Background and aims: Neuroblastoma (NB) is the most common extracranial solid tumor in children. The current treatment for NB is risk-adapted multimodal therapy. Poor coordination and miscommunication potentially exist between different health-care professionals. Here we reported the treatment results of NB patients in our hospital and the effects of the multidisciplinary care for the outcomes of NB patients.
Methods: Newly diagnosed NB patients in National Taiwan University Hospital began receiving TPOG N2002 protocol for NB treatment since 2002. We started multidisciplinary team approach, including nurse-led case management, for our patients treated by this protocol in the end of 2009 to enhance communication among relevant disciplines and improve timeliness of care. We compared the treatment results before and after the multidisciplinary approach of these patients.
Results: Fifty-eight patients treated by above protocol from 2002 to 2014 were included for analysis. There were 29 patients received treatment during 2002 to 2009 (group 1) and another 29 patients were during 2010 to 2014 (group 2). The 5-year overall survival (OS) and event-free survival (EFS) rate for all 58 patients were 59% and 54.7%, respectively. When comparing treatment results before and after the multidisciplinary approach, group 2 patients showed significant superior outcome to group 1 in 3-year EFS (P=0.046), but not OS (P=0.162). In further analysis, patients with HR, stage 4 disease, non-amplified MYCN belonged to group 2 had significant better 3-year EFS (P<0.05) than those belonged to group 1. In multivariate analysis of prognostic factors among 58 patients, the multidisciplinary approach is the only significant independent prognostic factor.
Conclusions: Multidiscipline team approach can benefit patients with high-risk NB. The long term effects of this multidiscipline care for our patients needs further followed-up.