Czerwiński W, Ordyniec J
Probl Med Wieku Rozwoj. 1982;11:231-6.
In advanced stages of neuroblastoma, surgical management is limitedly indicated. In majority of cases (25/26 in own material) surgical procedures were performed for the sake of receiving samples for pathological examination. Surgical treatment was very rarely indicated. The only one case of neuroblastoma in stage IV that was indicated to surgical treatment after complete remission of metastases, the child died in spite of radical excision of the primary tumour. The reason of that was new metastases in distant lymphonodes which appeared when complex therapy was finished. A little larger indications for surgery exist in stage IV-S of neuroblastoma, which gives better prognosis than stage IV. Anyhow indications for surgery in stages IV and IV-S have to be given very cautiously. Histopathological evaluation can be done on the basis of fine needle biopsy, that is much safer for the children.
在神经母细胞瘤的晚期，手术治疗的指征有限。在大多数病例中（我们自己资料中的25/26例），进行手术是为了获取病理检查样本。很少有手术治疗的指征。唯一一例IV期神经母细胞瘤患者在转移灶完全缓解后接受了手术治疗，尽管对原发肿瘤进行了根治性切除，但患儿仍死亡。原因是在综合治疗结束时出现了远处淋巴结的新转移灶。神经母细胞瘤IV-S期的手术指征稍多一些，其预后比IV期要好。无论如何，IV期和IV-S期的手术指征必须非常谨慎地给出。组织病理学评估可以基于细针穿刺活检进行，这对儿童来说要安全得多。
