A new risk score for patients after first recurrence of stage 4 neuroblastoma aged ≥18 months at first diagnosis

Autor: Thorsten Simon, Angela Ernst, Matthias Fischer, Barbara Hero, Ruth Volland, Rene Schmidt, Kiana Kreitz, Frank Berthold
Jazyk: angličtina
Rok vydání: 2019
Předmět:
0301 basic medicine
Male
Cancer Research
Kaplan-Meier Estimate
Neuroblastoma
0302 clinical medicine
Risk Factors
Germany
Clinical endpoint
Medicine
Stage (cooking)
Child
Randomized Controlled Trials as Topic
Original Research
relapse
Framingham Risk Score
Hazard ratio
Age Factors
clinical trial
Prognosis
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Primary tumor
Oncology
030220 oncology & carcinogenesis
Child
Preschool
Female
Prognostic variable
medicine.medical_specialty
recurrence
Adolescent
high‐risk neuroblastoma
risk score
Risk Assessment
lcsh:RC254-282
Disease-Free Survival
03 medical and health sciences
Young Adult
time‐dependent variable
Internal medicine
Humans
Radiology
Nuclear Medicine and imaging
Neoplasm Staging
Proportional Hazards Models
Retrospective Studies
business.industry
Proportional hazards model
Infant
Clinical Cancer Research
medicine.disease
Clinical trial
030104 developmental biology
Clinical Trials
Phase III as Topic
Neoplasm Recurrence
Local
business
Zdroj: Cancer Medicine, Vol 8, Iss 17, Pp 7236-7243 (2019)
Cancer Medicine
ISSN: 2045-7634
Popis: Background The prognosis of patients with recurrences from stage 4 neuroblastoma is not uniformly dismal. The evaluation of new therapies therefore needs to consider the individual risks of the treated patients. This study aims to define clinically useful risk criteria. Patients and Methods Inclusion criteria were: first recurrence of neuroblastoma stage 4 aged ≥18 months and enrollment in first line trials between 1997 and 2016. Patients were randomized into a training set (N = 310) and an independent validation set (N = 159). The primary endpoint was secondary event‐free survival. The individual treatment elements the patients received during initial and recurrent disease were analyzed as binary and time‐dependent variables. A five‐step multiple time‐dependent Cox regression analysis was performed on the training set to identify prognostic variables adjusted for the individual frontline treatment. The selected variables resulted in a prognostic index (PI) and were used to build a risk score system. The score was validated with the validation set. Results Of the 469 patients, 372 were treated with curative intent and 97 with palliative intent. The PI included the variables number of recurrence organs (hazard ratio [HR] = 2.27), time to recurrence (HR = 2.03), liver metastasis at diagnosis (HR = 1.77), first recurrence at site of the primary tumor (HR = 1.55), and age (HR = 1.29). Three risk groups were built and confirmed in the validation set. The scoring system was likewise useful for the curatively or palliatively treated subgroups. Conclusion A new risk score system for patients with first recurrence of stage 4 neuroblastoma aged ≥18 months at diagnosis is proposed.
The prognostic index of each patient with first recurrence of stage 4 neuroblastoma aged >18 months at first diagnosis can be calculated. If a characteristic is present, use the indicated figure. If absent, use 0. The sum indicates the related risk group.
Databáze: OpenAIRE
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