TRENDS OF SURVIVAL IN NEUROBLASTOMA AND INDEPENDENT RISK-FACTORS FOR SURVIVAL AT A SINGLE INSTITUTION

To assess the progress of survival in neuroblastoma which varies with many risk factors and to evaluate the influence of these factors on su rvival as independent risk factors. The study subjects were 159 neurob lastoma patients seen from 1965-1994 at the oldest and largest childre n's hospital in Japan. Trends of survival in three treatment eras-1965 -81, 1982-86, 1987-94-were assessed by the Kaplan-Meier method for dif ferent sex, age at diagnosis, the clinical stage, the site of onset, a nd the histological type. Then the influence on survival of these fact ors as independent prognostic variables was evaluated by the Cox propo rtional hazards regression analysis. Age at diagnosis, the clinical st age, the site of onset, the histological type, and the treatment era w ere independent risk factors in the order of their influence on surviv al. Unfavorable survival outcomes were obtained for patients with age at diagnosis above 1 year, the clinical stage of VI by the Evans class ification, adrenal onset, and neuroblastoma rather than ganglioneurobl astoma. Survival improved from the first to the second and from the se cond to the third treatment era. Improvement of survival in neuroblast oma took place during the past 3 decades. Age at diagnosis, the clinic al stage, and the histological type have still remained overwhelming p rognostic factors over the progress in treatment. (C) 1997 Wiley-Liss, Inc.