PROGNOSTIC-SIGNIFICANCE OF AGE, MYCN ONCOGENE AMPLIFICATION, TUMOR-CELL PLOIDY, AND HISTOLOGY IN 110 INFANTS WITH STAGE D(S) NEUROBLASTOMA - THE PEDIATRIC-ONCOLOGY-GROUP EXPERIENCE - A PEDIATRIC-ONCOLOGY-GROUPSTUDY

Purpose: Although a high rate of spontaneous regression is observed in infants with stage D(S) neuroblastoma (NB), survival is not uniform. To determine the prognostic relevance of age at diagnosis, therapy, an d tumor biology in infants with stage D(S) NE, we reviewed the Pediatr ic Oncology Group (POC) experience. Patients and Methods: A review of patients diagnosed with stage D(S) NE registered on FOG protocols was performed. Survival according to age at diagnosis, treatment and tumor biology was determined. Results: Between 1987 and 1996, 110 infants w ith stage D(S) NE had an estimated 3-year survival rate of 85% +/- 4%; survival rate was 71% +/- 8% for infants 2 months of age or younger a nd 68% +/- 12%, 44% +/- 33%, and 33% +/- 19% for patients with diploid , MYCN-amplified, and unfavorable histology tumors, respectively. Surv ival rates were similar for patients who received adjuvant chemotherap y versus those who did not (82% +/- 5% v 93% +/- 6%, respectively; P = .187). Furthermore, there was no statistical difference in survival r ate for patients who underwent complete resection of their primary tum or compared with those who underwent partial resection or biopsy only (90% +/- 5% v78% +/- 7%, respectively; P = .083). Conclusion: Our revi ew confirmed that the survival of infants with stage D(S) NE is excell ent. However, subsets of patients with poor prognosis can be identifie d by young age and unfavorable biologic factors. More effective therap y is needed for the group of stage D(S) infants who show unfavorable c linical and biologic features.