Associations between Tumor Ploidy and Overall Survival in Pediatric Neuroblastoma

Abstract

Objective: To investigate the relationships between pediatric neuroblastoma outcomes, tumor ploidy, and ethnicity, focusing on disparities in overall survival (OS) while also accounting for race and ethnicity. Methods: Clinical and tumor ploidy data for 63 Hispanic White, 561 non-Hispanic White, and 86 non-Hispanic Black patients were obtained from cBioPortal for Cancer Genomics (TARGET [Therapeutically Applicable Research to Generate Effective Treatments], 2018). Kaplan Meier survival curves were analyzed using log-rank and Gehan–Breslow Wilcoxon tests. Hazard ratios (HR) with 95% CIs were calculated using the Mantel–Haenszel method. Associations between ethnicity and tumor ploidy were assessed using the chi-square test. Results: Significant differences in overall survival (OS) were observed between White patients who self-identified as Hispanic and those who identified as non Hispanic, with Hispanic patients exhibiting worse outcomes. (P = .0076, HR = 1.907, 95% CI: 1.187–3.062). Median survival for Hispanic patients was 94 months but was undefined for non-Hispanic patients. Diploid tumors were associated with worse outcomes than hyperdiploid tumors were (P < .0001, HR = 2.291, 95% CI: 1.689–3.109). The chi square test revealed a significant association between ethnicity and tumor ploidy (χ2 = 4.220, P = .0400), with non-Hispanic patients having a higher proportion of hyperdiploid tumors (66.99%) than Hispanic patients (53.97%). Conclusion: Hispanic White patients with neuroblastoma had lower OS than did non-Hispanic White patients, partly due to the former having a higher proportion of diploid tumors. These findings highlight the importance of considering ethnicity and tumor ploidy in risk stratification and treatment strategies.