Journal of Clinical Oncology, Vol 14, 1537-1544, Copyright © 1996 by American Society of Clinical Oncology

ARTICLES

Resection of primary tumor at diagnosis in stage IV-S neuroblastoma: does it affect the clinical course?

M Guglielmi, B De Bernardi, A Rizzo, S Federici, C Boglino, F Siracusa, A Leggio, F Cozzi, G Cecchetto, L Musi, T Bardini, AM Fagnani, GC Bartoli, A Pampaloni, D Rogers, M Conte, C Milanaccio and P Bruzzi
Department of Hematology-Oncology, Giannina Gaslini Children's Hospital, Genova, Italy.

PURPOSE: To determine whether resection of primary tumor has a favorable influence on outcome of infants (age 0 to 11 months) with stage IV-S neuroblastoma. PATIENTS AND METHODS: Between March 1976 and December 1993, 97 infants with previously untreated neuroblastoma diagnosed in 21 Italian institutions were classified as having stage IV- S disease. Seventy percent were younger than 4 months. Adrenal was the primary tumor site in 64 of 85 patients with a recognizable primary tumor. Liver was the organ most often infiltrated by the tumor (82 patients), followed by bone marrow and skin. RESULTS: The overall survival (OS) rate at 5 years in 80% and event-free survival (EFS) rate 68%. In 24 infants, the effect of resection of primary tumor could not be evaluated because of rapidly fatal disease progression (n = 8), absence of a primary tumor (n = 12), or partial resection (n = 4). Of 73 assessable patients, 26 underwent primary tumor resection at diagnosis: one died of surgical complications, one relapsed locally and died, and two others relapsed (one of these two locally) and survived, for a 5-year OS rate of 92% and EFS rate of 84%. Of the remaining 47 patients who did not undergo primary tumor resection at diagnosis 11 suffered unfavorable events, of whom five died, for an OS rate of 89% and EFS rate of 75% (no significant difference from previous group). Disease recurred at the primary tumor site in only one five who died, and in only one of six survivors of progression or relapse; in these patients, the primary tumor, located in the mediastinum, was successfully resected. CONCLUSION: Infants who underwent resection of the primary tumor at diagnosis had no better outcome than those in whom the decision was made not to operate.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				B. De Bernardi, M. Gerrard, L. Boni, H. Rubie, A. Canete, A. Di Cataldo, V. Castel, A. Forjaz de Lacerda, R. Ladenstein, E. Ruud, et al. Excellent Outcome With Reduced Treatment for Infants With Disseminated Neuroblastoma Without MYCN Gene Amplification J. Clin. Oncol., March 1, 2009; 27(7): 1034 - 1040. [Abstract] [Full Text] [PDF]

				G. Cecchetto, V. Mosseri, B. De Bernardi, P. Helardot, T. Monclair, E. Costa, E. Horcher, S. Neuenschwander, P. Toma, A. Rizzo, et al. Surgical Risk Factors in Primary Surgery for Localized Neuroblastoma: The LNESG1 Study of the European International Society of Pediatric Oncology Neuroblastoma Group J. Clin. Oncol., November 20, 2005; 23(33): 8483 - 8489. [Abstract] [Full Text] [PDF]

				B. H. Kushner Neuroblastoma: A Disease Requiring a Multitude of Imaging Studies J. Nucl. Med., July 1, 2004; 45(7): 1172 - 1188. [Abstract] [Full Text] [PDF]

				G. J. Lonergan, C. M. Schwab, E. S. Suarez, and C. L. Carlson From the Archives of the AFIP : Neuroblastoma, Ganglioneuroblastoma, and Ganglioneuroma: Radiologic-Pathologic Correlation RadioGraphics, July 1, 2002; 22(4): 911 - 934. [Abstract] [Full Text] [PDF]

				J. Mora, W. L. Gerald, J. Qin, and N.-K. V. Cheung Molecular Genetics of Neuroblastoma and the Implications for Clinical Management: A Review of the MSKCC Experience Oncologist, June 1, 2001; 6(3): 263 - 268. [Abstract] [Full Text] [PDF]

				H. J. Nickerson, K. K. Matthay, R. C. Seeger, G. M. Brodeur, H. Shimada, C. Perez, J. B. Atkinson, M. Selch, R. B. Gerbing, D. O. Stram, et al. Favorable Biology and Outcome of Stage IV-S Neuroblastoma With Supportive Care or Minimal Therapy: A Children’s Cancer Group Study J. Clin. Oncol., February 1, 2000; 18(3): 477 - 477. [Abstract] [Full Text] [PDF]