Experiences in the treatment of neuroblastoma

The clinical presentation, diagnosis and treatment of a series of 18 cases of neuroblastoma is reviewed. About half the patients were below the age of 2 years. Fever, loss of weight and appetite appeared to be the common manifestations, underscoring the vague and non-specific symptomatology of such a grave childhood disorder. Unusual presentations included paraplegia, chronic diarrhoea, lower limb edema and respiratory distress. Management consisted of radical surgery with adjunctive chemotherapy where indicated. It is emphasised that in resectable lesions every attempt must be made to remove tumour involved tissue as thoroughly as possible. With this approach 50% of patients followed up to 4 years have survived. Comparison of characteristics of survivors against non-survivors showed that the only significant difference was in the state of the disease--survivors having generally earlier state tumours.