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Background <p>Intermediate-risk (IR) neuroblastoma represents a biologically and clinically diverse group of tumors. This study evaluates the feasibility of surgical excision and identifies prognostic factors that influence survival in IR-neuroblastoma patients, particularly those with suboptimal responses to induction chemotherapy.</p> Methods <p>We conducted a retrospective analysis of 50 pediatric patients diagnosed with IR-neuroblastoma at a tertiary cancer center between 2007 and 2016. Treatment responses, surgical outcomes, and survival data were assessed. Prognostic variables were evaluated using univariable and multivariable models.</p> Results <p>After four cycles of induction chemotherapy, 26% of patients showed an objective response, increasing to 62% by treatment completion. Surgical resection was performed in 70% of patients, with a higher proportion among non-responders. Initial response to induction chemotherapy was a significant independent predictor of surgical feasibility (<i>p</i> = 0.022) and final disease status (<i>p</i> = 0.026). Five-year overall survival (OS) was 84%, and event-free survival (EFS) was 72%. Surgical resection significantly improved end-of-treatment disease status in slow-responder patients but did not independently affect OS or EFS.</p> Conclusion <p>Moderate-intensity chemotherapy with or without surgery provides acceptable survival outcomes in IR-neuroblastoma. An early favorable response to induction therapy may justify avoiding surgery, while surgical resection remains critical for slow-responder patients.</p>

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Lessons learned from different prognostic factors analysis in intermediate-risk neuroblastoma: ten years’ experience at a tertiary center

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月15日

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  • Mustafa Selim,
  • Hanafy Hafez,
  • Abeer M. Elsayed,
  • Mohamed Shalaby,
  • Abdalwahab R. Abdalwahab,
  • Soad A. Eltokhy,
  • Mohamed Fawzy

摘要

Background

Intermediate-risk (IR) neuroblastoma represents a biologically and clinically diverse group of tumors. This study evaluates the feasibility of surgical excision and identifies prognostic factors that influence survival in IR-neuroblastoma patients, particularly those with suboptimal responses to induction chemotherapy.

Methods

We conducted a retrospective analysis of 50 pediatric patients diagnosed with IR-neuroblastoma at a tertiary cancer center between 2007 and 2016. Treatment responses, surgical outcomes, and survival data were assessed. Prognostic variables were evaluated using univariable and multivariable models.

Results

After four cycles of induction chemotherapy, 26% of patients showed an objective response, increasing to 62% by treatment completion. Surgical resection was performed in 70% of patients, with a higher proportion among non-responders. Initial response to induction chemotherapy was a significant independent predictor of surgical feasibility (p = 0.022) and final disease status (p = 0.026). Five-year overall survival (OS) was 84%, and event-free survival (EFS) was 72%. Surgical resection significantly improved end-of-treatment disease status in slow-responder patients but did not independently affect OS or EFS.

Conclusion

Moderate-intensity chemotherapy with or without surgery provides acceptable survival outcomes in IR-neuroblastoma. An early favorable response to induction therapy may justify avoiding surgery, while surgical resection remains critical for slow-responder patients.