Association of image-defined risk factors with clinical features, histopathology, and outcomes in neuroblastoma

William C. Temple, Kieuhoa T. Vo, Katherine K. Matthay, Brunilda Balliu, Christina Coleman, Jennifer Michlitsch, Andrew Phelps, Spencer Behr, Matthew A. Zapala

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Clinical, molecular, and histopathologic features guide treatment for neuroblastoma, but obtaining tumor tissue may cause complications and is subject to sampling error due to tumor heterogeneity. We hypothesized that image-defined risk factors (IDRFs) would reflect molecular features, histopathology, and clinical outcomes in neuroblastoma. Methods: We performed a retrospective cohort study of 76 patients with neuroblastoma or ganglioneuroblastoma. Diagnostic CT scans were reviewed for 20 IDRFs, which were consolidated into five IDRF groups (involvement of multiple body compartments, vascular encasement, tumor infiltration of adjacent organs/structures, airway compression, or intraspinal extension). IDRF groups were analyzed for association with clinical, molecular, and histopathologic features of neuroblastoma. Results: Patients with more IDRF groups had a higher risk of surgical complications (OR = 3.1, p = 0.001). Tumor vascular encasement was associated with increased risk of surgical complications (OR = 5.40, p = 0.009) and increased risk of undifferentiated/poorly differentiated histologic grade (OR = 11.11, p = 0.013). Tumor infiltration of adjacent organs and structures was associated with decreased survival (HR = 8.90, p = 0.007), MYCN amplification (OR = 9.91, p = 0.001), high MKI (OR = 6.20, p = 0.003), and increased risk of International Neuroblastoma Staging System stage 4 disease (OR = 8.96, p < 0.001). Conclusions: The presence of IDRFs at diagnosis was associated with high-risk clinical, molecular, and histopathologic features of neuroblastoma. The IDRF group tumor infiltration into adjacent organs and structures was associated with decreased survival. Collectively, these findings may assist surgical planning and medical management for neuroblastoma patients.

Original languageEnglish (US)
Pages (from-to)2232-2241
Number of pages10
JournalCancer medicine
Volume10
Issue number7
DOIs
StatePublished - Apr 2021
Externally publishedYes

Keywords

  • pathology
  • pediatric cancer
  • surgical oncology
  • survival

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Fingerprint Dive into the research topics of 'Association of image-defined risk factors with clinical features, histopathology, and outcomes in neuroblastoma'. Together they form a unique fingerprint.

Cite this