{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T18:24:33Z","timestamp":1773685473287,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T00:00:00Z","timestamp":1667174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["5T32CA136432\u201010"],"award-info":[{"award-number":["5T32CA136432\u201010"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Outcomes for patients with INRGSS metastatic special (MS) metastatic pattern neuroblastoma at initial diagnosis are well described. Prognosis after an initial event (relapse, progression, secondary malignancy) is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We investigated characteristics of MS pattern neuroblastoma patients in the International Neuroblastoma Risk Group database who subsequently experienced an event. Post\u2010event overall survival (OS)\u00a0\u00b1\u00a0standard error was calculated overall and by diagnosis era: before 2000 versus 2001 or after. Cox models were used to identify factors prognostic of post\u2010event OS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 209 patients with an event, 88% were less than 365\u00a0days old at diagnosis; tumors were <jats:italic>MYCN<\/jats:italic> amplified in 24% and diploid in 33%. The median (range) time from diagnosis to first event was 8.16\u00a0months (7\u00a0days to 11.24\u00a0years). Of 96 patients with known relapse\/progression pattern, 75% were metastatic or primary plus metastatic. Five\u2010year post\u2010event OS was 53%\u00a0\u00b1\u00a03.6% and was higher for 2001 and afterwards (62%\u00a0\u00b1\u00a05.0%) compared to before 2001 (44%\u00a0\u00b1\u00a04.9%; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.0046). In patients diagnosed in 2001 and after, older age, Hispanic ethnicity, <jats:italic>MYCN<\/jats:italic> amplification, 1p LOH, diploidy, high Mitotic Karyorrhexis Index, high lactate dehydrogenase (LDH), unfavorable histology, and longer time to first event were prognostic of worse post\u2010event OS. Independent adverse prognostic factors on multivariable testing were non\u2010White race, <jats:italic>MYCN<\/jats:italic> amplification, and diploidy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Summary<\/jats:title><jats:p>Patients diagnosed in and after 2001 have substantially better post\u2010event OS compared to before 2001. In those diagnosed in and after 2001, most well\u2010accepted prognostic factors for OS at diagnosis are also prognostic of post\u2010event OS. Future studies may evaluate strategies to improve outcomes in this rare population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.30054","type":"journal-article","created":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T04:50:25Z","timestamp":1667278225000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Clinical and biological features prognostic of survival after relapse or progression of INRGSS stage MS pattern neuroblastoma: A report from the International Neuroblastoma Risk Group (INRG) project"],"prefix":"10.1002","volume":"70","author":[{"given":"Kevin","family":"Campbell","sequence":"first","affiliation":[{"name":"Dana\u2010Farber\/Boston Children's Cancer and Blood Disorders Center and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei\u2010Chi","family":"Kao","sequence":"additional","affiliation":[{"name":"Dana\u2010Farber\/Boston Children's Cancer and Blood Disorders Center and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arlene","family":"Naranjo","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Children's Oncology Group Statistics and Data Center University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4798-7546","authenticated-orcid":false,"given":"Takehiko","family":"Kamijo","sequence":"additional","affiliation":[{"name":"Research Institute for Clinical Oncology Saitama Cancer Center  Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramya","family":"Ramanujachar","sequence":"additional","affiliation":[{"name":"Paediatric Oncology University Hospital Southampton NHS Foundation Trust  Southampton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3571-6538","authenticated-orcid":false,"given":"Wendy B.","family":"London","sequence":"additional","affiliation":[{"name":"Dana\u2010Farber\/Boston Children's Cancer and Blood Disorders Center and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0882-738X","authenticated-orcid":false,"given":"Steven G.","family":"DuBois","sequence":"additional","affiliation":[{"name":"Dana\u2010Farber\/Boston Children's Cancer and Blood Disorders Center and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,10,31]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(71)91606-0"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197102)27:2<374::AID-CNCR2820270221>3.0.CO;2-G"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1998.16.6.2007"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1993.11.8.1466"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1988.6.12.1874"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.16.6785"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1716836"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20067"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.35.9570"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.34.3392"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.56.4.271"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.28359"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.29.6103"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djaa107"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2016.302"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000001517"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.00278"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.11642"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0911123"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30934"}],"container-title":["Pediatric Blood &amp; 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