Regression of Neuroblastoma in Infancy Common

March 25, 2008

Localized neuroblastoma in infancy often regresses spontaneously, and a watchful-waiting strategy that avoids chemotherapy and extensive surgery may be appropriate in some patients, according to new research published in the March 20 issue of the Journal of Clinical Oncology.

TUESDAY, March 25 (HealthDay News) -- Localized neuroblastoma in infancy often regresses spontaneously, and a watchful-waiting strategy that avoids chemotherapy and extensive surgery may be appropriate in some patients, according to new research published in the March 20 issue of the Journal of Clinical Oncology.

Barbara Hero, M.D., of the University of Cologne in Germany, and colleagues enrolled 340 infants with localized neuroblastoma without MYCN amplification in a prospective trial to observe the course of neuroblastoma without cytotoxic treatment. Tumors were either resected or observed with ultrasound and MRI. Chemotherapy was only used in patients with threatening symptoms caused by the tumor.

In all, 190 patients underwent resection, 93 were observed without treatment and 57 received chemotherapy, the researchers report. Of the 93 patients with unresected tumors, 44 experienced spontaneous regression of tumor, while 28 had local progression and 11 had progression to advanced stages. Overall and metastases-free survival at three years for patients with unresected tumor was excellent (99 percent and 94 percent, respectively), and did not differ from patients treated with surgery or chemotherapy, the investigators found.

"In conclusion, this study provides strong evidence for spontaneous regression in localized neuroblastoma in infancy," the authors write. "A wait-and-see strategy avoiding chemotherapy and extensive surgical procedures is justified in infants with localized neuroblastoma, unless MYCN is amplified."

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