Resectability and operative morbidity after chemotherapy in neuroblastoma patients with encasement of major visceral arteries Journal Article
| Authors: | Rich, B. S.; McEvoy, M. P.; Kelly, N. E.; Oh, E.; Abramson, S. J.; Price, A. P.; Cheung, N. K. V.; La Quaglia, M. P. |
| Article Title: | Resectability and operative morbidity after chemotherapy in neuroblastoma patients with encasement of major visceral arteries |
| Abstract: | Background/Purpose: Image-defined vessel encasement is a significant risk factor for surgical complications and incomplete resection for intermediate-risk tumors. We sought to examine the impact of vessel encasement on complications or resectability in intermediate-risk or high-risk patients after neoadjuvant chemotherapy. Methods: We retrospectively reviewed 207 consecutive patients with circumferential encasement of the renal vessels, celiac axis, and/or superior mesenteric artery (SMA) who underwent resection between 1991 and 2009. Specifically, we evaluated resection rates, complications, and outcome. Results: Median age at diagnosis was 3.0 years, and 79% of patients had stage 4 disease. Of known MYCN status, 23.4% had MYCN amplification. Vessel encasement included renal vessels, celiac axis, or SMA alone in 107, 7, and 4 patients, respectively. Both the renal vessels and celiac axis were encased in 5 patients, renal vessels and SMA in 7 patients, and celiac axis and SMA in 14 patients. Sixty-three patients had all 3 vessels encased. The gross total resection (GTR) rate was 94%. No operative or postoperative deaths occurred. The overall complication rate was 34.8% (n = 72). Overall 5-year survival (±SEM) was 67.4% (±7.4%). Conclusion: Encasement of major visceral arteries in patients with neuroblastoma who have received chemotherapy does not preclude gross total resection. © 2011 Elsevier Inc. All rights reserved. |
| Keywords: | adolescent; adult; child; preschool child; school child; treatment outcome; major clinical study; overall survival; cancer adjuvant therapy; antineoplastic agent; computer assisted tomography; gene amplification; kidney disease; morbidity; retrospective study; risk factor; high risk patient; postoperative complication; survival time; infant; neuroblastoma; surgical risk; oncogene c myb; gastrointestinal disease; vascular disease; resectability; vessel encasement; celiac artery; intermediate risk patient; kidney artery; postoperative thrombosis; retroperitoneal abscess; superior mesenteric artery |
| Journal Title: | Journal of Pediatric Surgery |
| Volume: | 46 |
| Issue: | 1 |
| ISSN: | 0022-3468 |
| Publisher: | W.B. Saunders Co-Elsevier Inc. |
| Date Published: | 2011-01-01 |
| Start Page: | 103 |
| End Page: | 107 |
| Language: | English |
| DOI: | 10.1016/j.jpedsurg.2010.09.075 |
| PROVIDER: | scopus |
| PUBMED: | 21238649 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 4 March 2011" - "CODEN: JPDSA" - "Source: Scopus" |
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