title: Tumour markers are poor predictors for relapse or progression in neuroblastoma.
abstract: 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.
authors.affiliation: Children's Hospital, University of Cologne, 50924 Cologne, Germany. thorsten.simon@medizin.uni-koeln.de
authors.forename: T
authors.initials: T
authors.lastname: Simon
authors.forename: B
authors.initials: B
authors.lastname: Hero
authors.forename: D H
authors.initials: DH
authors.lastname: Hunneman
authors.forename: F
authors.initials: F
authors.lastname: Berthold
mesh_terms: 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
chemical_list: D014408:Biomarkers, Tumor; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D014642:Vanilmandelic Acid; D007770:L-Lactate Dehydrogenase; D010751:Phosphopyruvate Hydratase; D006719:Homovanillic Acid