Qureshi Sajid S, Bhagat Monica, Harris Caleb, Chinnaswamy Girish, Vora Tushar, Kembhavi Seema, Prasad Maya, Ramadwar Mukta, Shetty Omshree, Laskar Siddharth, Khanna Nehal, Amin Nayna, Talole Sanjay
Division of Pediatric Surgical Oncology, Department of Surgical Oncology, Tata Memorial Centre, Ernest Borges Road, Parel, Bombay, 400012, India.
Division of Pediatric Oncology, Department of Medical Oncology, Tata Memorial Centre, Bombay, India.
Pediatr Surg Int. 2018 Apr;34(4):435-442. doi: 10.1007/s00383-018-4241-5. Epub 2018 Feb 27.
The treatment of intermediate risk (IR) neuroblastoma has evolved with the focus now on reducing the drugs, dosage, and duration of chemotherapy. The aim of this study is to present the outcomes of treatment and the complications of surgery in patients with IR neuroblastoma treated at a tertiary cancer center in India.
All eligible patients with IR neuroblastoma treated between April 2005 and August 2016 were identified. The presence and number of image-defined risk factors (IDRF) before and after neoadjuvant chemotherapy were retrospectively analyzed as were the extent of surgery, complications, and outcomes.
Of 282 neuroblastoma patients treated during the study period, 54 had IR neuroblastoma. Complete excision was achieved in 25 patients. There were 26 surgical complications in 22 patients with a similar incidence in patients with complete (n = 13) or incomplete (n = 13) resection (p = 0.78). After a median follow-up of 47 months, the 4-year overall and event-free survival was 91.5% and 75%, respectively. There was no difference in survival between patients who underwent complete resection versus those with incomplete resection (p = 0.9).
Outcomes of IR neuroblastoma are favorable. The extent of resection does not affect the survival and complications can occur even when the resection is incomplete.
中危（IR）神经母细胞瘤的治疗方法不断演变，目前重点在于减少化疗药物、剂量及疗程。本研究旨在呈现印度一家三级癌症中心治疗的IR神经母细胞瘤患者的治疗结果及手术并发症。
确定2005年4月至2016年8月期间接受治疗的所有符合条件的IR神经母细胞瘤患者。回顾性分析新辅助化疗前后影像定义的危险因素（IDRF）的存在情况及数量，以及手术范围、并发症和治疗结果。
在研究期间治疗的282例神经母细胞瘤患者中，54例为IR神经母细胞瘤。25例患者实现了完整切除。22例患者出现26例手术并发症，完整切除（n = 13）和未完整切除（n = 13）的患者发生率相似（p = 0.78）。中位随访47个月后，4年总生存率和无事件生存率分别为91.5%和75%。完整切除患者与未完整切除患者的生存率无差异（p = 0.9）。
IR神经母细胞瘤的治疗结果良好。切除范围不影响生存率，即使切除不完整也可能发生并发症。
