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Experience with "second-look" operations in pediatric solid tumors.

J L Grosfeld, T V Ballantine, R L Baehner

    Journal of Pediatric Surgery
    |June 1, 1978
    PubMed
    Summary
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    Second-look operations improved outcomes for pediatric solid tumors, making 81% of initially unresectable or recurrent tumors resectable. This approach enhanced staging and treatment, achieving disease-free survival in 56% of patients.

    Area of Science:

    • Pediatric Oncology
    • Surgical Oncology
    • Cancer Treatment

    Background:

    • Many pediatric solid tumors are initially unresectable or recur after treatment.
    • Combination chemotherapy and irradiation are standard treatments for these advanced tumors.
    • The role of "second-look" operations in managing these complex cases requires further elucidation.

    Purpose of the Study:

    • To evaluate the efficacy and impact of "second-look" operations in pediatric patients with initially unresectable or recurrent solid tumors.
    • To assess the resectability rates, information gained, survival outcomes, and mortality associated with these procedures.

    Main Methods:

    • Retrospective analysis of 32 infants and children undergoing "second-look" operations after neoadjuvant chemotherapy and/or irradiation.

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  • Assessment of tumor resectability, staging information, disease-free survival, and causes of mortality.
  • Specific evaluation of benefits in Wilms' tumor, neuroblastoma, rhabdomyosarcoma, teratoma, and Ewing's sarcoma.

    • Main Results:

    • Tumors were resectable in 26 of 32 patients (81%).
    • Disease-free survival was achieved in 18 of 32 patients (56%).
    • Second-look procedures provided valuable staging and treatment information, particularly for Wilms' tumor, bilateral tumors, stage III neuroblastoma, and metastatic neuroblastoma responding to chemotherapy.

    Conclusions:

    • "Second-look" operations are beneficial in managing initially unresectable or recurrent pediatric solid tumors.
    • These procedures enhance treatment strategies and improve survival outcomes in selected pediatric cancer patients.
    • The increasing use of combination chemotherapy has expanded the applicability of "second-look" operations in pediatric oncology.