We have clinically observed 39 patients with abdominal tumors who were admitted in Severance Hospital during the past 10 years from April 1960 to March 1970. Unfortunately follow-up study couldn't be made. The following results were obtained. 1) Of the total number observed, 25 patients were male and 14 patients female. 2) The majority of the patients, 34 (87%) were under 6 years of age and 20 (51%) were between 1 to 3 years of age. The youngest patient was a 3-month-old female with Wilms' tumor. 3) In our series, Wilms' tumor (15 cases, 38.5%) was the most common and neuroblastoma (8 cases) was next most common tumor in the abdominal cavity. In addition we found another 4 cases of neuroblastoma in other sites. We observed hepatoma (8cases), ovarian tumor (3cases), lymphosarcoma (2cases), mesenteric cyst (one case) and adenoma of the left adrenal gland (one case) in that order of frequency. 4) In 15patients with Wilms' tumor, hypertension was observed in 8 patients and hematuria in 4 patients. Compared with Wilms' tumor, no hematuria was noted in the cases with neuroblastoma and hypertension occurred in 3 of these. 5) On abdominal X-ray, calcification was present in 4 cases with neuroblastoma (50%) and was present in only one of 15 patients with Wilms' tumor. 6) Comparing the sites of metastasis between Wilms' tumor and neuroblastoma, 4 of 15 patients with Wilms' tumor had lung metastasis and 4 of 8 patients of neuroblastoma had bony metastasis. Liver metastasis was found at autopsy in one case of neuroblastoma. 7) Three cases of hepatoblastoma were under 2 years of age and three cases of hepatocarcinoma were over 12 years of age. 8) Three cases of ovarian tumor were benign cystic teratoma. Tortion of the ovarian pedicle occurred in one of 3 patients with severe low abdominal pain. All patients were discharged in good condition after salphingo-oophorectomy. 9) One case of lymphosarcoma of the ileum was associated with intussusception. 10) A one year o1d female with adenoma of the left adrenal gland had typical Cushing's syndrome.
Abdominal Neoplasms/epidemiology* ; Adolescent ; Carcinoma, Hepatocellular/epidemiology ; Child ; Child, Preschool ; Female ; Human ; Infant ; Korea ; Liver Neoplasms ; Lymphoma, Non-Hodgkin/epidemiology ; Male ; Mesenteric Cyst/epidemiology ; Nephroblastoma/epidemiology ; Neuroblastoma/epidemiology ; Ovarian Neoplasms/epidemiology

INTRODUCTIONIt is unknown whether screening for neuroblastoma has the benefit of reducing the incidence of advanced diseaseor mortality due to neuroblastoma.Japanese nationwide massscreening for 6 month old infants was launched in 1985 and was performed using quantitative high-performance liquid chromatography (HPLC) between years 1990 to 2003.

MATERIALS AND METHODSWe compared the incidence rates (IR) and the mortality rates (MR) per 100,000 births of neuroblastomas diagnosed before 6 years of age between 2 cohorts: children born during the years 1980 to1984 (Pre-screen cohort, n = 7,620,203) and 1990 to1998 (Screen cohort, n = 10,878,918). We then proposed the optimal timing and procedures for future screening.

RESULTSCumulative IR in the Screen cohortwas significantly higher than the Pre-screen cohort (29.80 vs. 11.96, P <0.0001). On the other hand, IR of neuroblastoma diagnosed after 24 months old in the Screen cohort was significantly lower than in the Pre-screen cohort (P <0.0001). The cumulative MR of the Pre-screen cohort was 5.35, whereas that of the Screen cohort was 2.82 (P <0.0001).

CONCLUSIONSHPLC mass-screening for neuroblastoma at 6 months of age found a marked increase in incidence in younger children (less than 12 month old) and a significant decrease in mortality rates overall. To reduce overdiagnosis of regressing cases and to identify preclinical stages of unfavourable cases, we propose using HPLC-screening at 18 months of age.

Child ; Child, Preschool ; Chromatography, High Pressure Liquid ; Cohort Studies ; Forecasting ; Humans ; Incidence ; Infant ; Japan ; Mass Screening ; Neuroblastoma ; diagnosis ; epidemiology

PURPOSE: This study was carried to examine the temporal trend and geographical distribution of the childhood cancers in Taegu and Kyungpook province and to postulate an etiological hypothesis for development of the childhood cancer. METHODS: A total of 799 childhood cancer patients whose addresses were either Taegu or Kyungpook province were diagnosed at 5 major hospitals in Taegu from January 1982 to December 1996. The types, sexes, years, and frequencies of the childhood cancer and regional distributions were analyzed, based on the hospital records of these patients. RESULTS: The most common childhood cancer was leukemia that accounted for 49.2% of all childhood cancer cases and it was followed by CNS tumor (12.3%), lymphoma (8.4%), neuroblastoma (7.4%), Wilms tumor (3.9%), retinoblastoma (3.4%), rhabdomyo sarcoma (2.7%), bone tumor (2.4%), embryonal carcinoma (1.9%), hepatoblastoma (1.3%) and others (7.1%). Male to female ratio of the cases was 1.5:1. The changes of the annual incidence rates over 15 years in Taegu and Kyungpook area were not consistently increasing but rather variable. Cancer incidence rate of Taegu was significantly higher than that of Kyungpook province (P<0.005). The incidence rates of industrialized cities around Taegu were significantly higher than those of agricultural regions of northern Kyungpook (P<0.05). CONCLUSION: Geographical difference in cancer incidence rate suggested that certain environmental factors may be associated with the childhood cancer. To identify such factors an analytical epidemiologic study is warranted. For the analytical epidemiologic study, a detailed history of residential area and occupational history of parents should be recorded uniformly for all the new childhood cancer cases.
Carcinoma, Embryonal ; Daegu* ; Epidemiologic Studies ; Epidemiology ; Female ; Gyeongsangbuk-do* ; Hepatoblastoma ; Hospital Records ; Humans ; Incidence ; Leukemia ; Lymphoma ; Male ; Neuroblastoma ; Parents ; Retinoblastoma ; Sarcoma ; Wilms Tumor

Disease relapse after autologous peripheral blood stem cell transplantation (APBSCT) is the main cause of treatment failure in high-risk neuroblastoma (NBL). To reduce relapse, various efforts have been made such as CD34+ selection and double APBSCT. Here the authors reviewed the clinical features and outcomes of highrisk NBL patients and analyzed their survival. The medical records of 36 patients with stage III or IV NBL who underwent APBSCT at Seoul National University Children's Hospital between May 1996 and May 2004 were reviewed. Total 46 APBSCTs were performed in 36 patients. Disease free survival (DFS) and overall survival of all patients were 47.7% and 68.8%, respectively. The patients were allocated to three groups according to the APBSCT type. The DFS of CD34+ non-selected single APBSCT patients (N=13), CD34+ selected single APBSCT patients (N=14), and CD34+ selected double APBSCT patients (N=9) were 55.6%, 40.6%, and 50.0%, respectively, which were not significantly different. Thus the survival was not found to be affected by CD34+ selection or transplantation number. To improve long-term survival, various efforts should be made such as chemotherapy dose intensification, more effective tumor purging, and control of minimal residual disease via the use of differentiating and immune-modulating agents.
Antigens, CD34/metabolism ; Child ; Child, Preschool ; Disease-Free Survival ; Female ; Hematopoietic Stem Cell Mobilization ; Humans ; Infant ; Korea/epidemiology ; Male ; Neuroblastoma/mortality/*therapy ; Peripheral Blood Stem Cell Transplantation/adverse effects/mortality ; Prognosis ; Retrospective Studies ; Survival Rate ; Transplantation Conditioning ; Transplantation, Autologous

The efficacy of tandem high-dose chemotherapy and autologous stem cell rescue (HDCT/ASCR) was investigated in patients with high-risk neuroblastoma. Patients over 1 yr of age who were newly diagnosed with stage 4 neuroblastoma from January 2000 to December 2005 were enrolled in The Korean Society of Pediatric Hematology-Oncology registry. All patients who were assigned to receive HDCT/ASCR at diagnosis were retrospectively analyzed to investigate the efficacy of single or tandem HDCT/ASCR. Seventy and 71 patients were assigned to receive single or tandem HDCT/ASCR at diagnosis. Fifty-seven and 59 patients in the single or tandem HDCT group underwent single or tandem HDCT/ASCR as scheduled. Twenty-four and 38 patients in the single or tandem HDCT group remained event free with a median follow-up of 56 (24-88) months. When the survival rate was analyzed according to intent-to-treat at diagnosis, the probability of the 5-yr event-free survival+/-95% confidence intervals was higher in the tandem HDCT group than in the single HDCT group (51.2+/-12.4% vs. 31.3+/-11.5%, P=0.030). The results of the present study demonstrate that the tandem HDCT/ASCR strategy is significantly better than the single HDCT/ASCR strategy for improved survival in the treatment of high-risk neuroblastoma patients.
Adolescent ; Child ; Child, Preschool ; Combined Modality Therapy/mortality ; Drug Therapy/*mortality ; Female ; Humans ; Infant ; Korea/epidemiology ; Longitudinal Studies ; Male ; Neuroblastoma/*mortality/*therapy ; Prevalence ; Risk Assessment/methods ; Risk Factors ; Stem Cell Transplantation/*mortality ; Survival Analysis ; Survival Rate ; Treatment Outcome

INTRODUCTION: In Europe and North America, the majority of children with high-risk neuroblastoma survive the disease. Elsewhere, the treatment outcomes are poor. METHODS: A retrospective review of children treated for high-risk neuroblastoma in a single institution in Singapore from 2007 to 2019 was carried out. Treatment consisted of intensive chemotherapy, surgery aimed at gross total resection of residual disease after chemotherapy, consolidation with high-dose therapy followed by autologous stem cell rescue, and radiotherapy to the primary and metastatic sites followed by maintenance treatment with either cis-retinoic acid or anti-disialoganglioside monoclonal antibody therapy. Survival data were examined on certain clinical and laboratory factors. RESULTS: There were 57 children (32 male) treated for high-risk neuroblastoma. Their mean age was 3.9 (range 0.7-14.9) years. The median follow-up time was 5.5 (range 1.8-13.0) years for the surviving patients. There were 31 survivors, with 27 patients surviving in first remission, and the five-year overall survival and event-free survival rates were 52.5% and 47.4%, respectively. On log-rank testing, only the group of 17 patients who were exclusively treated at our centre had a survival advantage. Their five-year overall survival rate compared to patients whose initial chemotherapy was done elsewhere was 81.6% versus 41.1% (P = 0.011), and that of event-free survival was 69.7% versus 36.1% (P = 0.032). Published treatment results were obtained from four countries in Southeast Asia with five-year overall survival rates from 13.5% to 28.2%. CONCLUSION Intensified medical and surgical treatment for high-risk neuroblastoma proved to be effective, with superior survival rates compared to previous data from Southeast Asia.
Child ; Humans ; Male ; Infant ; Child, Preschool ; Adolescent ; Disease-Free Survival ; Neuroblastoma/pathology* ; Hematopoietic Stem Cell Transplantation/methods* ; Treatment Outcome ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Asia, Southeastern/epidemiology* ; Combined Modality Therapy