Neuroblastoma is one of the most common cancers found in children. For a better prognosis, early diagnosis is a prerequisite. On the basis of stage and severity of the disease, it is divided into low-risk, intermediate-risk and high-risk and prognosis and survival rate depends upon the inclusion of the patient in particular risk group and on other factors.
What Is The Prognosis For Neuroblastoma?
Various factors impact the final outcome of the disease. Only the doctor who has the knowledge of all the aspects related to the child is able to determine the prognosis and chances of survival. Various factors impacting the prognosis and survival includes4:
Stage: Stage at which the cancer is diagnosed significantly impact the prognosis. Early diagnosis leads to a favorable prognosis. As the condition progresses to advanced stages more aggressive treatment is required and the condition has a poor prognosis.
Age: If the condition is diagnosed before the age of 1 year, the disease has a favorable outcome.
Tumor Characteristics: If the tumor has favorable histology, the progression is slower and the condition can be managed. Tumor with unfavorable histology requires aggressive treatment and progression of the condition is fast.
Chromosomal Changes: Greater number of chromosomal changes increases the risk of recurrence, the fast progression of the disease and poor outcome. Multiple gene copies of MYN also leads to poor prognosis.
DNA Index: Cells with diploid index equals to 1 are less responsive to treatment and more aggressive treatment is required. Cells with DNA index greater than 1 are more responsive to treatment and result in a favorable prognosis.
How Long Can You Live With It?
5-year survival rate indicates the percentage of patients survived for 5 years after the diagnosis of disease. In the case of neuroblastoma, the 5-year survival rate is 80%. This rate is affected by various prognosis factors. On the basis of risk-groups, the 5-year survival rate for the low-risk group is about 95%, while that of intermediate-group is 90-95%. For the high-risk group, the 5-year survival rate is about 40-50%5. With the advancement in diagnosis and treatments strategy and with prior experience of treating neuroblastoma, the survival rate, especially in the high-risk group would increase. The survival rate also depends upon the patient’s response towards treatment as well as its recurrence.
Complications Of Neuroblastoma
Complications of neuroblastoma may arise from the disease itself or the treatment of the disease. The disease is found in infants and children and the patients are not able to withstand the side effects of therapy.
Spinal Cord Compression: In almost 5-15% of the patient suffering from neuroblastoma intervertebral foramina invasion. This intraspinal extension of neuroblastoma leads to spinal cord compression1. The compression of the spinal cord leads to various neurological symptoms and has a significant impact on the quality of life.
Ototoxicity: Ototoxicity is the treatment of related complications. High-risk neuroblastoma is treated with platinum-based therapy2. The extent of ototoxicity varies from patient to patient. A patient who has a prior history of hospitalization due to infection is more prone to getting ototoxicity with platin therapy. The prevalence of ototoxicity with this therapy is 13% to 95%.
Ocular Effects: Neuroblastoma is a rapidly progressive condition and the condition may lead to exophthalmos, hydrocephalous and anemia3.
Tumor Lysis Syndrome: Tumor lysis syndrome is life-threatening complications of neuroblastoma. These tumors are rapidly progressing and in response to therapy rapidly release cations and anions resulting in an altered level of the chemical in the body including phosphates, potassium, and urea.
Opsoclonus-Myoclonus-Ataxia: This condition is also known as dancing eye syndrome or Kinsbourne syndrome. It is a rare but serious condition and is characterized by ataxia, opsoclonus, and myoclonus.
Focal Nodular Hyperplasia: Although, in isolation, the condition is rare in children but is more frequently observed in children suffering from neuroblastoma4. It is suspected to be caused because of therapy.
The 5-year survival rate in low-risk group is 95% while intermediate-risk survival is 90-95%. Patients with a high-risk group require aggressive treatment and survival rate is 40-50%.
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