Neuroblastoma in Vietnam: A retrospective analysis of MYCN status and clinical features to inform prognosis and improve outcome

Background: Neuroblastoma is the most common childhood cancer worldwide. While recent advances in diagnosis and treatment have resulted in dramatic improvements in patient survival, neuroblastoma recurrence and mortality rates in Vietnam are unknown. This study evaluated the survival rates of Vietnamese patients with NB and investigated the impact of clinical factors and MYCN status on prognosis. Methods: This study analysed survival rates, clinical factors and MYCN status of NB patients across three hospitals in Ho Chi Minh City. Kaplan-Meier and multivariable Cox proportional hazards models were used to describe Survival rates and determine hazard ratios. Patient samples were analysed retrospectively for MYCN amplification by fluorescence in-situ hybridization (FISH) and quantitative polymerase chain reaction (qPCR). Results: 5-year overall survival (OS) was 39.78% ± 4.31% and event-free survival (EFS) was 56.63% ± 5.47% in our cohort, and significantly lower than OS and EFS rates in Europe, USA, Japan, China and Thailand. MYCN- amplified or Stage III and IV NB patients showed significantly decreased survival time in comparison to those without MYCN amplification (log rank P =0.000) or diagnosed at stage I, II and IVs (log rank P =0.000). Furthermore, patients older than 18 months or at stage III and IV had a significantly higher probability of recurrence ( P =0.038 and P =0.000, respectively). Conclusions: This study demonstrates poor outcome for NB patients in Vietnam. Furthermore, prognosis is significantly worsened by their MYCN status; NB stage and age at diagnosis.