Tumour markers are poor predictors for relapse or progression in neuroblastoma.
The value of the tumour markers vanillylmandelic acid (VMA) and homovanillic acid (HVA) in urine (u) and serum (s), neurone-specific enolase (NSE), and lactate dehydrogenase (LDH) in the early prediction of relapse/progression in neuroblastoma is not known. We analysed the data of neuroblastoma patients who had successfully completed first-line treatment and had laboratory results available from their initial diagnosis and from relapse/progression (n=196). Patients' overall survival from relapse or progression was 21.5+/-4.2% (mean+/-standard deviation). At diagnosis, we found abnormal results in 75% for VMA and/or HVA (s), 92% for VMA and/or HVA (u), 90% for NSE, and 81% for LDH. We found a lower incidence of abnormal results at relapse or progression with 40% for VMA and/or HVA (s), 54% for HVA and/or VMA (u), 61% for NSE, and 48% for LDH. Sensitivity of all markers was higher for metastatic compared with local recurrence. NSE was the best, being able to detect 42% of the localised relapses, 77% of the combined local/metastatic relapses, and 69% of the metastatic recurrences. Relapse or progression in neuroblastoma cannot be detected reliably by monitoring tumour markers alone. Therefore, follow-up of neuroblastoma patients must include clinical assessment and imaging studies.
Simon
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Children's Hospital, University of Cologne, 50924 Cologne, Germany. thorsten.simon@medizin.uni-koeln.de
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Hunneman
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Berthold
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D000293:Adolescent; D014408:Biomarkers, Tumor / Q000032:analysis* / Q000097:blood / Q000652:urine; D019046:Bone Marrow Neoplasms / Q000097:blood / Q000556:secondary* / Q000652:urine; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D018450:Disease Progression; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006719:Homovanillic Acid / Q000097:blood / Q000652:urine; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D007770:L-Lactate Dehydrogenase / Q000097:blood / Q000652:urine; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000401:mortality; D009447:Neuroblastoma / Q000175:diagnosis* / Q000401:mortality; D010751:Phosphopyruvate Hydratase / Q000097:blood / Q000652:urine; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014642:Vanilmandelic Acid / Q000097:blood / Q000652:urine
D014408:Biomarkers, Tumor; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D014642:Vanilmandelic Acid; D007770:L-Lactate Dehydrogenase; D010751:Phosphopyruvate Hydratase; D006719:Homovanillic Acid