Neuroblastoma, its natural history and prognosis: a study of 487 cases.

The natural history of neuroblastoma and factors affecting survival for this disease were studied in an unselected group of children notified to cancer registries in Britain during 1962-7. The three-year survival rate based on 487 cases was 23%; many of the cases were followed up for more than five years, and this made it possible to calculate long-term survival and recurrence rates. There were only five deaths among 110 cases followed for more than three years, 64 of the survivors having been followed for more than five years. Factors affecting the prognosis included age at diagnosis, site, histological grade at diagnosis, and the sex of the child. The interrelationship between these factors together with their effect on prognosis were analysed, and in particular we attempted to elucidate factors which might explain our observation that girls have a significantly better survival rate than boys. Direct histological evidence and also the analyses of survival and recurrence rates seem to support the suggestion that the likelihood of maturation for this tumour is greater for girls than for boys.