title: An 18 gene expression-based score classifier predicts the clinical outcome in stage 4 neuroblastoma.
abstract: The prognosis of children with metastatic stage 4 neuroblastoma (NB) has remained poor in the past decade.
  
  
  
  Using microarray analyses of 342 primary tumors, we here developed and validated an easy to use gene expression-based risk score including 18 genes, which can robustly predict the outcome of stage 4 patients.
  
  
  
  This classifier was a significant predictor of overall survival in two independent validation cohorts [cohort 1 (n = 214): P = 6.3 × 10(-5); cohort 2 (n = 27): P = 3.1 × 10(-2)]. The prognostic value of the risk score was validated by multivariate analysis including the established markers age and MYCN status (P = 0.027). In the pooled validation cohorts (n = 241), integration of the risk score with the age and/or MYCN status identified subgroups with significantly differing overall survival (ranging from 35 to 100 %).
  
  
  
  Together, the 18-gene risk score classifier can identify patients with stage 4 NB with favorable outcome and may therefore improve risk assessment and treatment stratification of NB patients with disseminated disease.
authors.affiliation: Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80145, Naples, Italy.|CEINGE Biotecnolgie Avanzate Scarl, Naples, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Formicola
authors.affiliation: Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80145, Naples, Italy.|CEINGE Biotecnolgie Avanzate Scarl, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Petrosino
authors.affiliation: Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80145, Naples, Italy.|CEINGE Biotecnolgie Avanzate Scarl, Naples, Italy.
authors.forename: Vito Alessandro
authors.initials: VA
authors.lastname: Lasorsa
authors.affiliation: Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80145, Naples, Italy.|CEINGE Biotecnolgie Avanzate Scarl, Naples, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Pignataro
authors.affiliation: Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80145, Naples, Italy.|CEINGE Biotecnolgie Avanzate Scarl, Naples, Italy.
authors.forename: Flora
authors.initials: F
authors.lastname: Cimmino
authors.affiliation: Department of Oncology, Santobono-Pausilipon Children's Hospital, Naples, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Vetrella
authors.affiliation: U.O.C. Bioterapie, IRCCS AOU San Martino-IST, National Cancer Research Institute, Genoa, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Longo
authors.affiliation: Laboratory of Neuroblastoma, Onco/Hematology Department SDB University of Padua, Pediatric Research Institute, Padua, Italy.
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Tonini
authors.affiliation: Department of Pediatric Oncology and Hematology, and Center for Molecular Medicine Cologne (CMMC), University of Cologne Children's Hospital, Cologne, Germany.
authors.forename: André
authors.initials: A
authors.lastname: Oberthuer
authors.affiliation: Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80145, Naples, Italy.|CEINGE Biotecnolgie Avanzate Scarl, Naples, Italy.
authors.forename: Achille
authors.initials: A
authors.lastname: Iolascon
authors.affiliation: Department of Pediatric Oncology and Hematology, and Center for Molecular Medicine Cologne (CMMC), University of Cologne Children's Hospital, Cologne, Germany.|Max Planck Institute for Metabolism Research, Cologne, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Fischer
authors.affiliation: Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80145, Naples, Italy. mario.capasso@unina.it.|CEINGE Biotecnolgie Avanzate Scarl, Naples, Italy. mario.capasso@unina.it.
authors.forename: Mario
authors.initials: M
authors.lastname: Capasso
mesh_terms: D002675:Child, Preschool; D005260:Female; D020869:Gene Expression Profiling; D015972:Gene Expression Regulation, Neoplastic; D063990:Gene Ontology; D053263:Gene Regulatory Networks; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D015999:Multivariate Analysis; D009447:Neuroblastoma / Q000235:genetics*; D011379:Prognosis; D016016:Proportional Hazards Models; D012044:Regression Analysis; D015203:Reproducibility of Results; D016896:Treatment Outcome
keywords: Microarray; Neuroblastoma; Prognosis; Risk score