, lung metastasis, and tumor size were significantly associated with OS and CSS. Based on the multivariable analysis, age at 2 and 3 years, lung metastasis, and tumor size >10 cm remained significant negative predictors of OS and CSS.ConclusionFor NB patients with bone metastasis, three independent prognostic risk factors (age, lung metastasis, and tumor size) are helpful to clinicians for predicting prognosis and guiding treatment. Reasonable treatment modalities for these patients should be further investigated to prolong survival.

Highlights

Neuroblastoma (NB) is one of the most common malignant solid tumors that occur in infants and young children, accounting for 15% of childhood tumor-related deaths [1]
We presented the corresponding hazard ratio and 95% confidence interval to indicate the impact of each variable on survival
The present study revealed the clinical features of NB patients with bone

Summary

Introduction

Neuroblastoma (NB) is one of the most common malignant solid tumors that occur in infants and young children, accounting for 15% of childhood tumor-related deaths [1]. The adrenal gland is the most common primary site for NB, while bone is the most common site of distant metastasis of NB [2]. Patients with NB are linked to a good overall prognosis, those with metastasis usually have a poor survival outcome even after radical therapy [2, 3]. 50% of patients with NB had distant metastasis at the time of diagnosis [4]. The 5-year event-free survival rate of patients with high-risk NB is

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