@article {8340, title = {Metastatic neuroblastoma in infants: are survival rates excellent only within the stringent framework of clinical trials?}, journal = {Clin Transl Oncol}, volume = {19}, year = {2017}, month = {2017 Jan}, pages = {76-83}, abstract = {

INTRODUCTION: SIOPEN INES protocol yielded excellent 5-year survival rates for MYCN-non-amplified metastatic~neuroblastoma. Patients deemed ineligible due to lack or delay of MYCN status or late registration were treated, but not included in the study. Our goal was to analyse survival at 10~years among the whole population.

MATERIALS AND METHODS: Italian and Spanish metastatic INES patients{\textquoteright} data are reported. SPSS 20.0 was used for statistical analysis.

RESULTS: Among 98 infants, 27 had events and 19 died, while 79 were disease free. Five- and 10-year event-free survival (EFS) were 73 and 70~\%, and overall survival (OS) was 81 and 74~\%, respectively. MYCN status was significant for EFS, but not for OS in multivariate analysis.

CONCLUSIONS: The survival rates of patients who complied with all the inclusion criteria for INES trials are higher compared to those that included also not registered patients. Five-year EFS and OS for INES 99.2 were 87.8 and 95.7~\%, while our stage 4s population obtained 78 and 87~\%. Concerning 99.3, 5-year EFS and OS were 86.7 and 95.6~\%, while for stage 4 we registered 61 and 68~\%. MYCN amplification had a strong impact on prognosis and therefore we consider it unacceptable that many patients were not studied for MYCN and probably inadequately treated. Ten-year survival rates were shown to decrease: EFS from 73 to 70~\% and OS from 81 to 74~\%, indicating a risk of late events, particularly in stage 4s. Population-based registries like European ENCCA WP 11-task 11 will possibly clarify these data.

}, keywords = {Biomarkers, Tumor, Child, Child, Preschool, Clinical Trials as Topic, Combined Modality Therapy, Female, Follow-Up Studies, Gene Amplification, Humans, Infant, Infant, Newborn, Male, N-Myc Proto-Oncogene Protein, Neoplasm Staging, Neuroblastoma, Prognosis, Survival Rate}, issn = {1699-3055}, doi = {10.1007/s12094-016-1505-1}, author = {Di Cataldo, A and Agodi, A and Balaguer, J and Garaventa, A and Barchitta, M and Segura, V and Bianchi, M and Castel, V and Castellano, A and Cesaro, S and Couselo, J M and Cruz, O and D{\textquoteright}Angelo, P and De Bernardi, B and Donat, J and de Andoin, N G and Hernandez, M I and La Spina, M and Lillo, M and Lopez-Almaraz, R and Luksch, R and Mastrangelo, S and Mateos, E and Molina, J and Moscheo, C and Mura, R and Porta, F and Russo, G and Tondo, A and Torrent, M and Vetrella, S and Villegas, J A and Viscardi, E and Zanazzo, G A and Ca{\~n}ete, A} }