Initial Urinary Catecholamine Metabolite Concentrations and Prognosis in Neuroblastoma

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Abstract
Initial urinary catecholamine metabolite and amino acid excretion patterns were examined in 54 children with neuroblastoma. The relationships between prognosis and age at diagnosis, stage of disease, primary site and histologic grade of tumor were similar in this population to those found in previous studies, but only age and stage were independent prognostic variables. Prognosis in disseminated disease correlated directly with the urinary vanilmandelic acid (VMA)/homovanillic acid (HVA) ratio but not with the absolute levels of HVA. The presence of the dopa metabolite, vanillactic acid, as well as increased amounts of cystathionine and/or low levels of VMA indicated poor prognosis. Biochemically primitive neuroblastomas deficient in dopamine .beta.-hydroxylase apparently are more virulent than their mature analogs which produce epinephrine, norepinephrine and their metabolites.