title: Diagnostic and prognostic impact of urinary catecholamines in neuroblastoma patients.
abstract: BACKGROUND
  Urinary catecholamine metabolites are well-known to be elevated in patients with neuroblastoma. Some investigators have described different patterns in favorable and unfavorable cases. However, extended studies have not been published.
  
  
  METHODS
  We investigated urinary catecholamine patterns and their correlation to stage, biological features, and outcome in 114 consecutively clinically diagnosed neuroblastoma patients.
  
  
  RESULTS
  Sensitivity of vanillylmandelic acid (VMA), homovanillic acid (HVA), and dopamine (DA) was 80.7, 71.9, and 61.3%, respectively. In 91.2% of patients at least one parameter was above normal. High VMA levels were associated with favorable biological features, high DA levels were predominantly found in biologically unfavorable disease. Whereas patients with normal HVA levels had a significant better outcome, the other parameters showed no significant association with prognosis. For disseminated neuroblastoma of infancy, DA/VMA ratio proved to be helpful for the discrimination of stage 4 versus stage 4s.
  
  
  CONCLUSIONS
  Urinary catecholamines appear to be useful to give a first but important hint about the biological behavior and thus the prognosis of the underlying disease. Particularly DA/VMA ratio may serve as a tool for "biological grading"-especially in disseminated disease of infancy. In addition, it may be speculated that HVA negativity and low DA/VMA ratio may be helpful for the decision of a "wait and see" strategy in selected neuroblastoma patients with localized disease.
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria. volker.strenger@meduni-graz.at
authors.forename: Volker
authors.initials: V
authors.lastname: Strenger
authors.forename: Reinhold
authors.initials: R
authors.lastname: Kerbl
authors.forename: Hans Jürgen
authors.initials: HJ
authors.lastname: Dornbusch
authors.forename: Ruth
authors.initials: R
authors.lastname: Ladenstein
authors.forename: Peter F
authors.initials: PF
authors.lastname: Ambros
authors.forename: Inge M
authors.initials: IM
authors.lastname: Ambros
authors.forename: Christian
authors.initials: C
authors.lastname: Urban
mesh_terms: D000293:Adolescent; D002395:Catecholamines / Q000652:urine*; D002648:Child; D002675:Child, Preschool; D004298:Dopamine / Q000652:urine; D005260:Female; D006719:Homovanillic Acid / Q000652:urine; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009447:Neuroblastoma / Q000175:diagnosis* / Q000401:mortality / Q000652:urine; D011379:Prognosis; D012680:Sensitivity and Specificity; D014642:Vanilmandelic Acid / Q000652:urine
chemical_list: D002395:Catecholamines; D014642:Vanilmandelic Acid; D004298:Dopamine; D006719:Homovanillic Acid