Kurz R, Mutz I, Pichler E
Wien Klin Wochenschr Suppl. 1977;67:16-22.
Within the last 20 years 56 children with neuroblastoma were seen at the Paediatric Departments of the University Hospitals of Graz, Innsbruck and Vienna. Case histories, clinical details and diagnostic procedures are discussed. The poor prognosis (only 18 out of the 56 children i.e. 32% are still alive) is due to the high incidence of metastasis (55% of the patients were admitted in stage IV of the disease). Diagnosis within the first year of life, mediastinal localization and histological differentialtion to ganglioneuroblastoma are good prognostic features, whereas therapeutic measures are of less importance. Radical surgery still provides the patient with the best chance of survival, but is rarely feasible (complete primary removal was possible in only 7 out of the 56 patients; in futher 2 patients the tumour proved to be resectable at a 2nd look operation). Cytostatic therapy has not really increased the survival rate. At present improvement in prognosis can only be expected in case of early diagnosis of the tumour.
在过去20年里,格拉茨、因斯布鲁克和维也纳大学医院儿科共收治了56例神经母细胞瘤患儿。本文讨论了这些患儿的病史、临床细节及诊断方法。预后较差(56例患儿中仅18例即32%存活)是由于转移发生率高(55%的患者确诊时已处于疾病IV期)。出生后第一年内确诊、肿瘤位于纵隔以及组织学上分化为神经节神经母细胞瘤是良好的预后特征,而治疗措施的影响较小。根治性手术仍然是患者获得最佳生存机会的方法,但很少可行(56例患者中仅7例能完全切除原发肿瘤;另有2例患者在二次手术时证实肿瘤可切除)。细胞抑制疗法并未真正提高生存率。目前,只有早期诊断肿瘤才有望改善预后。