Resectability and operative morbidity after chemotherapy in neuroblastoma patients with encasement of major visceral arteries. Academic Article uri icon

Overview

abstract

  • BACKGROUND/PURPOSE: Image-defined vessel encasement is a significant risk factor for surgical complications and incomplete resection for intermediate-risk tumors. We sought to examine the impact of vessel encasement on complications or resectability in intermediate-risk or high-risk patients after neoadjuvant chemotherapy. METHODS: We retrospectively reviewed 207 consecutive patients with circumferential encasement of the renal vessels, celiac axis, and/or superior mesenteric artery (SMA) who underwent resection between 1991 and 2009. Specifically, we evaluated resection rates, complications, and outcome. RESULTS: Median age at diagnosis was 3.0 years, and 79% of patients had stage 4 disease. Of known MYCN status, 23.4% had MYCN amplification. Vessel encasement included renal vessels, celiac axis, or SMA alone in 107, 7, and 4 patients, respectively. Both the renal vessels and celiac axis were encased in 5 patients, renal vessels and SMA in 7 patients, and celiac axis and SMA in 14 patients. Sixty-three patients had all 3 vessels encased. The gross total resection (GTR) rate was 94%. No operative or postoperative deaths occurred. The overall complication rate was 34.8% (n = 72). Overall 5-year survival (± SEM) was 67.4% (± 7.4%). CONCLUSION: Encasement of major visceral arteries in patients with neuroblastoma who have received chemotherapy does not preclude gross total resection.

publication date

  • January 1, 2011

Research

keywords

  • Antineoplastic Agents
  • Chemotherapy, Adjuvant
  • Neoadjuvant Therapy
  • Neuroblastoma
  • Viscera

Identity

Scopus Document Identifier

  • 78751514516

Digital Object Identifier (DOI)

  • 10.1016/j.jpedsurg.2010.09.075

PubMed ID

  • 21238649

Additional Document Info

volume

  • 46

issue

  • 1