Biochemical and histologic determinants in the prognosis of neuroblastoma

Abstract

Of 98 consecutive patients with neuroblastoma, 54 could be separated into survivor and non-survivor groups on the basis of an opportunity for a 2 year minimum period of observation. Their excretions of the catecholamine metabolites, vanillylmandelic acid (VMA), homovanillic acid (HVA), 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG), and total metanephrines (TM) were assayed at the moment of their initial diagnosis as well as following therapy. Histologic specimens were evaluated independently by two pathologists at different institutions. Age-at-diagnosis, sex, catecholamine catabolite excretion pattern before and following therapy, histology, and prognosis were subjected to a statistical study of association probability. A better prognosis was associated with an age-at-onset of less than two years, greater histologic differentiation, lower initial HVA excretion, and a rapid return of catecholamine metabolism to normal following therapy. These data suggest the availability of criteria by which a prognostically useful classification of neuroblastoma may be established.