Survival Outcome of Patients with Stage 4 Neuroblastoma after Tumor Resection in Srinagarind Hospital

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Phicharmon Krittalack
Ratiyaporn Phannua
Kanokrat Thaiwatcharamas
Sinobol Chusilp
Patchareeporn Tanming
Suchat Areemit


Background and Objectives: More than half of patients with neuroblastoma were in stage 4 with metastatic disease at diagnosis, leading to high morbidity and mortality rates. We aimed to study the survival outcome of the patients who had stage 4 neuroblastoma at Srinagarind Hospital. Prognostic factors for survival were also determined.

Methods: A retrospective cohort review medical records of stage 4 neuroblastoma patients, from 2006 to 2015 at Srinagarind Hospital, Khon Kaen University. Using survival analysis for survival outcome and Cox-regression analysis for prognostic factors.

Results: 61 patients, 32 male (52%), 29 female (47%) were analyzed. Median age of patients was 4 years. 21 patients were categorized in unresectable group, while 38 were resectable which consisted of complete and incomplete resection (25 and 13 cases, respectively). In overall mortality data, 43 patients (72%) died after diagnosis. The mortality rates of unresectable complete resection and incomplete resection groups were 2.7%, 2.36%, and 1.6%, respectively. The median survival times of unresectable, complete resection, incomplete resection group was 11.43, 23.10, and 35.87 months, respectively. There were no statistically significant differences of survival experience between resectable and unresectable groups (p = 0.239), between complete resection and unresectable groups (p = 0.524), and between incomplete resection and unresectable group (p = 0.149). 

Conclusions: No significant differences of survival outcome between resectable and unresectable groups in stage 4 neuroblastoma. Prognostic factors are tumor location at spine, age group (>18 month), positive urine VMA and presentation of liver metastasis.


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Krittalack P, Phannua R, Thaiwatcharamas K, Chusilp S, Tanming P, Areemit S. Survival Outcome of Patients with Stage 4 Neuroblastoma after Tumor Resection in Srinagarind Hospital . SRIMEDJ [Internet]. 2021 Jan. 8 [cited 2023 Feb. 5];36(1):1-7. Available from:
Original Articles


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