[Evaluation of second-look operations in neuroblastoma]

The roles of surgery in the treatment of neuroblastoma differ significantly according to the stage of the disease and the age of patients. Infantile neuroblastoma has high resectability and shows a favorable outcome. Moreover, infants with nonresectable neuroblastoma also have a fairly good prognosis after an appropriate treatment. Extensive local resection for tumor eradication with high surgical risk should not be performed in infants with neuroblastoma at the initiation of the treatment. Delayed surgery should be considered in such cases. The principle of the treatment for children more than 1 year of age with advanced neuroblastoma consists of intensive anticancer chemotherapy followed by delayed surgery for complete resection of the original tumor and the regional lymph nodes. Complete response of the remote metastases to the chemotherapy at surgery has been proved to be a clue for cure of the diseases. Initial surgery for reduction of the tumor burden has no advantages for the ultimate survival of the patients with advanced diseases.