Find Information About:

Drugs & Supplements

Get information and reviews on prescription drugs, over-the-counter medications, vitamins, and supplements. Search by name or medical condition.

Pill Identifier

Pill Identifier

Having trouble identifying your pills?

Enter the shape, color, or imprint of your prescription or OTC drug. Our pill identification tool will display pictures that you can compare to your pill.

Get Started
My Medicine

My Medicine

Save your medicine, check interactions, sign up for FDA alerts, create family profiles and more.

Get Started

WebMD Health Experts and Community

Talk to health experts and other people like you in WebMD's Communities. It's a safe forum where you can create or participate in support groups and discussions about health topics that interest you.

  • Second Opinion

    Second Opinion

    Read expert perspectives on popular health topics.

  • Community


    Connect with people like you, and get expert guidance on living a healthy life.

Got a health question? Get answers provided by leading organizations, doctors, and experts.

Get Answers

Sign up to receive WebMD's award-winning content delivered to your inbox.

Sign Up

Brain Cancer Health Center

Font Size

Neuroblastoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Recurrent Neuroblastoma

Tumor growth due to maturation should be differentiated from tumor progression by performing a biopsy and reviewing histology. Patients may have persistent maturing disease with metaiodobenzylguanidine (mIBG) uptake that does not affect outcome, particularly in patients with low-risk and intermediate-risk disease.[1] When neuroblastoma recurs in a child originally diagnosed with high-risk disease, the prognosis is usually poor despite additional intensive therapy.[2,3,4,5] However, it is often possible to gain many additional months of life for these patients with alternative chemotherapy regimens.[6,7] Clinical trials are appropriate for these patients and may be offered. Information about ongoing clinical trials is available from the NCI Web site.

Prognostic Factors for Recurrent Neuroblastoma

Recommended Related to Brain Cancer

Life After a Brain Tumor: One Man's Story

During the fall of 1995, I had just turned 40 and was at the top of my legal profession. But I suddenly found myself getting totally exhausted each weekend. I was of no use to my wife, Ellie, or my kids. One morning while using the treadmill, I saw stars. I drove myself to the emergency room; the doctors there thought I was having a heart attack. But tests showed no heart problems, so I went back to work -- I had to because I own my business. My internist sent me to a cardiologist and other specialists...

Read the Life After a Brain Tumor: One Man's Story article > >

The International Neuroblastoma Risk Group Project performed a decision-tree analysis of clinical and biological characteristics (defined at diagnosis) associated with survival after relapse in 2,266 patients with neuroblastoma entered on large clinical trials in well-established clinical trials groups around the world.[2]

  • Overall survival (OS) in the entire relapse population was 20%.
  • Among patients with all stages of disease at diagnosis, MYCN amplification predicted a poorer prognosis, measured as 5-year OS.
  • Among patients diagnosed with International Neuroblastoma Staging System (INSS) stage 4 without amplification, age older than18 months and high lactate dehydrogenase (LDH) level predicted poor prognosis.
  • Among patients with MYCN amplification, stages 1 and 2 have a better prognosis than stages 3 and 4.
  • Among patients with MYCN-nonamplified who are not stage 4, patients with hyperdiploidy had a better prognosis than patients with diploidy in those younger than 18 months, while among those older than 18 months, differentiating tumors did much better than undifferentiated and poorly differentiated tumors.

Significant prognostic factors determined at diagnosis for postrelapse survival include the following:[2]

  • Age.
  • INSS stage.
  • MYCN status.
  • Time from diagnosis to first relapse.
  • LDH level, ploidy, and histologic grade of tumor differentiation (to a lesser extent).

The Children's Oncology Group (COG) experience with recurrence in low-risk and intermediate-risk neuroblastoma is that the majority of recurrences can be salvaged. The COG reported a 3-year event free survival (EFS) of 88% and an OS of 96% in intermediate-risk patients and a 5-year EFS of 89% and OS of 97% in low-risk patients.[8,9] Moreover, in most patients originally diagnosed with low-risk or intermediate-risk disease, local recurrence or recurrence in the 4S pattern may be treated successfully with surgery and/or with moderate dose chemotherapy, without hematopoietic stem cell transplantation.

1 | 2 | 3 | 4 | 5 | 6
1 | 2 | 3 | 4 | 5 | 6
Next Article:

Today on WebMD

doctor and patient
How to know when it’s time for home care
doctory with x-ray
Here are 10 to know.
sauteed cherry tomatoes
Fight cancer one plate at a time.
Lung cancer xray
See it in pictures, plus read the facts.
Malignant Gliomas
Pets Improve Your Health
Headache Emergencies
life after a brain tumor

Would you consider trying alternative or complementary therapies?