title: Adult versus Pediatric Neuroblastoma: The M.D. Anderson Cancer Center Experience.
abstract: Background. Staging and treatment of adult neuroblastoma has yet to be formalized. We sought to determine the utility of the pediatric classification system in adults and determine the efficacy of different treatment modalities. Methods. Medical records of 118 adults (patients >17 years old) and 112 pediatric patients (ages 2-17), who were treated for neuroblastoma at M.D. Anderson Cancer Center from January 1994 to September 2012, were reviewed. International neuroblastoma risk group (INRG) variables were abstracted. The primary outcome of interest was actuarial progression-free survival. Results. Median age of pediatric patients was 5 years (range 3-16) and 47 years (range 18-82) for adult patients. There were no differences in PFS or OS between stage-matched risk categories between pediatric and adult patients (L1-P = 0.40, L2-P = 0.54, and M-P = 0.73). In the treatment of L1 disease, median PFS for adults treated with surgery and radiation was 11.1 months compared with single modality local treatment ± chemotherapy (6.4 and 5.1 months, resp.; P = 0.07). Median PFS in L2 adult patients was 5.2 months with local therapy and 4 months with the addition of chemotherapy (P = 0.23). Conclusions. Adult and pediatric patients with neuroblastoma achieve similar survival outcomes. INRG classification should be employed to stratify adult neuroblastoma patients and help select treatment.
authors.affiliation: Division of Cancer Medicine, M.D. Anderson Cancer Center, 1400 Holcombe Boulevard, Unit 463, Houston, TX 77030, USA.
authors.forename: Henry J
authors.initials: HJ
authors.lastname: Conter
authors.affiliation: Division of Cancer Medicine, M.D. Anderson Cancer Center, 1400 Holcombe Boulevard, Unit 463, Houston, TX 77030, USA.
authors.forename: Vancheswaran
authors.identifier: 0000-0002-8704-035X
authors.initials: V
authors.lastname: Gopalakrishnan
authors.affiliation: Department of Sarcoma Medical Oncology, M.D. Anderson Cancer Center, 1400 Holcombe Boulevard, Unit 463, Houston, TX 77030, USA.
authors.forename: Vinod
authors.initials: V
authors.lastname: Ravi
authors.affiliation: Department of Pediatrics Patient Care, M.D. Anderson Cancer Center, 1400 Holcombe Boulevard, Unit 463, Houston, TX 77030, USA.
authors.forename: Joann L
authors.initials: JL
authors.lastname: Ater
authors.affiliation: Department of Sarcoma Medical Oncology, M.D. Anderson Cancer Center, 1400 Holcombe Boulevard, Unit 463, Houston, TX 77030, USA.
authors.forename: Shreyaskumar
authors.identifier: 0000-0002-0026-2348
authors.initials: S
authors.lastname: Patel
authors.affiliation: Department of Sarcoma Medical Oncology, M.D. Anderson Cancer Center, 1400 Holcombe Boulevard, Unit 463, Houston, TX 77030, USA.
authors.forename: Dejka M
authors.initials: DM
authors.lastname: Araujo