Clinical Features at Diagnosis Are Associated With the Need of Emergency Invasive Procedures and Intensive Care Unit Admission in Patients With High-risk Neuroblastoma – A Retrospective Cohort Study

Abstract

Abstract Purpose Patients affected by high-risk may occasionally need emergency procedures due to acute complications during induction chemotherapy. The aim of the present study is to find risk factors associated with these complications. Methods Patients diagnosed with high-risk neuroblastoma from January 2013 until February 2022 were retrospectively reviewed. Primary outcomes were the need of emergency invasive procedures and the Intensive Care Unit (ICU) admission. Clinical data at diagnosis were recorded and the correlation with the primary outcomes was analyzed. Results Fifty patients were diagnosed with high-risk neuroblastoma. Six patients required emergency procedures for hemothorax (2 patients), hemothorax and hemoperitoneum (1 patient), hydronephrosis (3 patients); two of them were admitted to ICU. Factors associated with emergency procedures were stage 2 hypertension (p = 0.0001), higher number of vascular IDRF (p= 0,0068), larger diameter of the primary tumor (p = 0,0043), high LDH levels (p < 0.0001) and low levels of urinary VMA (p < 0.0001). Factors associated with ICU admission were stage 2 hypertension (p = 0,0229), high levels of LDH (p < 0.0001) and low levels of urinary VMA (p< 0.0001). Discussion Specific features at diagnosis are associated with the need of emergency invasive procedures and ICU admission in high-risk neuroblastoma patients.