Localized resectable neuroblastoma: Results of the second study of the Italian Cooperative Group for Neuroblastoma

B. De Bernardi, M. Conte, A. Mancini, A. Donfrancesco, P. Alvisi, P. Toma, F. Casale, L. Cordero di Montezemolo, P. E. Cornelli, M. Carli, G. P. Tonini, A. Pession, W. Giaretti, A. Garaventa, N. Marchese, P. Magillo, M. Nigro, Z. Kotitsa, P. Tamaro

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

Purpose: To optimize treatment for children with localized resectable neuroblastoma in 21 Italian institutions using a common protocol based on previous experience. Patients and Methods: Between January 1985 and December 1992, 152 children aged 0 to 15 years with nondisseminated neuroblastoma were entered onto this study following complete resection of tumor without tumor rupture (TR) (stage 1), or resection with minimal tumor residue, and/or tumor infiltration of regional lymph nodes (LN+), and/or TR (stage 2). Of 144 assessable children, 69 were classified as having stage 1 disease and 75 as stage 2. Of stage 2 children, 49 had low-risk (LR) characteristics (age, 0 to 11 months or 1 to 15 years but negative lymph nodes and no TR). Stage 1 and stage 2 LR children did not receive adjuvant therapy. The remaining 26 stage 2 children had high-risk (HR) characteristics (age, 1 to 15 years with LN+ and/or TR) and received adjuvant chemotherapy for 6 months. Results: Of 144 children, three died of therapy-related complications and 19 relapsed, of whom six died of disease. The estimated 5-year overall survival (OS) rate was 93% and the event-free survival (EFS) rate was 83%. Of 69 stage 1 children, one died postoperatively and five relapsed (one local and four disseminated, two of whom died), for 94% OS and 90% EFS rates. Of 49 stage 2 LR children, six relapsed (four local and two disseminated); relapses occurred in five of 20 infants with LN+, in one of four infants with TR, and in none of the remaining 25 children. One child died of disease and one of toxicity, for 96% OS and 85% EFS rates. Of 26 stage 2 HR children, eight relapsed (three of 20 with LN+, three of four with TR, and two of two with LN+ and TR), of whom three died of disease and one of toxicity, for 87% OS and 61% EFS rates. Conclusion: Our data confirm the overall good prognosis of children with localized resectable neuroblastoma. LN+ and TR predisposed to relapse at all ages, but infants tended to have a less aggressive course after relapse. Stage 1 and 2 LR children had 94% and 96% OS rates, respectively, which justifies a policy of no adjuvant chemotherapy. Eight of 26 children with stage 2 HR relapsed despite 6 months of chemotherapy; for these children, more intensive chemotherapy may be required.

Original languageEnglish
Pages (from-to)884-893
Number of pages10
JournalJournal of Clinical Oncology
Volume13
Issue number4
Publication statusPublished - 1995

Fingerprint

Neuroblastoma
Rupture
Survival Rate
Neoplasms
Disease-Free Survival
Adjuvant Chemotherapy
Recurrence
Lymph Nodes
Drug Therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Localized resectable neuroblastoma : Results of the second study of the Italian Cooperative Group for Neuroblastoma. / De Bernardi, B.; Conte, M.; Mancini, A.; Donfrancesco, A.; Alvisi, P.; Toma, P.; Casale, F.; Cordero di Montezemolo, L.; Cornelli, P. E.; Carli, M.; Tonini, G. P.; Pession, A.; Giaretti, W.; Garaventa, A.; Marchese, N.; Magillo, P.; Nigro, M.; Kotitsa, Z.; Tamaro, P.

In: Journal of Clinical Oncology, Vol. 13, No. 4, 1995, p. 884-893.

Research output: Contribution to journalArticle

De Bernardi, B, Conte, M, Mancini, A, Donfrancesco, A, Alvisi, P, Toma, P, Casale, F, Cordero di Montezemolo, L, Cornelli, PE, Carli, M, Tonini, GP, Pession, A, Giaretti, W, Garaventa, A, Marchese, N, Magillo, P, Nigro, M, Kotitsa, Z & Tamaro, P 1995, 'Localized resectable neuroblastoma: Results of the second study of the Italian Cooperative Group for Neuroblastoma', Journal of Clinical Oncology, vol. 13, no. 4, pp. 884-893.
De Bernardi, B. ; Conte, M. ; Mancini, A. ; Donfrancesco, A. ; Alvisi, P. ; Toma, P. ; Casale, F. ; Cordero di Montezemolo, L. ; Cornelli, P. E. ; Carli, M. ; Tonini, G. P. ; Pession, A. ; Giaretti, W. ; Garaventa, A. ; Marchese, N. ; Magillo, P. ; Nigro, M. ; Kotitsa, Z. ; Tamaro, P. / Localized resectable neuroblastoma : Results of the second study of the Italian Cooperative Group for Neuroblastoma. In: Journal of Clinical Oncology. 1995 ; Vol. 13, No. 4. pp. 884-893.
@article{21d19d0ee3ab4679a057972c148f2cd4,
title = "Localized resectable neuroblastoma: Results of the second study of the Italian Cooperative Group for Neuroblastoma",
abstract = "Purpose: To optimize treatment for children with localized resectable neuroblastoma in 21 Italian institutions using a common protocol based on previous experience. Patients and Methods: Between January 1985 and December 1992, 152 children aged 0 to 15 years with nondisseminated neuroblastoma were entered onto this study following complete resection of tumor without tumor rupture (TR) (stage 1), or resection with minimal tumor residue, and/or tumor infiltration of regional lymph nodes (LN+), and/or TR (stage 2). Of 144 assessable children, 69 were classified as having stage 1 disease and 75 as stage 2. Of stage 2 children, 49 had low-risk (LR) characteristics (age, 0 to 11 months or 1 to 15 years but negative lymph nodes and no TR). Stage 1 and stage 2 LR children did not receive adjuvant therapy. The remaining 26 stage 2 children had high-risk (HR) characteristics (age, 1 to 15 years with LN+ and/or TR) and received adjuvant chemotherapy for 6 months. Results: Of 144 children, three died of therapy-related complications and 19 relapsed, of whom six died of disease. The estimated 5-year overall survival (OS) rate was 93{\%} and the event-free survival (EFS) rate was 83{\%}. Of 69 stage 1 children, one died postoperatively and five relapsed (one local and four disseminated, two of whom died), for 94{\%} OS and 90{\%} EFS rates. Of 49 stage 2 LR children, six relapsed (four local and two disseminated); relapses occurred in five of 20 infants with LN+, in one of four infants with TR, and in none of the remaining 25 children. One child died of disease and one of toxicity, for 96{\%} OS and 85{\%} EFS rates. Of 26 stage 2 HR children, eight relapsed (three of 20 with LN+, three of four with TR, and two of two with LN+ and TR), of whom three died of disease and one of toxicity, for 87{\%} OS and 61{\%} EFS rates. Conclusion: Our data confirm the overall good prognosis of children with localized resectable neuroblastoma. LN+ and TR predisposed to relapse at all ages, but infants tended to have a less aggressive course after relapse. Stage 1 and 2 LR children had 94{\%} and 96{\%} OS rates, respectively, which justifies a policy of no adjuvant chemotherapy. Eight of 26 children with stage 2 HR relapsed despite 6 months of chemotherapy; for these children, more intensive chemotherapy may be required.",
author = "{De Bernardi}, B. and M. Conte and A. Mancini and A. Donfrancesco and P. Alvisi and P. Toma and F. Casale and {Cordero di Montezemolo}, L. and Cornelli, {P. E.} and M. Carli and Tonini, {G. P.} and A. Pession and W. Giaretti and A. Garaventa and N. Marchese and P. Magillo and M. Nigro and Z. Kotitsa and P. Tamaro",
year = "1995",
language = "English",
volume = "13",
pages = "884--893",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "4",

}

TY - JOUR

T1 - Localized resectable neuroblastoma

T2 - Results of the second study of the Italian Cooperative Group for Neuroblastoma

AU - De Bernardi, B.

AU - Conte, M.

AU - Mancini, A.

AU - Donfrancesco, A.

AU - Alvisi, P.

AU - Toma, P.

AU - Casale, F.

AU - Cordero di Montezemolo, L.

AU - Cornelli, P. E.

AU - Carli, M.

AU - Tonini, G. P.

AU - Pession, A.

AU - Giaretti, W.

AU - Garaventa, A.

AU - Marchese, N.

AU - Magillo, P.

AU - Nigro, M.

AU - Kotitsa, Z.

AU - Tamaro, P.

PY - 1995

Y1 - 1995

N2 - Purpose: To optimize treatment for children with localized resectable neuroblastoma in 21 Italian institutions using a common protocol based on previous experience. Patients and Methods: Between January 1985 and December 1992, 152 children aged 0 to 15 years with nondisseminated neuroblastoma were entered onto this study following complete resection of tumor without tumor rupture (TR) (stage 1), or resection with minimal tumor residue, and/or tumor infiltration of regional lymph nodes (LN+), and/or TR (stage 2). Of 144 assessable children, 69 were classified as having stage 1 disease and 75 as stage 2. Of stage 2 children, 49 had low-risk (LR) characteristics (age, 0 to 11 months or 1 to 15 years but negative lymph nodes and no TR). Stage 1 and stage 2 LR children did not receive adjuvant therapy. The remaining 26 stage 2 children had high-risk (HR) characteristics (age, 1 to 15 years with LN+ and/or TR) and received adjuvant chemotherapy for 6 months. Results: Of 144 children, three died of therapy-related complications and 19 relapsed, of whom six died of disease. The estimated 5-year overall survival (OS) rate was 93% and the event-free survival (EFS) rate was 83%. Of 69 stage 1 children, one died postoperatively and five relapsed (one local and four disseminated, two of whom died), for 94% OS and 90% EFS rates. Of 49 stage 2 LR children, six relapsed (four local and two disseminated); relapses occurred in five of 20 infants with LN+, in one of four infants with TR, and in none of the remaining 25 children. One child died of disease and one of toxicity, for 96% OS and 85% EFS rates. Of 26 stage 2 HR children, eight relapsed (three of 20 with LN+, three of four with TR, and two of two with LN+ and TR), of whom three died of disease and one of toxicity, for 87% OS and 61% EFS rates. Conclusion: Our data confirm the overall good prognosis of children with localized resectable neuroblastoma. LN+ and TR predisposed to relapse at all ages, but infants tended to have a less aggressive course after relapse. Stage 1 and 2 LR children had 94% and 96% OS rates, respectively, which justifies a policy of no adjuvant chemotherapy. Eight of 26 children with stage 2 HR relapsed despite 6 months of chemotherapy; for these children, more intensive chemotherapy may be required.

AB - Purpose: To optimize treatment for children with localized resectable neuroblastoma in 21 Italian institutions using a common protocol based on previous experience. Patients and Methods: Between January 1985 and December 1992, 152 children aged 0 to 15 years with nondisseminated neuroblastoma were entered onto this study following complete resection of tumor without tumor rupture (TR) (stage 1), or resection with minimal tumor residue, and/or tumor infiltration of regional lymph nodes (LN+), and/or TR (stage 2). Of 144 assessable children, 69 were classified as having stage 1 disease and 75 as stage 2. Of stage 2 children, 49 had low-risk (LR) characteristics (age, 0 to 11 months or 1 to 15 years but negative lymph nodes and no TR). Stage 1 and stage 2 LR children did not receive adjuvant therapy. The remaining 26 stage 2 children had high-risk (HR) characteristics (age, 1 to 15 years with LN+ and/or TR) and received adjuvant chemotherapy for 6 months. Results: Of 144 children, three died of therapy-related complications and 19 relapsed, of whom six died of disease. The estimated 5-year overall survival (OS) rate was 93% and the event-free survival (EFS) rate was 83%. Of 69 stage 1 children, one died postoperatively and five relapsed (one local and four disseminated, two of whom died), for 94% OS and 90% EFS rates. Of 49 stage 2 LR children, six relapsed (four local and two disseminated); relapses occurred in five of 20 infants with LN+, in one of four infants with TR, and in none of the remaining 25 children. One child died of disease and one of toxicity, for 96% OS and 85% EFS rates. Of 26 stage 2 HR children, eight relapsed (three of 20 with LN+, three of four with TR, and two of two with LN+ and TR), of whom three died of disease and one of toxicity, for 87% OS and 61% EFS rates. Conclusion: Our data confirm the overall good prognosis of children with localized resectable neuroblastoma. LN+ and TR predisposed to relapse at all ages, but infants tended to have a less aggressive course after relapse. Stage 1 and 2 LR children had 94% and 96% OS rates, respectively, which justifies a policy of no adjuvant chemotherapy. Eight of 26 children with stage 2 HR relapsed despite 6 months of chemotherapy; for these children, more intensive chemotherapy may be required.

UR - http://www.scopus.com/inward/record.url?scp=0028911197&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028911197&partnerID=8YFLogxK

M3 - Article

C2 - 7707115

AN - SCOPUS:0028911197

VL - 13

SP - 884

EP - 893

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 4

ER -