{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T08:42:32Z","timestamp":1771231352912,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T00:00:00Z","timestamp":1737417600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Neuroblastoma is the most common extracranial solid tumor in children, with about half of cases classified as high risk. Treatment varies by risk level, with high\u2010risk patients undergoing aggressive multimodal therapy. While long\u2010term survival has improved, survivors face significant risks of late treatment effects, including adrenal insufficiency. This study investigates the incidence of adrenal insufficiency among neuroblastoma patients of varying disease risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>This retrospective cohort study at a single tertiary children's hospital reviewed records from 1998 to 2021, identifying 370 neuroblastoma patients, with 137 having complete risk stratification. The primary outcome was the incidence of adrenal insufficiency, diagnosed via clinical evaluation, and compared by risk group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 137 patients with neuroblastoma, nine (12.0%) high\u2010risk and three (4.9%) non\u2010high\u2010risk patients were diagnosed with adrenal insufficiency. The cumulative incidence of adrenal insufficiency at 3\u00a0years after neuroblastoma diagnosis was 9.9% in high\u2010risk and 3.5% in non\u2010high\u2010risk patients. Among high\u2010risk neuroblastoma patients with adrenal insufficiency, median time to adrenal insufficiency diagnosis was 10.2\u00a0months from neuroblastoma diagnosis, with cases more commonly occurring in patients with adrenal primary tumors (<jats:italic>p<\/jats:italic> = 0.0234). There were no other significant differences in demographic or clinical characteristics between high\u2010risk patients with and without adrenal insufficiency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Adrenal insufficiency occurs more commonly in children with high\u2010risk neuroblastoma than in non\u2010high\u2010risk cases, particularly those with adrenal primary tumors. These findings underscore the need for vigilant monitoring and screening for adrenal insufficiency during and after treatment. Future research should include larger, multi\u2010institutional cohorts to better understand risk factors and optimize screening protocols.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31543","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T13:14:16Z","timestamp":1737465256000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Incidence of Adrenal Insufficiency in Patients With High\u2010Risk Neuroblastoma: A Single\u2010Institution Analysis"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1678-7548","authenticated-orcid":false,"given":"Shachi","family":"Srivatsa","sequence":"first","affiliation":[{"name":"Center for Surgical Outcomes Research, Abigail Wexner Research Institute Nationwide Children's Hospital Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greg","family":"Metzger","sequence":"additional","affiliation":[{"name":"Department of Surgery The Ohio State University College of Medicine Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyle","family":"Horvath","sequence":"additional","affiliation":[{"name":"Center for Surgical Outcomes Research, Abigail Wexner Research Institute Nationwide Children's Hospital Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelli","family":"Patterson","sequence":"additional","affiliation":[{"name":"Department of Surgery The Ohio State University College of Medicine Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Scruggs","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology and BMT Department of Pediatrics, Nationwide Children's Hospital The Ohio State University College of Medicine Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tran","family":"Bourgeois","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology and BMT Department of Pediatrics, Nationwide Children's Hospital The Ohio State University College of Medicine Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1630-2102","authenticated-orcid":false,"given":"Joseph","family":"Stanek","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology and BMT Department of Pediatrics, Nationwide Children's Hospital The Ohio State University College of Medicine Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter C.","family":"Minneci","sequence":"additional","affiliation":[{"name":"Nemours Surgical Outcomes Center and Department of Surgery Nemours Children's Health\u2010Delaware Valley Wilmington Delaware USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6547-1220","authenticated-orcid":false,"given":"Jennifer H.","family":"Aldrink","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery Nationwide Children's Hospital, The Ohio State University College of Medicine Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2469-2553","authenticated-orcid":false,"given":"Keri A.","family":"Streby","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology and BMT Department of Pediatrics, Nationwide Children's Hospital The Ohio State University College of Medicine Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,1,21]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/EDBK_349783"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12030754"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.00278"},{"key":"e_1_2_11_5_1","unstructured":"\u201cNeuroblastoma Survival Rates \u201dAmerican Cancer Society accessed April 28 2021 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