Prognostic significance of circulating tumor cells and bone marrow micrometastasis in advanced neuroblastoma

Tatsuo Kuroda, Nobuyuki Morikawa, Kentaro Matsuoka, Akihiro Fujino, Toshiro Honna, Atsuko Nakagawa, Masaaki Kumagai, Hidekazu Masaki, Morihiro Saeki

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)


Purpose: The aim of this study was to study the prognostic significance of circulating tumor cells (CTC) and the appropriate indications for aggressive surgery in advanced neuroblastoma. Materials and Methods: Micrometastasis was sequentially explored using our reverse transcriptase-polymerase chain reaction method in 29 neuroblastoma patients (International Neuroblastoma Staging System stage 4, n = 24; stage 3, n = 5) who treated at our department with the united chemotherapeutic regimen since 1991. Their medical records and detection of CTC and/or the bone marrow micrometastasis were retrospectively reviewed then analyzed statistically. Results: The overall survival rate was 58.6% (17/29). Circulating tumor cells were detected in 55.6% of the stage 4 patients, and all deaths were related to systemic metastases in the CTC-positive patients. The detection of CTC scarcely associated with MYCN amplification. In the patients showing MYCN amplification but no CTC, all deaths were related to local relapse or chemotherapy-associated complications. The survival rate was not significantly different between the patients with and without MYCN amplification (56.8% vs 52.7%). However, it was significantly lower in the patients with CTC and/or persistent bone marrow micrometastasis compared to those without detectable micrometastasis (33.8% vs 87.5%; P < .05). Conclusions: The presence of CTC and/or persistent micrometastasis may indicate a significantly high risk, regardless of MYCN amplification. Patients with MYCN amplification but no micrometastasis would be most benefited by highly intensive surgery.

Original languageEnglish
Pages (from-to)2182-2185
Number of pages4
JournalJournal of Pediatric Surgery
Issue number12
Publication statusPublished - 2008 Dec
Externally publishedYes


  • Circulating tumor cells
  • Micrometastasis
  • Neuroblastoma
  • Prognosis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery


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