Management of neuroblastoma in limited-resource settings

Table 1 Age distribution at diagnosis

Country	n	< 12 mo	< 18 mo	< 60 mo	< 120 mo	< 180 mo	Mean	Median
Asia
China (2008-2013)[17]	59	44%	56%					24
China (2000-2006)[18]	98	16.3%	4.1%	53%	21.5%	4%		48
India (1990-2004)[19]	103	0%-5.9%	77%-98.1%		1.9%		41	-
Pakistan (2015-2016)[20]	70	30%		63%		7%		36
South America
Argentina (2000-2012)[29]	753	30%	52.2%		12.9%	45.3%		26.4
Brazil (1991-2012)[30]	258	29%	49%		17%	5%	40.5	28.9
Brazil (1990-2000)[16]	125	26%	13%	41%	20%		38.2	33
Middle East and North Africa
Egypt (2005-2010)[23]	142	24.2%	75.8%					30
Egypt (2001-2010)[24]	53	22.6%	77.4%
Iran (1974-2005)[25]	219	21.5%		78.5%			40.5
Iraq (2008-2014)[26]	62	30.6%	50%		16.1%	3.2%	37
Sub-Saharan Africa
Ethiopia (2010-2013)[79]	5	0	40%		40%	20%
Kenya (1997-2005)[44]	22	31.8%	50%		18.2%			60

Table 2 Incidences of neuroblastoma according to the age at diagnosis

Country	n	< 12 mo	< 60 mo	Ratio < 12: < 60	< 120 mo	< 180 mo	Total incidence
South America
Argentina (2000-2012)[29]	753	32.9	14.6	2.3: 1	2.8	1.0	8.3
Uruguay (2001-2010)[35]	69	63.1	18.1	3.4: 1	2.3	0	9.1
Chile (2007-2012)[31]	88	21.9	6.7	3.2: 1	2.1	0.3	4.7
Brazil (1998-2002)[33]	372	15.3	12.4	1.2: 1	3.8	1.3	5.9
Central America and the Caribbean
Mexico (1996-2005)[32]	72	18.5	5.4	3.4: 1	1.1	0.2	3.8
Cuba (2001-2003)[34]	46	3.9	0.8	4.8: 1	0.5	0.2	0.1
Sub-Saharan Africa
Reunion (2005-2011)[36]	12	44.1	15.8	2.7: 1	4.1	0	9.6

Table 3 Distribution of sex at diagnosis

Country	Total	Male	Female	Ratio M: F
Asia
Pakistan (2015-2016)[20]	70			1.8: 1
India (2000-2017)[64]	85	57 (67%)	28 (33%)	2: 1
India (1990-2004)[19]	103	76 (74%)	27 (26%)	2.8: 1
Thailand (2000-2007)[21]	67	39 (58.2%)	23(34.3%)	1.7: 1
Vietnam (2010-2012)[22]	130	76(58.5%)	54 (41.6%)	1.4: 1
China (2008-2013)[17]	59	35 (59%)	24 (40.1%)	1.5: 1
China (2000-2006)[18]	98			1.3: 1
South America
Brazil (1991-2012)[30]	258	148 (57%)	110 (43%)	1.3: 1
Brazil (1990-2000)[16]	125	68 (54.4%)	57 (45.6%)	1.2: 1
Argentina (1999-2015)[12]	39	21 (54%)	18 (46%)	1.2: 1
Argentina (2000-2012)[29]	971	509 (52%)	462 (48%)	1.1: 1
Middle East and North Africa
Iran (1974-2005)[25]	219			1.9: 1
Iraq (2008-2014)[26]	62	37 (59.7%)	25 (40.3%)	1.5: 1
Morocco (2012-2015)[27]	40	26 (65%)	14 (35%)	1.8: 1
Egypt (2005-2010)[23]	142	68 (51.5%)	64 (48.5%)	1.06: 1
Egypt (2001-2010)[24]	53	35 (66%)	18 (35%)	1.9: 1
Egypt (2007-2011)[28]	271	169 (62.4%)	102 (37.6%)	1.65: 1
Sub-Saharan Africa
Northern Nigeria (2003-2009)[79]	14	10 (71.4%)	4 (28.6%)	2.5: 1
Southern Africa (South Africa and Namibia) (1983-1997)[43]				1.7: 1
Ethiopia (2010-2013)[78]	5	3 (60%)	2 (40%)	1.5: 1
Kenya (1997-2005)[44]	22	11 (50%)	11 (50%)	1: 1

Table 4 Disease characteristics of neuroblastoma at diagnosis

Country	n	Stage 1	Stage 4	Non-MYCN amplified	MYCN amplified	Non-HR	HR
Asia
China (2008-2013)[17]	59	6.8%	37.3%	55%	45%	53%	47%
China (2000-2006)[18]	98	3%	50%
India (1990-2004)[19]	103	1%	71.8%
Pakistan (2015-2016)[20]	70	0%	79%				> 61.1%
South America
Argentina (2000-2012)[29]	753	12%	55.5%	80%	20%
Brazil (1991-2012)[30]	258	15%	46%	75%	25%
Brazil (1990-2000)[16]	125	7%	64%	53%	47%
Middle East and North Africa
Egypt (2005-2010)[23]	142	0%	64.7%			24.2%	75.8%
Egypt (2001-2010)[24]	53	0%	67.9%	79.2%	20.8%	32%	68%
Iran (1974-2005)[25]	219	14.5%	53.8%
Iraq (2008-2014)[26]	62	1.6%	69.4%			45.2%	54.8%
Sub-Saharan Africa
Kenya (1997-2005)[44]	26	0%	92.3%

HR: High-risk.

Table 5 Most common clinical presentations in low- and middle-income countries

Asia
China (2000-2006)[18]	Abd pain (73.5%)	Abd mass (54.1%)	Fever (45.9%)	Limb pain (25.5%)
India (1990-2004)[19]	Fever (65%)	Abd mass (54%)	Bone pain (31%)	Proptosis (27%)
South America
Brazil (1991-2012)[30]	Fever (25%)	Abd pain (22%)	Abd mass (19%)	Bone pain (19%)
Middle East and North Africa
Egypt (2005-2010)[23]	Abd mass (87%)	Pallor (57.6%)	Fever (45.5%)	Proptosis (42.4%)
Sub-Saharan Africa
Kenya (1997-2005)[44]	Abd mass (53.8%)	Bone pain (50%)	Proptosis (38.5%)	Fever (19.8%)