Back to Search
Start Over
The current contribution of molecular factors to risk estimation in neuroblastoma patients.
- Source :
-
European journal of cancer (Oxford, England : 1990) [Eur J Cancer] 1997 Oct; Vol. 33 (12), pp. 2092-7. - Publication Year :
- 1997
-
Abstract
- The association of molecular characteristics with prognosis has been reported, but not their relationship with each other and their impact in the context of known clinical risk factors. In this study, data of 1249 consecutive intent-to-treat-neuroblastoma patients with more than 1 year follow-up were examined by multivariate analysis using loglinear and Cox proportional hazard regression models on a stage-related basis (stages 1-3: 600, 4S: 116, 4: 533). In a first step, risk factors were identified from 18 selected clinical variables, and risk groups defined. The second step investigated whether molecular characteristics (MYCN, LOH 1p, del 1p, CD44, N-ras, NGF-R, bcl-2, APO-1 (CD95)) contributed additional prognostic information to the model. The loglinear model demonstrated several interactions between clinical factors. By the Cox regression model, seven independent clinical risk factors were found for stages 1-3, seven for stage 4 and two for stage 4S. By subsequent introduction of all molecular variables, MYCN amplification only added significant prognostic information to the clinical factors in localised and stage 4 neuroblastoma. The models allowed the definition of risk groups for stages 1-3 patients by age (e beta = 5.09) and MYCN (e beta = 4.26), for stage 4 by MYCN (e beta = 2.78) and number of symptoms (e beta = 2.44) and for stage 4S by platelet count (e beta = 3.91) and general condition (e beta = 2.99). Molecular factors and in particular MYCN contribute significantly to risk estimation. In conjunction with clinical factors, they are powerful tools to define risk groups in neuroblastoma.
- Subjects :
- Adolescent
Adult
Child
Child, Preschool
Cohort Studies
Disease-Free Survival
Follow-Up Studies
Gene Amplification
Genes, myc genetics
Humans
Infant
Infant, Newborn
Multivariate Analysis
Neoplasm Staging
Neuroblastoma pathology
Prognosis
Proportional Hazards Models
Risk Factors
Biomarkers, Tumor metabolism
Neuroblastoma genetics
Neuroblastoma metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 0959-8049
- Volume :
- 33
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- European journal of cancer (Oxford, England : 1990)
- Publication Type :
- Academic Journal
- Accession number :
- 9516860
- Full Text :
- https://doi.org/10.1016/s0959-8049(97)00237-2