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Micrometastases in neuroblastoma: are they clinically important?

Correspondence to:
Dr S A Burchill
Children’s Cancer Research Laboratory, Cancer Research UK Clinical Centre, St James’s University Hospital, Beckett Street, Leeds LS9 7TF, UK; s.a.burchill{at}leeds.ac.uk
ABSTRACT
Despite advances in the treatment of neuroblastoma (NBL), recurrence and metastases continue to pose major problems in clinical management. The relation between micrometastases and the development of secondary disease is not fully understood. However, accurate methods to detect low numbers of tumour cells may allow the evaluation of their role in the disease process, and by implication the possible benefits of eliminating them. Although there is substantial evidence for the increased sensitivity of current molecular methods for the detection of NBL cells compared with more conventional cytology, the clinical relevance and usefulness of detecting this disease remain controversial. The primary goal of current translational research must be to evaluate the clinical relevance of micrometastatic disease detected by these methods in multicentre prospective clinical outcome studies. Only then can the clinical usefulness of these methods be defined so that they may be introduced into relevant clinical practice.

Abbreviations: BM, bone marrow; IC, immunocytology; NBL, neuroblastoma; PB, peripheral blood; PBSC, peripheral blood stem cells; PCR, polymerase chain reaction; RT, reverse transcriptase; TH, tyrosine hydroxylase

Keywords: micrometastases; neuroblastoma; clinical significance; minimal residual disease; immunocytology; reverse transcriptase polymerase chain reaction

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