title: Spontaneous regression of localized neuroblastoma detected by mass screening.
abstract: OBJECTIVE
  To clarify whether and when neuroblastomas identified through screening do regress, and to ascertain how to treat them appropriately, we observed screened patients who had localized tumors, without any therapeutic intervention.
  
  
  METHODS
  The criteria for the observation program were as follows: disease stage I or II; tumor less than 5 cm in diameter; no invasion to the intraspinal canal or growth to the great vessels; urinary vanillylmandelic acid (VMA) and homovanillic acid (HVA) less than 50 microg/mg creatinine; and informed consent. Of 25 patients identified through screening for 6-month-old infants in Saitama Prefecture, Japan between April 1994 and March 1996, 11 patients who met the criteria and one other patient with stage III tumor were enrolled onto the program. They were examined by abdominal ultrasonography (US) and their urinary VMA and HVA levels were assessed approximately once per month. The observation periods ranged from 4 to 27 months.
  
  
  RESULTS
  The 11 tumors decreased in size, although one of these 11 tumors initially enlarged until the patient was 12 months of age and decreased in size thereafter. One other tumor slightly increased in size. Urinary VMA levels decreased in all patients. None of the tumors had completely disappeared by the last observation day.
  
  
  CONCLUSIONS
  Our results suggest that regression of screened neuroblastoma is not a rare phenomenon. At present, it seems reasonable to adopt a wait-and-see strategy, with careful observation, for selected stage I or II tumors identified in infants screened at 6 months of age.
authors.affiliation: Division of Hematology/Oncology, Saitama Children's Medical Center, Iwatsuki, Japan. CXQ00045@niftyserve.or.jp
authors.forename: K
authors.initials: K
authors.lastname: Yamamoto
authors.forename: R
authors.initials: R
authors.lastname: Hanada
authors.forename: A
authors.initials: A
authors.lastname: Kikuchi
authors.forename: M
authors.initials: M
authors.lastname: Ichikawa
authors.forename: T
authors.initials: T
authors.lastname: Aihara
authors.forename: E
authors.initials: E
authors.lastname: Oguma
authors.forename: T
authors.initials: T
authors.lastname: Moritani
authors.forename: Y
authors.initials: Y
authors.lastname: Shimanuki
authors.forename: M
authors.initials: M
authors.lastname: Tanimura
authors.forename: Y
authors.initials: Y
authors.lastname: Hayashi
mesh_terms: D006719:Homovanillic Acid / Q000652:urine; D006801:Humans; D007223:Infant; D008403:Mass Screening / Q000379:methods; D009365:Neoplasm Regression, Spontaneous; D009447:Neuroblastoma / Q000378:metabolism* / Q000473:pathology; D014642:Vanilmandelic Acid / Q000652:urine
chemical_list: D014642:Vanilmandelic Acid; D006719:Homovanillic Acid