Definitive Tumor Resection after Myeloablative High Dose Chemotherapy Is a Feasible and Effective Option in the Multimodal Treatment of High-Risk Neuroblastoma: A Single Institution Experience
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Read the article on jpedsurg.org ↗Article · Sep 2019 · 1 min read
In brief
In brief
Single-institution study comparing delayed tumor resection (after myeloablative chemotherapy) versus conventional early resection in 47 high-risk neuroblastoma patients. Delayed approach showed reduced surgical complications and less vascular encasement, supporting feasibility of deferring resection until after completion of intensive chemotherapy.
Written by the GCMD Library team from the article.
Background/Purpose
The delayed local treatment approach (DL) in high-risk neuroblastoma (HR-NB) refers to the process in which tumor resection is performed after the completion of all the courses of chemotherapy, including myeloablative high-dose chemotherapy (HDC). Alternatively, in the conventional local treatment approach (CL), tumor resection is performed during induction chemotherapy. In this study, we compared the surgical outcomes in HR-NB patients treated by CL and DL.
Method
Forty-seven patients with abdominal HR-NB underwent primary tumor resection from 2002 to 2018. The timing of surgery was generally determined by following the trials and guidelines available at the time. The outcomes and surgical complications between the two strategies were compared.
Result
Operation time, blood loss, and postoperative WBC counts were lower in the DL group (n = 25) when compared to the CL group (n = 22), statistical significance notwithstanding. Major vascular structures were less frequently encased in the DL group tumors, while immediate surgical complications were significantly more frequent in the CL group (P