Analysis of factors that may affect the therapeutic course of neuroblastoma. Summary of 17 years of own experience and literature review

Introduction
Neuroblastoma (NB) is the fourth most commonly diagnosed childhood cancer. The stage of the disease at the time of diagnosis has an impact on treatment outcomes and survival. The aim of this study was to analyse factors that may affect the therapeutic course of NB.

Material and methods
The study group consisted of 77 patients. When analysing the time between the first visit to the doctor and the start of oncological treatment, significant differences were found between the group of patients with complete remission and the group that did not respond to treatment.

Results
Over the 17 years of the study, there was a tendency for the diagnosis of NB in the lower, 1st and 2nd stages of NB to increase. The stage of the disease correlated with the risk of disease progression, relapse, and risk of death. Although our study did not show a significant correlation between the timely implementation of the HR-NBL SIOPEN and the LINES protocols and the effectiveness of treatment, it proved that the period of time between the first visit to the doctor and the start of oncological treatment significantly affects the final response to the applied therapy.

Conclusions
The mild trend towards more frequent diagnosis of lower stage patients and prenatally detected cases may be related to increased availability of ultrasound and improved parental education.