An Evaluation of Its Natural History and the Effects of Therapy,

The problem of cancer in childhood assumes increasing importance as other formerly killing diseases, notably infections, have been to a large extent conquered. In recent years malignant neoplastic disease has accounted for 15 to 20% of deaths from natural causes in children between the ages of I to 14 years in England and Wales, and similar figures have been obtained from other countries, including the U.S.A. and France. Tumours arising from the sympathetic nervous system, i.e. neuroblastoma, ganglioneuroma and phaeochromocytoma, accounted for roughly 10% of neoplasms seen at The Hospital for Sick Children during the period from 1925 to 1962 inclusive. The other major figures were about 36 % leukaemia, 25 % intracranial neoplasms and 7 5 % nephroblastoma. The total number involved during the quoted period was about 1,800. The following remarks in this paper will be entirely concerned with sympathetic nervous system tumours, and in particular with neuroblastoma. In the period from 1925-1962 inclusive the number of verified cases of neuroblastoma was 165, that of ganglioneuroma, 18 and of phaeochromocytoma, one. Age and Sex Incidence The great majority (133) of affected children presented with symptoms during the first four years of life, and the first year of life (infancy) accounted for 63. The sex distribution was about equal; 79 male (47 9 %), 86 female (52 l %).