Thoracic Neuroblastoma in Children: Treatment Results and Outcome According To the Age and Stage

Feki J, Boudawara O, Mhiri R, Nouri Ab, Daoud J and Khanfir A

Published on: 2022-03-06

Abstract

Background: Thoracic neuroblastoma is known to be less aggressive than tumors arising in other sites. We aimed to evaluate treatment results and outcome of patients with thoracic NB.

Methods: We performed a retrospective analysis including children with mediastinal neuroblastoma treated at our hospital between 2018 and 2020.

Results: Six patients were included. The median age was 41, 3 months. For children aged under 12 months, respiratory symptoms were the initial sings leading to diagnosis. One of the patients presented with paraplegia as the first symptom of the tumor involving the epidural space. Ganglioneuroblastoma was found in 2 cases. Half of the children were under 1-year-old with localized disease. The 3 remaining patients over 1-year- old presented with disseminated metastases. All tumors were unrespectable with image defined risk factors. MYCN amplification was identified in 2 cases. Chemotherapy was administered according to the age, stage and MYCN status. Children with localized disease underwent surgery following prior chemotherapy and were still alive in complete remission at the time of data cut-off. All patients with metastatic neuroblastoma died from disease progression.

Conclusion: Metastatic stages have a poorer prognosis despite high dose chemotherapy. Young children under 1-year-old with localized thoracic NB have a favorable outcome even for unrespectable tumors at diagnosis. Delayed surgery following prior chemotherapy offers a survival benefit to these patients in spite of incomplete resection.