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Role of surgery in delayed local treatment for INSS 4 neuroblastoma
Shuichiro Uehara1, Akihiro Yoneda2, Takaharu Oue1
1Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
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.
