title: [Neuroblastoma. Tumor rupture as an unfavorable prognostic factor].
abstract: Since there is little information regarding the possible prognostic significance of tumor rupture in localized neuroblastoma, we have analyzed the clinical courses of 163 children registered from 1979-1990 in 12 italian pediatric oncology Centers participating in the Neuroblastoma Cooperative Group of the A.I.E.O.P. (Italian Association for Paediatric Haematology-Oncology). Ten instances (6%) of tumor rupture were described. Ruptures occurred preoperatively in one child, during the operation in 9; among these 9, two were provoked by the surgeon to allow radical tumor excision, 7 were accidental. Of these 10 children, 7 relapsed at 3-25 months (median, 8 months) from diagnosis. Relapses were local in 5 children (2 of the 5 died), disseminated in one (who died), local + disseminated in one (presently alive with disease). Two local relapses were followed by bony or haematologic spread at 4 and 8 months, respectively. Of the 7 children who relapsed, 2 are alive in complete remission at 29, 100 months, respectively; two are alive with disease at 3 and 65 months, 3 died at 8, 15 and 24 months, respectively. We conclude that rupture of a localized neuroblastoma is a factor predisposing to relapse and may compromise the chance of cure. The surgeon should be aware of the risks connected with this complication and make any effort to avoid it.
authors.affiliation: Clinica Pediatrica, Istituto Burlo Garofalo, Trieste, Italia.
authors.forename: M
authors.initials: M
authors.lastname: Mascarin
authors.forename: B
authors.initials: B
authors.lastname: De Bernardi
authors.forename: M
authors.initials: M
authors.lastname: Brisigotti
authors.forename: G P
authors.initials: GP
authors.lastname: Cuneo
authors.forename: M
authors.initials: M
authors.lastname: Conte
authors.forename: A
authors.initials: A
authors.lastname: Taccone
authors.forename: P
authors.initials: P
authors.lastname: Tamaro
authors.forename: R
authors.initials: R
authors.lastname: Boldrini
mesh_terms: D000008:Abdominal Neoplasms / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009364:Neoplasm Recurrence, Local; D009447:Neuroblastoma / Q000401:mortality* / Q000503:physiopathology*; D011379:Prognosis; D012422:Rupture, Spontaneous; D013899:Thoracic Neoplasms / Q000503:physiopathology
vernacular_title: Neuroblastoma. Rottura tumorale come fattore prognosticamente sfavorevole.