Neuroblastoma: experience from National University Health System, Singapore (1987-2008)

Tan C, Sabai SM, Tin  AS, Quah TC, Aung L
Correspondence: Dr LeLe Aung, aung.lele@kkh.com.sg

ABSTRACT
Introduction Neuroblastoma is the most common extracranial solid tumour in childhood. We report our experience at National University Health System (NUHS), Singapore. 
Methods We performed a retrospective chart review of 43 patients diagnosed with neuroblastoma, who were seen and  treated at the Department of Paediatrics, NUHS from November 1987 to November 2008. 
Results The median age of the patients at diagnosis was 1.9 (range 0.1–20.2) years. The majority (70.1%) of primary tumours were of abdominal and/or adrenal origin. According to the International Neuroblastoma Staging System, six (14.0%) patients were in stages 1 and 2, 11 (25.6%) in stage 3, 19 (44.2%) in stage 4, and seven (16.2%) in stage 4s. Therapy for all patients included surgery and/or chemotherapy and/or radiation therapy. Patients with stage 4 disease also underwent autologous stem cell transplant. The median follow-up for the cohort was 2.5 (range 0.4–21.0) years. At the time of analysis, 29 (67.4%) patients were alive. The two- and five-year overall survival for the cohort was 65.0% (95% confidence interval [CI] 51.0%–80.0%) and 62.0% (95% CI 45.0%–79.0%), respectively. The five-year overall survival rates according to risk status were 100.0% for low-risk, 75.0% for intermediate risk and 28.2% for high-risk neuroblastoma. 
Conclusion The prognosis for those with advanced stage neuroblastoma remains poor. A collaborative effort, with an emphasis on research in detecting biologic characteristics of aggressive disease and tailoring therapy, needs to be strengthened in order to further our understanding of this disease.

Keywords: neuroblastoma, Singapore, survival, treatment
Singapore Med J 2012; 53(1): 19–25