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Eur J Pediatr Surg 2016; 26(01): 117-122
DOI: 10.1055/s-0035-1566100
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Can Image-Defined Risk Factors Predict Surgical Complications in Localized Neuroblastoma?

Akihiro Yoneda
1   Department of Paediatric Surgery, Osaka City General Hospital, Osaka, Japan
,
Masanori Nishikawa
2   Department of Radiology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan
,
Shuichiro Uehara
3   Department of Paediatric Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
,
Takaharu Oue
4   Department of Paediatric Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
,
Noriaki Usui
5   Department of Paediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan
,
Masami Inoue
6   Department of Paediatric Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan
,
Masahiro Fukuzawa
5   Department of Paediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan
,
Hiroomi Okuyama
3   Department of Paediatric Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
› Author Affiliations
Further Information

Publication History

25 May 2015

11 September 2015

Publication Date:
03 November 2015 (online)

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Abstract

Introduction Image-defined risk factors (IDRFs) have been propounded for predicting the surgical risks associated with localized neuroblastoma (NB) since 2009. In 2011, a new guideline (NG) for assessing IDRFs was published. According to the NG, the situation in which “the tumor is only in contact with renal vessels,” should be considered to be “IDRF-present.” Previously, this situation was diagnosed as “IDRF absent.” In this study, we evaluated the IDRFs in localized NB patients to clarify the predictive capability of IDRFs for surgical complications, as well as the usefulness of the NG.

Materials and Methods A total of 107 localized patients with NB were included in this study. The enhanced computed tomography and magnetic resonance images from the time of their diagnoses were evaluated by a single radiologist. We also analyzed the association of clinical factors, including the IDRFs (before and after applying the NG), with surgical complications.

Results Of the 107 patients, 33 and 74 patients were diagnosed as IDRF-present (OP group), and IDRF-absent (ON group) before the NG, respectively. According to the NG, there were 76 and 31 patients who were classified as IDRF-present (NP group) and IDRF absent (NN group), respectively. Thus, 43 (40%) patients in the ON group were reassigned to the NP group after the NG. Surgical complications were observed in 17 of 82 patients who underwent surgical resection. Of the patients who underwent secondary operations, surgical complication rates were 55% in the OP group and 44% in the NP group. According to a univariate analysis, non-INSS 1, IDRFs before and after the NG and secondary operations were significantly associated with surgical complications. In a multivariate analysis, non-INSS 1 status and IDRFs after the NG were significantly associated with surgical complications.

Keywords

neuroblastoma - image-defined risk factor - surgical complication - new guideline
 

  • References

  • 1 Cohn SL, Pearson AD, London WB , et al; INRG Task Force. The International Neuroblastoma Risk Group (INRG) classification system: an INRG Task Force report. J Clin Oncol 2009; 27 (2) 289-297
    CrossrefPubMedGoogle Scholar
  • 2 Evans AE, Silber JH, Shpilsky A, D'Angio GJ. Successful management of low-stage neuroblastoma without adjuvant therapies: a comparison of two decades, 1972 through 1981 and 1982 through 1992, in a single institution. J Clin Oncol 1996; 14 (9) 2504-2510
    PubMedGoogle Scholar
  • 3 Ikeda H, Iehara T, Tsuchida Y , et al. Experience with International Neuroblastoma Staging System and Pathology Classification. Br J Cancer 2002; 86 (7) 1110-1116
    CrossrefPubMedGoogle Scholar
  • 4 Matthay KK, Perez C, Seeger RC , et al. Successful treatment of stage III neuroblastoma based on prospective biologic staging: a Children's Cancer Group study. J Clin Oncol 1998; 16 (4) 1256-1264
    PubMedGoogle Scholar
  • 5 Perez CA, Matthay KK, Atkinson JB , et al. Biologic variables in the outcome of stages I and II neuroblastoma treated with surgery as primary therapy: a children's cancer group study. J Clin Oncol 2000; 18 (1) 18-26
    PubMedGoogle Scholar
  • 6 Rubie H, Hartmann O, Michon J , et al. N-Myc gene amplification is a major prognostic factor in localized neuroblastoma: results of the French NBL 90 study. Neuroblastoma Study Group of the Société Francaise d'Oncologie Pédiatrique. J Clin Oncol 1997; 15 (3) 1171-1182
    PubMedGoogle Scholar
  • 7 Monclair T, Brodeur GM, Ambros PF , et al; INRG Task Force. The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report. J Clin Oncol 2009; 27 (2) 298-303
    CrossrefPubMedGoogle Scholar
  • 8 Brisse HJ, McCarville MB, Granata C , et al; International Neuroblastoma Risk Group Project. Guidelines for imaging and staging of neuroblastic tumors: consensus report from the International Neuroblastoma Risk Group Project. Radiology 2011; 261 (1) 243-257
    CrossrefPubMedGoogle Scholar
  • 9 Hiyama E, Iehara T, Sugimoto T , et al. Effectiveness of screening for neuroblastoma at 6 months of age: a retrospective population-based cohort study. Lancet 2008; 371 (9619) 1173-1180
    CrossrefPubMedGoogle Scholar
  • 10 Simon T, Hero B, Benz-Bohm G, von Schweinitz D, Berthold F. Review of image defined risk factors in localized neuroblastoma patients: Results of the GPOH NB97 trial. Pediatr Blood Cancer 2008; 50 (5) 965-969
    CrossrefPubMedGoogle Scholar