对于4s期神经母细胞瘤进展至4期且伴有弥漫性肝脏受累的患者，积极的局部治疗是否必要？

Is aggressive local treatment necessary for diffuse liver involvement in patients with progression of stage 4s neuroblastoma to stage 4?

作者信息

Heij Hugo A, Verschuur Arnauld C, Kaspers Gert-Jan L, van Rijn Rick R, Adam Judit A, Aronson Daniel C

机构信息

Pediatric Surgical Center of Amsterdam (Emma Children's Hospital AMC and VU University Medical Center), PO Box 22660, 1100 DD Amsterdam, The Netherlands.

出版信息

J Pediatr Surg. 2008 Sep;43(9):1630-5. doi: 10.1016/j.jpedsurg.2008.03.062.

DOI:10.1016/j.jpedsurg.2008.03.062

PMID:18778997

Abstract

Three patients with stage 4S neuroblastoma without MYC-N amplification who progressed to stage 4 with persistent liver involvement, were treated with iodine 131-meta-iodobenzylguanidine therapy, chemotherapy, and surgery. Successive histologic examination of the liver showed differentiation of the tumor in 2 patients and fibrosis in the third. One patient died of brain metastases at the age of 30 months. The other 2 patients are alive at 50 and 44 months. Diffuse liver involvement in patients with stage 4 progression of previous stage 4S without MYC-N amplification may differentiate after treatment. The aim of this report is to draw attention to major liver surgery that it may not be necessary in tumors without MYC-N amplification, despite the persistence of lesions in the liver.

摘要

3例4S期无MYC-N扩增的神经母细胞瘤患者进展为4期且肝脏持续受累，接受了碘131-间碘苄胍治疗、化疗和手术。对肝脏进行的连续组织学检查显示，2例患者的肿瘤出现分化，第3例出现纤维化。1例患者在30个月时死于脑转移。另外2例患者分别在50个月和44个月时仍存活。先前4S期无MYC-N扩增的患者进展为4期时出现的弥漫性肝脏受累在治疗后可能会分化。本报告的目的是提醒注意，对于无MYC-N扩增的肿瘤，尽管肝脏病变持续存在，但可能无需进行大型肝脏手术。