Insight in the older neuroblastoma patient, a clinical and molecular characteristics overview

Abstract

Background: Neuroblastoma is a malignant tumour and one of the most common extracranial malignant solid tumours in childhood. It most commonly affects children aged £5 years, though it may rarely occur in older children, with 10% of cases ≥6 years. There appear to be differences in age-related groups. We combined clinical factors and molecular characteristics, which provides a comprehensive overview. Methods: Data was conducted within a multi-database system: Radboudumc and Emma Children’s Hospital from 2008 till 2014; Princess Maxima Center from 2014 till April 2023. Pathological and clinical records were obtained for molecular characteristics. We reviewed the medical records for clinical presentation, biochemical studies, treatment, and follow-up survival. Results: Higher proportion of female individuals were diagnosed with neuroblastoma (55.8% vs. 47.7%). Our study indicated a higher proportion of patients classified as high risk (83.7%). Our study revealed lower overall survival rates compared to those reported in the literature for both intermediate-risk disease (83.3% vs. >90%) and high-risk patients (41.9% vs. >50%). Immunotherapy was significantly associated with overall survival (p=0.008). We have found MYCN mutations in 16.3% of the cases. The LOH1p was close to significantly associated with overall survival (p=0.058) and event-free survival (p=0.085). The overall survival was not significantly associated with Risk groups (p=0.162), ATRX mutations (p=0.246), gain of 17q (p=0.250), age above 10 (p=0.296). Conclusion: These findings suggest a potentially unfavourable prognosis for patients aged six years and above. This study initiates a comprehensive overview of the patient population, setting the stage for future research to build upon.