2009 Southern Regional Meeting Abstracts

Purpose of Study: To report the University of Mississippi Medical Center's experience on the diagnosis and tx of patients with neuroblastomas.
Methods Used: We searched the cancer registry for neuroblastomas diagnosed within the past five years. We compiled data including age at diagnosis, clinical presentation, size and location of primary tumor, stage, and histology. Staging was based on the proposed INSS staging system. Treatment course and clinical outcomes were retrospectively analyzed.
Summary of Results: We included 18 cases (12 males, 6 females; 10 white, 8 black) for which sufficient data was available. Age at diagnosis ranged from birth to 11 years (mean of 2.17 years). Most patients presented with abdominal symptoms but other presentations included neck mass, Horner’s syndrome and subcutaneous nodules. One patient had opsoclonus-myoclonus syndrome. Primary sites included abdomen (13), neck (3) and chest (2). Patients were categorized as stage 1 (1), stage 2 (1), stage 3 (4), and stage 4 (11); 1 patient was diagnosed post-mortem and staging was not possible. Twelve patients are living (mean follow-up of 39.6 months), including 7 without evidence of disease; 5 patients died within a mean of 12.6 months from diagnosis; status is unknown for one patient. 11/12 alive patients had surgical resection (of which 10 received chemo and 3 received combined chemo/XRT); the one patient without surgery (stage III) did receive chemo and XRT. Of the dead pts, one received surgery/chemo/XRT, 1 received surgery/chemo and 1 received chemo/XRT; 2 died before treatment could be initiated. Amongst the 12 living patients, there were 5 black and 7 white; and amongst the 5 dead, 3 were black and 2 were white.
Conclusions: Neuroblastomas are highly variable in both presentation and behavior. About half of pts present with metastatic disease, though our rate was somewhat higher (64%). One possible explanation for this is limited access to health care (common among our patient population) and delayed diagnosis. Our mortality rate (29%) is consistent with what has been previously reported. Based on our preliminary data there seems to be no health disparity, as 7/9 white pts are alive compared to 5/8 black pts.