title: Neuroblastoma management in Chinese children.
abstract: BACKGROUND
  This study assesses the clinical features of neuroblastoma and survival. Data for 98 patients between January 2000 and December 2006 at Children's Hospital of Fudan University, Shanghai, China, were retrospectively analyzed.
  
  
  METHODS
  Diagnostic methods included imaging, 24-hr urine catecholamines, bone marrow biopsies, and histopathology analyses. Treatment followed the modified Japanese Study Group Protocol. Clinical characteristics, treatment, and outcome were depicted, and difficulties encountered were analyzed.
  
  
  RESULTS
  The median age of patients was 48 months. There were 3, 13, 31, 49, and 2 patients in stages 1, 2, 3, 4, and 4s disease, respectively. Positive urinary vanillylmandelic acid (VMA) prevalence was low in localized disease (51.1%) and high in disseminated disease (70.6%, p = .03). Gross total resection rate was 60.8%. The five-year overall survival (OS) rate was 80% for stages 1 and 2, 48.3% for stage 3, and 20% for stage 4. The five-year OS rates significantly decreased in children older than 18 months (p < .01), and were higher after gross total resection was performed (p = .023). In stage 4 patients, gross total resection significantly improved the five-year OS rate (p = .029).
  
  
  CONCLUSIONS
  From these data, we suggest that positive urinary VMA, age greater than 18 months, incomplete tumor resection, and advanced stage predict poor prognosis. The results in children with advanced neuroblastoma were not satisfactory in our center. We speculated that lack of multidisciplinary teamwork, nonstandardized treatment, resource limitation, and indigence were the main causes for poorer outcome in late stages.
authors.affiliation: Children's Hospital of Fudan University, Shanghai, PR China.
authors.forename: Kai
authors.initials: K
authors.lastname: Li
authors.forename: Kuiran
authors.initials: K
authors.lastname: Dong
authors.forename: Jiechun
authors.initials: J
authors.lastname: Gao
authors.forename: Wei
authors.initials: W
authors.lastname: Yao
authors.forename: Xianmin
authors.initials: X
authors.lastname: Xiao
authors.forename: Shan
authors.initials: S
authors.lastname: Zheng
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D044466:Asian People; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008297:Male; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014642:Vanilmandelic Acid / Q000652:urine
chemical_list: D014642:Vanilmandelic Acid