Clinical characteristics and survival outcomes of surgically managed prenatally diagnosed neuroblastoma: a single-center, real-world study

With the advancement of ultrasound technology, prenatally diagnosed neuroblastoma (PNB) has become increasingly common. However, knowledge of this particular case remains limited and is usually confined to individual case reports. There is still a lack of research on the clinical characteristics, treatment-related complications, long-term abnormal health problems and quality of life (QoL) of patients with PNB. This retrospective study included 49 patients with PNB treated at a tertiary center between 2012 and 2025 and 102 cases from 32 prior studies (total n = 151). Collected data encompassed demographics, tumor characteristics, treatment methods, complications, and survival outcomes. And conduct follow-up evaluations on the patient’s treatment outcome, long-term health status, and QoL. PNB originated predominantly in the adrenal glands (83.7%), with 63.3% classified as low-risk. Metastasis occurred in 30.6% of cases, primarily involving the liver (80%). MYCN amplification was rare (6.1%), and elevated 24-hour urinary vanillylmandelic acid (VMA) levels were present in only 10.2% of cases. Five-year overall survival (OS) and event-free survival (EFS) rates reached 93.3% and 86.8%, respectively. Survivors had few long-term health problems and QoL scores were comparable to those of healthy children. A comprehensive analysis of 151 patients showed a survival rate of 93.4%, further confirming that PNB has a favorable prognosis. This study is the largest retrospective cohort analysis of PNB to date. It systematically summarizes the clinical characteristics of PNB patients and demonstrates their favorable prognosis and QoL. Furthermore, the findings provide critical evidence to guide risk-stratified management and prenatal counseling.