Should Renal Vessel Contact Be Considered an Image-Defined Risk Factor in Abdominal Neuroblastoma?

Area of Science:

• Pediatric Oncology
• Nephrology
• Radiology

Background:

• Renal vessel contact is an image-defined risk factor (IDRF) in neuroblastoma, impacting staging and treatment decisions.
• The clinical significance of renal vessel contact on renal outcomes and risk stratification requires further evaluation.

Purpose of the Study:

• To assess the impact of renal vessel contact on renal outcomes in children with abdominal neuroblastoma.
• To evaluate how renal vessel contact influences neuroblastoma staging and risk classification using current systems.

Main Methods:

• Retrospective review of pediatric patients with abdominal neuroblastoma and radiologic renal vessel contact.
• Analysis of staging and risk stratification using 2009 International Neuroblastoma Risk Group and 2021 Children's Oncology Group criteria.
• Retrospective reclassification analysis to determine the effect of excluding renal vessel contact as an IDRF.

Main Results:

• Of 59 patients, 44 had renal vessel contact as the sole IDRF. Excluding this factor reclassified 18 patients under both classification systems.
• No patient experienced nephrectomy or renal atrophy; one had transient renal ischemia.
• Long-term oncologic outcomes were favorable, with no events in reclassified patients and excellent survival rates.

Conclusions:

• Renal vessel contact alone does not lead to kidney loss or significant renal complications in neuroblastoma.
• Excluding renal vessel contact as an IDRF substantially alters neuroblastoma staging and risk stratification.
• Reconsideration of renal vessel contact as an independent IDRF in abdominal neuroblastoma is warranted.