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Role of surgery in delayed local treatment for INSS 4 neuroblastoma
Author(s) -
Uehara Shuichiro,
Yoneda Akihiro,
Oue Takaharu,
Nakahata Kengo,
Zenitani Masahiro,
Miyamura Takako,
Hashii Yoshiko,
Fukuzawa Masahiro,
Okuyama Hiroomi
Publication year - 2017
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.13349
Subject(s) - medicine , surgery , period (music) , resection , neuroblastoma , waiting period , toxicology , physics , biology , acoustics , genetics , cell culture
Background The aim of the present study was to compare the efficacy, complications and outcomes of the following two surgical strategies for delayed local treatment for International Neuroblastoma Staging System ( INSS ) 4 neuroblastoma ( NB ): complete resection ( CR ; period A); and gross total resection/subtotal resection ( GTR / STR ) with local irradiation (period B). Methods We retrospectively analyzed 17 patients with INSS 4 NB who received delayed local treatment (period A, n = 11; period B, n = 6). Results Eleven patients in period A received CR . Two patients underwent GTR and four patients underwent STR in period B. The amount of blood loss in period A was significantly greater than that in period B. Postoperative complications were observed in eight patients in period A (73%), but in only one patient in period B (17%; P < 0.01). Recurrence was observed in five patients in period A and in one patient in period B (45.4% vs 16.6%; P = n.s.). Distant metastasis at recurrence was observed in four patients in period A and in one patient in period B. Conclusions Gross total resection/subtotal resection with local irradiation may be a safe and effective delayed local treatment for INSS 4 NB .