Poster Presentation Advances in Neuroblastoma Research Congress 2016

Impact of the involvement of the separate body regions in the modified Curie and the SIOPEN mIBG-scoring systems in patients with stage 4 neuroblastoma (#263)

Boris Decarolis 1 , Barbara Hero 1 , Thorsten Simon 1 , Christina Schneider 2 , Ruth Volland 1 , Frank Berthold 1 , Matthias Schmidt 2
  1. Department of Children's Oncology, University Hospital of Cologne, Cologne, Germany
  2. Department of Nuclear Medicine, University Hospital of Cologne, Cologny, Germany

Background: Semi-quantitative scoring of initial I-123-mIBG-scans using the modified Curie- or the SIOPEN-score allows prediction of outcome in patients with stage 4 neuroblastoma1. However, the impact of involvement of the separate body regions on outcome and effect of the degree of subdivision has not been investigated yet.

Methods: Initial mIBG-scans of 71 patients diagnosed with stage 4 neuroblastoma >1 year of age were retrospectively scored using both scores (modified Curie: 9 skeletal regions plus soft tissue, score 0-30, SIOPEN: 12 skeletal regions (assessing left and right humeri, forearms, femora, and lower legs separately) score 0-72). For the separate body regions correlation to other body regions and impact on prognosis was analyzed.

Results: Results of both scoring methods were highly correlated (Pearson’s correlation coefficient: r=0.97, p<0.001). The regions most frequently involved were femora (84%), spine (74%), pelvis (74%), and humeri (73%) while forearms (32%) and soft tissue (13%) were rarely affected.

There was a high correlation between involvement of right and left humeri (r=0.903, p<0.001), forearms (r=0.881, p<0.001), femora (r=0.838, p<0.001), and lower legs (r=0.861, p<0.001) as well as between cervico-thoracal and lumbo-sacral spine (r=0.916, p<0.001).

Using the modified Curie-score, EFS and OS were inferior if humeri (EFS p=0.009; OS p=0.007) or femora (EFS p=0.014; OS p=0.004) were involved, while involvement of the lower legs was only associated with worse OS (p=0.030). Using the SIOPEN-score this held true for EFS and OS for involvement of the humeri (right: EFS p=0.014; OS p=0.013; left: EFS p=0.037; OS p=0.017) and for OS only for involvement of femora (right: p=0.006; left: p=0.046) and tibiae (right: p=0.019; left: p=0.018).

Conclusions: Regions with prognostic impact (humeri, femora, tibiae) could be identified, while differentiation between left and right limbs did not reveal additional prognostic value and involvement of left and right limbs was highly correlated to each other. However, the subtler subdivision in the SIOPEN-score might allow a more sensitive assessment of the course of disease.

  1. Iodine-123 metaiodobenzylguanidine scintigraphy scoring allows prediction of outcome in patients with stage 4 neuroblastoma: results of the Cologne interscore comparison study, Decarolis et al., J Clin Oncol. 2013 Mar 1;31(7):944-51