Image-defined risk factors for nephrectomy in patients undergoing neuroblastoma resection Journal Article

Authors: Lim, I. I. P.; Goldman, D. A.; Farber, B. A.; Murphy, J. M.; Abramson, S. J.; Basu, E.; Roberts, S.; LaQuaglia, M. P.; Price, A. P.
Article Title: Image-defined risk factors for nephrectomy in patients undergoing neuroblastoma resection
Abstract: Background: Although nephrectomy rates are higher in children with neuroblastoma who have image-defined risk factors and/or high-risk disease who undergo resection prior to chemotherapy, no published data outline the key radiographic and clinical characteristics associated with nephrectomy. Methods: With IRB approval, imaging studies of children undergoing primary resection of intraabdominal neuroblastoma between 2000 and 2014 were retrospectively reviewed. Fisher's exact and Wilcoxon rank-sum tests were used to compare categorical and continuous variables, respectively, with p-values adjusted for multiple testing using the false discovery rate approach. Results: Twenty-seven of 380 consecutive patients with CT imaging obtained prior to primary neuroblastoma resection underwent partial or total nephrectomy. On preoperative imaging, renal vessel narrowing and encasement and tumor invasion of the renal hilum, pelvis, and/or parenchyma were present significantly more frequently among patients undergoing nephrectomy. Delayed renal excretion of contrast, hydronephrosis, and tumors with MYCN amplification were also more prevalent in the nephrectomy group. Conclusion: Encasement and narrowing of renal vessels, delayed excretion, and tumor invasion into the kidney, particularly pelvis and capsule invasion, are significantly associated with partial or total nephrectomy at initial neuroblastoma resection. These observations provide valuable information for surgical planning as well as presurgical discussions with families prior to neuroblastoma resection. (C) 2016 Elsevier Inc. All rights reserved.
Keywords: chemotherapy; nephrectomy; partial nephrectomy; neuroblastoma; local-control; factors; renal-function; surgical complications; cancer; abdominal neuroblastoma; image defined risk; simulating wilms-tumor; pediatric nephrectomy
Journal Title: Journal of Pediatric Surgery
Volume: 51
Issue: 6
ISSN: 0022-3468
Publisher: W.B. Saunders Co-Elsevier Inc.  
Date Published: 2016-06-01
Start Page: 975
End Page: 980
Language: English
ACCESSION: WOS:000378908600021
DOI: 10.1016/j.jpedsurg.2016.02.069
PMCID: PMC4921302
PUBMED: 27015902
Notes: Article; Proceedings Paper -- 67th Annual Meeting of the Section-on-Surgery of the American-Academy-of-Pediatrics -- OCT 23-25, 2015 -- Washington, DC -- Source: Wos
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MSK Authors
  1. Anita P Price
    34 Price
  2. Ellen Marlese Basu
    34 Basu
  3. Stephen Stacy Roberts
    40 Roberts
  4. Debra Alyssa Goldman
    92 Goldman
  5. Jennifer Michelle Murphy
    11 Murphy
  6. Benjamin Asher Farber
    12 Farber