Tumour markers are poor predictors for relapse or progression in neuroblastoma

Eur J Cancer. 2003 Sep;39(13):1899-903. doi: 10.1016/s0959-8049(03)00376-9.


The value of the tumour markers vanillylmandelic acid (VMA) and homovanillic acid (HVA) in urine (u) and serum (s), neurone-specific enolase (NSE), and lactate dehydrogenase (LDH) in the early prediction of relapse/progression in neuroblastoma is not known. We analysed the data of neuroblastoma patients who had successfully completed first-line treatment and had laboratory results available from their initial diagnosis and from relapse/progression (n=196). Patients' overall survival from relapse or progression was 21.5+/-4.2% (mean+/-standard deviation). At diagnosis, we found abnormal results in 75% for VMA and/or HVA (s), 92% for VMA and/or HVA (u), 90% for NSE, and 81% for LDH. We found a lower incidence of abnormal results at relapse or progression with 40% for VMA and/or HVA (s), 54% for HVA and/or VMA (u), 61% for NSE, and 48% for LDH. Sensitivity of all markers was higher for metastatic compared with local recurrence. NSE was the best, being able to detect 42% of the localised relapses, 77% of the combined local/metastatic relapses, and 69% of the metastatic recurrences. Relapse or progression in neuroblastoma cannot be detected reliably by monitoring tumour markers alone. Therefore, follow-up of neuroblastoma patients must include clinical assessment and imaging studies.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Biomarkers, Tumor / analysis*
  • Biomarkers, Tumor / blood
  • Biomarkers, Tumor / urine
  • Bone Marrow Neoplasms / blood
  • Bone Marrow Neoplasms / secondary*
  • Bone Marrow Neoplasms / urine
  • Child
  • Child, Preschool
  • Clinical Trials as Topic
  • Disease Progression
  • Disease-Free Survival
  • Follow-Up Studies
  • Homovanillic Acid / blood
  • Homovanillic Acid / urine
  • Humans
  • Infant
  • Infant, Newborn
  • Iodine Radioisotopes
  • Iodobenzenes
  • L-Lactate Dehydrogenase / blood
  • L-Lactate Dehydrogenase / urine
  • Magnetic Resonance Imaging
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Recurrence, Local / mortality
  • Neuroblastoma / diagnosis*
  • Neuroblastoma / mortality
  • Phosphopyruvate Hydratase / blood
  • Phosphopyruvate Hydratase / urine
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed
  • Vanilmandelic Acid / blood
  • Vanilmandelic Acid / urine


  • Biomarkers, Tumor
  • Iodine Radioisotopes
  • Iodobenzenes
  • Vanilmandelic Acid
  • L-Lactate Dehydrogenase
  • Phosphopyruvate Hydratase
  • Homovanillic Acid