Abstract:
BACKGROUND:It remains unclear whether primary tumor resection benefits patients with metastatic neuroblastoma. The authors assessed the impact of extent and timing of resection on outcome in these patients. METHODS:The authors reviewed the records of 124 patients > 1 year of age at diagnosis of International Neuroblastoma Staging System Stage 4 neuroblastoma. The survival estimates of those who did and did not have a gross total resection (GTR) and of those who had initial versus delayed GTR were compared. Surgical complications were reviewed. RESULTS:The 5-year survival estimates were comparable for the 90 patients who had a GTR and the 17 who underwent surgery but did not have a GTR (29.9% +/- 5.1% [standard error] vs. 29.4% +/- 10.1%). The 7 patients who underwent GTR at the time of diagnosis had a higher 5-year survival estimate than the 83 patients who had a GTR after induction chemotherapy (83.3% +/- 13.9% vs. 25.2% +/- 5.0%) (P = 0.001). Five-year event-free survival estimates were similarly higher in the initial-GTR group (57.1% +/- 18.7% vs. 14.5% +/- 4.2%) (P = 0.002). These two groups did not differ significantly in age at diagnosis (P = 0.118), site of primary tumor (P = 0.34), MYCN amplification status (P = 1), serum lactate dehydrogenase activity at diagnosis (P = 0.34), or treatment protocol (P = 0.22). Twenty-two (21%) patients had a surgical complication. CONCLUSIONS:In this small cohort of patients with metastatic neuroblastoma, GTR at the time of diagnosis offered a survival benefit. Further prospective studies are warranted before this approach can be applied to all patients with metastatic neuroblastoma.
journal_name
Cancerjournal_title
Cancerauthors
McGregor LM,Rao BN,Davidoff AM,Billups CA,Hongeng S,Santana VM,Hill DA,Fuller C,Furman WLdoi
10.1002/cncr.21566subject
Has Abstractpub_date
2005-12-15 00:00:00pages
2837-46issue
12eissn
0008-543Xissn
1097-0142journal_volume
104pub_type
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