Exploring Pediatric Neuroblastoma: A Comprehensive Analysis of Adrenal and Non-Adrenal Tumor Characteristics in the United States

Abstract Background and Purpose Neuroblastoma (NB) is an aggressive malignant tumor arising from a primitive neural crest origin. While the significance of tumor location in survival outcomes is recognized, it remains inadequately explored. This study provides a comprehensive analysis of the survival, and characteristics of pediatric adrenal and non-adrenal NB in the United States (US).Methods Retrospective analysis of pediatric primary NB between 1975 and 2016 was conducted using the Surveillance, Epidemiology and End Results (SEER) database. Univariate and multivariate regression analysis were used to determine prognostic variables.Results A total of 4554 patients were included, 52% Males (n = 2385) and 79.2% Caucasians (n = 3569). Median age was 1 year old [Range 0–19]. 44.4% (n = 1996) had adrenal NB and 55.6% (n = 2496) non-adrenal. Adrenal NB was significantly more prevalent among males and those presenting at a younger age (p < 0.001). Adrenal NB was more likely to have a higher grade and distant metastasis at diagnosis (p < 0.001). Non-adrenal NB, female sex, surgical resection, and later year of diagnosis were associated with improved survival (p < 0.001).Conclusion This study highlights important risk factors that are helpful for prognostication of NB patients in the US. Tailored approaches considering tumor site are crucial for effective management of NB.