Hata Y, Naito H, Sasaki F, Ohkawa M, Takeda T, Sasaki M, Uchino J
First Department of Surgery, University of Hokkaido School of Medicine, Sapporo, Japan.
J Pediatr Surg. 1990 Mar;25(3):326-9. doi: 10.1016/0022-3468(90)90078-n.
Our policy of preoperative and postoperative adjuvant therapy of advanced neuroblastoma changed from mild to aggressive chemotherapy in 1978. In order to evaluate the clinical effects of this policy, 39 cases before 1977 and 37 cases after 1978 were retrospectively reviewed using the Evans and the International Union Against Cancer (UICC) staging systems. Both clinical stages (CS) and postsurgical histopathological stages (PS) of the UICC staging system showed an almost 100% cure rate in stages I (CSI, PSI) and II (CSII, PSII). The cure rates of CS III, PS IIIA, and PS IIIB cases were remarkably improved after 1978, but those of CS IV and PS IV cases remained extremely low. However, it was found that a disease-free survival rate of advanced neuroblastoma could be produced by complete resection of the tumor accompanied by adjuvant chemotherapy. In these conditions, we found that for predicting the prognosis of advanced neuroblastoma, the UICC staging system, especially the PS staging system, may be more rational than the Evans staging system.
我们对晚期神经母细胞瘤的术前和术后辅助治疗策略在1978年从温和化疗转变为积极化疗。为了评估该策略的临床效果，我们使用埃文斯分期系统和国际抗癌联盟（UICC）分期系统对1977年之前的39例病例和1978年之后的37例病例进行了回顾性分析。UICC分期系统的临床分期（CS）和术后组织病理学分期（PS）在I期（CSI、PSI）和II期（CSII、PSII）显示出几乎100%的治愈率。1978年之后，CS III、PS IIIA和PS IIIB病例的治愈率显著提高，但CS IV和PS IV病例的治愈率仍然极低。然而，我们发现通过肿瘤的完全切除并辅以辅助化疗，可以提高晚期神经母细胞瘤的无病生存率。在这些情况下，我们发现，对于预测晚期神经母细胞瘤的预后，UICC分期系统，尤其是PS分期系统，可能比埃文斯分期系统更合理。
