Stage IV Neuroblastoma

Joel W. Goldwein, MD
Last Modified: November 1, 2001

Dear OncoLink "Ask the Experts,"
My son was diagnosed in '87 with stage IV, spread from adrenal gland to the aorta and vena cava arteries. He received 2 yrs of aggressive chemotherapy. All tumor scar tissue was NOT removed. He is now 13 years old, and has been cancer- free for almost 11 years. What is the longest survival time for this type of patient? I'm so afraid of recurring and of secondary cancer. I would also like to know if there are any long term survival patients out there.
Please send me in the right direction.
JB

Joel W. Goldwein, MD, OncoLink Founder, responds:

Dear JB:
Thank you for your excellent question. We are pleased to hear that your son has done so well. From your description, it appears that he was diagnosed with neuroblastoma below the age of 1 year. Other parameters such as the biology of his particular tumor and where it had spread factor into his prognosis. However, even with stage IV metastatic disease, infants with neuroblastoma are often cured of their tumor and live relatively normal, healthy lives (1, 2). Long term survival is the rule rather than the exception, and relapse after 5 years of remission is very rare (3). In fact, some series include patients followed over 20 years.

As you know, children who are treated for cancer may, in some cases, be at higher risk for developing another cancer long after they have been cured of their original tumor. It is always a good idea to have these patients followed for the rest of their lives by physicians who are experienced in such matters and understand these risks. Often, these experts can be found at University hospitals, NCI-designated cancer centers and/or sites where cancer clinical trials are ongoing.

Schmidt ML, Lukens JN, Seeger RC, Brodeur GM, Shimada H, Gerbing RB, Stram DO, Perez C, Haase GM, Matthay KK. Biologic factors determine prognosis in infants with stage IV neuroblastoma: A prospective Children's Cancer Group study. J Clin Oncol 2000 Mar;18(6):1260-8.
Paul SR, Tarbell NJ, Korf B, Kretschmar CS, Lavally B, Grier HE. Stage IV neuroblastoma in infants. Long-term survival. Cancer. 1991 Mar 15;67(6):1493-7.
Hata Y, Sasaki F, Naito H, Takahashi H, Namieno T, Uchino J. Late recurrence in neuroblastoma. J Pediatr Surg. 1991 Dec;26(12):1417-9.