Low-stage Pediatric Neuroblastoma: A 20-Year Single Institution Review

Background: Neuroblastoma is a common childhood cancer with poor prognosis. This is a retrospective review of the outcomes in children with low-stage neuroblastoma in Taiwan. Methods: We reviewed the charts of all children with International Neuroblastoma Staging System (INSS) stages 1 and 2 diagnosed at the Mackay Memorial Hospital between November 1994–December 2013. The patients' demographic data, age of diagnosis, treatment, and survival rates were analyzed. Results: A total of 75 children with all stages of neuroblastoma were identified, of which 23 children in the low stage were enrolled. There were 12 (16.0%) patients in stage 1, and 11 (14.6%) patients in stage 2. The mean age of diagnosis for stage 1 and stage 2 was 5.4 months and 10.2 months, respectively. A total of 18 (78.3%) patients received initial complete surgical excision, and 5 patients received initial biopsy. The site of the tumor was the adrenal gland in 19 (82.6%) patients. Total or near-total resection was possible in 18 (78.3%) patients; all children with stage 1 were treated by complete surgical resection. Seven patients (63.6%) in stage 2 received chemotherapy. Children in both stages 1 and 2 had the same 5-year overall survival of 100%. The event-free survival rate for patients in stage 1 and stage 2 was 91.7% and 81.8%, respectively. Conclusion: This retrospective study confirmed that children with stage 1 and 2 neuroblastoma had good outcomes. Specifically, children with stage 1 disease are best treated by surgery alone, but selected patients in stage 2 need additional chemotherapy.