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Long-term outcome of children with neuroblastoma in Shanghai China
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  • Jie Zhao,
  • Yali Han,
  • Jing Shao,
  • Ci Pan,
  • Min Xu,
  • Yijin Gao,
  • Dongqing Lu,
  • Wenting Hu,
  • Min Zhou,
  • Hui Jiang,
  • Jingyan Tang
Jie Zhao
Shanghai Childrens Medical Center Affiliated to Shanghai Jiaotong University School of Medicine
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Yali Han
Shanghai Childrens Medical Center Affiliated to Shanghai Jiaotong University School of Medicine
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Jing Shao
Shanghai Jiaotong University Children's Hospital
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Ci Pan
Shanghai Childrens Medical Center Affiliated to Shanghai Jiaotong University School of Medicine
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Min Xu
Shanghai Childrens Medical Center Affiliated to Shanghai Jiaotong University School of Medicine
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Yijin Gao
Shanghai Childrens Medical Center Affiliated to Shanghai Jiaotong University School of Medicine
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Dongqing Lu
Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine
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Wenting Hu
Shanghai Childrens Medical Center Affiliated to Shanghai Jiaotong University School of Medicine
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Min Zhou
Shanghai Childrens Medical Center Affiliated to Shanghai Jiaotong University School of Medicine
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Hui Jiang
Shanghai Jiaotong University Children's Hospital
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Jingyan Tang
Shanghai Childrens Medical Center Affiliated to Shanghai Jiaotong University School of Medicine
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Abstract

Objective This study aimed to assess the development and current state of management and outcome for neuroblastoma (NB) in Shanghai China. Methods The clinical characteristics and survival rates of a large cohort of 717 NB cases in the recent 10 years from two children’s medical institutions in Shanghai China were retrospectively analyzed. Results The 8y-EFS and OS of the whole cohort in the 10 years were 67.6±2.2% and 81.2±2.1%. Our risk stratification system was updated twice during the 10 years, forming three periods. The percentage of very low risk (VLR) cohort who accepting only surgery without chemotherapy was increased in 2016-2018 period than the 2010-2015 period and 2008-2009 period. While the 3y-EFS of the three periods were similar (P=0.961). The outcome in VLR and low risk (LR) patients were excellent with 8y-EFS around 92% (VLR=93.0±2.8%, LR= 92.1±1.8%). The outcome in high risk (HR) patients was significantly poorer with 8y-EFS only as 16.6±4.1% even than intermediate risk (IR) patients with 8y-EFS as 69.6±4.4% (P<0.001). Conclusions The revision of our risk stratification system was effective, making an increasing percentage of patients without chemotherapy while with similar EFS rates. The VLR and LR cohort had excellent outcomes, however the HR cohort with most of the mortality remains one of the greatest challenges. Enriching the transplant resources, importing melphalan to make ASCT more available and effective, and importing advanced novel therapies like anti-GD2 antibody and 131I-mIBG are our objectives to improve the survival of the HR patients.