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Titolo:
Which cases are found and missed by neuroblastoma screening at 1 year? Results from the 1992 to 1995 study in three federal states of Germany
Autore:
Berthold, F; Baillot, A; Hero, B; Schurr, P; Nerenz, A; Hunneman, DH; Sander, J;
Indirizzi:
Univ Cologne, Childrens Hosp, Cologne, Germany Univ Cologne Cologne Germany Cologne, Childrens Hosp, Cologne, Germany Univ Gottingen, Childrens Hosp, D-3400 Gottingen, Germany Univ Gottingen Gottingen Germany D-3400 Hosp, D-3400 Gottingen, Germany Hlth Care Inst Lower Saxony, Hannover, Germany Hlth Care Inst Lower Saxony Hannover Germany Saxony, Hannover, Germany
Titolo Testata:
JOURNAL OF CLINICAL ONCOLOGY
fascicolo: 4, volume: 17, anno: 1999,
pagine: 1200 - 1207
SICI:
0732-183X(199904)17:4<1200:WCAFAM>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
NEURO-BLASTOMA; INFANTS; EUROPE; JAPAN; AGE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Berthold, F Univ924logne, Klin & Poliklin Kinderheilkunde, Joseph Stelzmann Str 9, D-50 Univ Cologne Joseph Stelzmann Str 9 Cologne Germany D-50924 0
Citazione:
F. Berthold et al., "Which cases are found and missed by neuroblastoma screening at 1 year? Results from the 1992 to 1995 study in three federal states of Germany", J CL ONCOL, 17(4), 1999, pp. 1200-1207

Abstract

Purpose: Neuroblastoma screening during the first half-year of life is associated with a two- to three-fold overdiagnosis. Because regression processes seem to be confined to infancy, we investigated whether screening at 1 year would be associated with fewer overdiagnoses, and we investigated the characteristics of thus-detected and not-detected patients. Patients and Methods: Thin-layer chromatography was used for semiquantitative assessment of urine samples dried on filter paper and obtained when patients were 10 to 14 months old (sample 1) and 17 to 19 months old (sample 2). Abnormal results were reanalysed quantitatively from the same specimen by highperformance liquid chromatography and/or gas chromatography-mass spectrometry. Results: A total of 200,054 children of the German federal stares Lower Saxony, Northern Rhine-Westphalia, and Bremen were screened from May 1992 to April 1995. Of 229,078 investigated samples (100%), 228,245 (99.6%) were first, 657 (0.3%) were second, and 176 (0.08%) were third urine specimens. The compliance rate was 27.8%, bur it continued to increase throughout the study period and in the last year it was 43.3%. The second screening offered at 18 months was accepted by only 12.1% (24,259) of the children. Thirty children underwent clinical examination, and nine asymptomatic neuroblastoma cases were detected (stage 1,n = 4; stage 2, n = 2; stage 3, n = 2; stage 4, n = 1;detection rate, 1:22,228). The results of 21 tests were false-positive. Ten children with false-negative test results presented 8 to 35 monthslater with neuroblastoma (stage 1 tumor, n = I;stage 2, n = I;stage 3, n =1; stage 4, n = 7; five of nine tumors were N-myc-amplified tumors). Threechildren were nonsecretors at the time of diagnosis. Fifty-two patients were "missed" (not screened), and 37 children developed neuroblastoma before the age of screening (early cases). During the same period, ct total of 23.6 cases per million children within the screening area and 24.0 cases per million children outside the screening area were diagnosed as neuroblastoma cases (not significant [NS]). In prescreening times in the area of the later screening states, 20.7 cases per million children were found (NS). Conclusion: Screening at 1 year of age demonstrated a lower detection ratethan earlier screening programs and did not produce a "halo effect. " The good prognostic features of early-detected cases and the poor characteristics of not-detected-but-late-presenting cases corresponded to those of the related age groups. (C) 1999 by American Society of Clinical Oncology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/09/20 alle ore 06:33:44