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Research Papers:

A multidisciplinary team care approach improves outcomes in high-risk pediatric neuroblastoma patients

Hsiu-Hao Chang, Yen-Lin Liu, Meng-Yao Lu, Shiann-Tarng Jou, Yung-Li Yang, Dong-Tsamn Lin, Kai-Hsin Lin, Kai-Yuan Tzen, Ruoh-Fang Yen, Ching-Chu Lu, Chia-Ju Liu, Steven Shinn-Forng Peng, Yung-Ming Jeng, Shiu-Feng Huang, Hsinyu Lee, Hsueh-Fen Juan, Min-Chuan Huang, Yung-Feng Liao, Ya-Ling Lee, Wen-Ming Hsu _

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Abstract

Hsiu-Hao Chang1, Yen-Lin Liu1,2, Meng-Yao Lu1, Shiann-Tarng Jou1, Yung-Li Yang1,3 Dong-Tsamn Lin1,3, Kai-Hsin Lin1, Kai-Yuan Tzen4, Ruoh-Fang Yen4, Ching-Chu Lu4, Chia-Ju Liu4, Steven Shinn-Forng Peng5, Yung-Ming Jeng6, Shiu-Feng Huang7, Hsinyu Lee8,9, Hsueh-Fen Juan8,10, Min-Chuan Huang11, Yung-Feng Liao12, Ya-Ling Lee13,14, Wen-Ming Hsu15

1Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

2Department of Pediatrics, Taipei Medical University Hospital, Taipei, Taiwan

3Department of Laboratory Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

4Department of Nuclear Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

5Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

6Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

7Division of Molecular and Genomic Medicine, National Health Research Institutes, Miaoli County, Taiwan

8Department of Life Science, National Taiwan University, Taipei, Taiwan

9Institutes of Zoology, National Taiwan University, Taipei, Taiwan

10Institutes of Molecular and Cellular Biology, National Taiwan University, Taipei, Taiwan

11Graduate Institute of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan

12Institute of Cellular and Organismic Biology, Academia Sinica, Taipei, Taiwan

13Department of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan

14Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan

15Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

Correspondence to:

Ya-Ling Lee, email: yallee@ntu.edu.tw

Wen-Ming Hsu, email: billwmhsu@gmail.com

Keywords: chemotherapy, high-risk, multidisciplinary team care, neuroblastoma, outcomes

Received: June 30, 2016     Accepted: December 01, 2016     Published: December 10, 2016

ABSTRACT

We assessed the impact of a multidisciplinary team care program on treatment outcomes in neuroblastoma patients. Newly diagnosed neuroblastoma patients received treatment under the Taiwan Pediatric Oncology Group (TPOG) N2002 protocol at the National Taiwan University Hospital beginning in 2002. A multidisciplinary team care approach that included nurse-led case management for patients treated under this protocol began in January 2010. Fifty-eight neuroblastoma patients, including 29 treated between 2002 and 2009 (Group 1) and 29 treated between 2010 and 2014 (Group 2), were enrolled in the study. The 5-year overall survival (OS) and event-free survival (EFS) rates for all 58 patients were 59% and 54.7%, respectively. Group 2 patients, who were treated after implementation of the multidisciplinary team care program, had better 3-year EFS (P = 0.046), but not OS (P = 0.16), rates than Group 1 patients. In a multivariate analysis, implementation of the multidisciplinary team approach was the only significant independent prognostic factor for neuroblastoma patients. In further subgroup analyses, the multidisciplinary team approach improved EFS, but not OS, in patients with stage 4 disease, those in the high-risk group, and those with non-MYCN amplified tumors. These data indicate a multidisciplinary team care approach improved survival outcomes in high-risk neuroblastoma patients. However, further investigation will be required to evaluate the long-term effects of this approach over longer follow-up periods.

Author Information

Hsiu-Hao Chang

Yen-Lin Liu

Meng-Yao Lu

Shiann-Tarng Jou

Yung-Li Yang

Dong-Tsamn Lin

Kai-Hsin Lin

Kai-Yuan Tzen

Ruoh-Fang Yen

Ching-Chu Lu

Chia-Ju Liu

Steven Shinn-Forng Peng

Yung-Ming Jeng

Shiu-Feng Huang

Hsinyu Lee

Hsueh-Fen Juan

Min-Chuan Huang

Yung-Feng Liao

Ya-Ling Lee

Wen-Ming Hsu
Primary Contact  _


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