Efficacies of surgery alone for patients with low-risk neuroblastoma

Abstract

Objective To evaluate the immediate efficacies of surgery alone for patients with low-risk neuroblastoma and examine the importance of risk groups so as to provide rationales for standardized treatment of neuroblastoma and reducing the intensity of treatment. Methods A retrospective review was conducted for 24 neuroblastoma patients with low risk group between January 2009 and December 2012. There were 13 males and 11 females with a mean age of 38.6 months (5 days to 158 months). The sites were posterior mediastinum (n=7), adneral (n=13), retroperitoneal (n=3) and neck (n=1). According to INSS, the stages were I (n=19) and IIa (n=5). According to Shimada pathology classification, there were neuroblastoma (n=16) and gangliocytoma (n=8). All cases were negative for N-myc gene amplification. Results All primary tumors were completely resected. Five cases of adneral tumor were completely resected by laparoscopic and another 2 cases were explored laparoscopically. Recurrence was observed in 4 cases. Except for one case of local recurrence in neck, there were mediastinal (n=2) and retroperitoneal (n=1) metastases. The follow-up period was 8-50 months. All patients survived, including 21 cases of tumor-free survival. Conclusions For low-risk group neuroblastoma, surgery alone and regular follow-ups are efficacious and may reduce the treatment-related complications. For recurrent cases, salvage chemotherapy and re-operation can cure and control tumor progression. Key words: Neuroblastoma; Surgical procedures, operative; Treatment outcome