[Risk and benefits of surgical interventions in localized neuroblastoma--experiences from cooperative studies in Germany].

Current therapy strategies for localized neuroblastomas are mainly based on surgical procedures. In our analysis of 657 patients with localized neuroblastomas (mean follow-up: 6.2 years), the extent of surgical removal predicted outcome (complete resection: 0.91 +/- 0.02; partial resection: 0.79 +/- 0.04; biopsy 0.49 +/- 0.11). But for stage 2/II (0.96 +/- 0.02 vs. 0.91 +/- 0.06) and stage 3/III tumors (0.82 +/- 0.04 vs. 0.78 +/- 0.04) no difference in survival was seen between complete and partial resection of the primary tumor. Outcome was worse in stage 3/III patients who underwent biopsy only (0.48 +/- 0.11). Complications were seen after 20% of 853 surgical procedures, sometimes requiring second operations (n = 29) or leading to death (n = 11). Infants were especially at risk from complications: eight infants died of complications. Looking at these results, extended surgical procedures should be avoided to minimize the risk for the patient.