title: Mortality and morbidity of patients with neuroblastoma who survived for more than 10 years after treatment--Niigata Tumor Board Study.
abstract: OBJECTIVE
  To evaluate the utility of treatment strategies in neuroblastoma (NB), the survival of the NB patients was retrospectively examined.
  
  
  METHODS
  During the past 40 years from 1967 to 2006, 103 NB patients not detected by the mass screening program were treated. The patients were divided into 3 groups; the period of aggressive surgery (AS group: 43 patients) from 1967 to 1984, the period of aggressive chemotherapy (AC group: 40 patients), from 1985 to 1996, and the period of mega-chemotherapy with stem cell transplantation since 1997. The patients treated in the AC and the AS groups were examined.
  
  
  RESULTS
  The survival curve reached a nadir within 3 years in the AS group, whereas the second major drop of the survival curve was found in the AC group, which was owing to late mortality of 7 patients more than 10 years after the initiation of treatment. As a result, the overall survival in the AS and the AC groups were approximately 30.2% and 30.0% at 20 years after treatment, respectively. A different kind of strategy-related morbidity was found in 46% of EFS in both the AS and the AC groups.
  
  
  CONCLUSIONS
  The effectiveness of a treatment strategy should therefore be assessed after several decades.
authors.affiliation: Department of Pediatric Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan. mkubota@med.niigata-u.ac.jp
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kubota
authors.forename: Naoki
authors.initials: N
authors.lastname: Okuyama
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hirayama
authors.forename: Keiko
authors.initials: K
authors.lastname: Asami
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ogawa
authors.forename: Akihiro
authors.initials: A
authors.lastname: Watanabe
mesh_terms: D000293:Adolescent; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D009017:Morbidity; D009447:Neuroblastoma / Q000453:epidemiology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D017741:Survivors; D016896:Treatment Outcome