title: [Evaluation of the role of surgery in 25 patients with metastatic neuroblastoma].
abstract: The role of surgery was evaluated using a recently proposed TNM staging system in metastatic neuroblastomas. Of twenty-five patients, twenty-four were over 1 year, 1 case was 3 months old, nine were boys, sixteen were girls, and all were stage IV using Evans-D'Angio staging system (excluding IV-s). They were retrospectively assigned a TNM clinical stage (CS) preoperatively and a pathologic stage (PS) postoperatively. All twenty-five patients were CS 4 using this TNM staging system. The role of surgery was evaluated by analyzing survival according to the postoperative PS. PS 1-2-3A were regarded as satisfactory resections, since all macroscopic tumor was removed, while PS 3B-3C-4-5 were regarded as unsatisfactory resections. With Kaplan-Meier analysis, there was a slight survival advantage when satisfactory resection of the primary tumor was achieved in the cases with any evidence of metastasis at the time of operation. However, in the cases with no evidence of metastasis at operation, there was a survival advantage when satisfactory resection of the primary tumor was done (p = 0.05). If metastatic disease is controlled prior to operation, total resection improves prognosis of metastatic neuroblastoma.
authors.affiliation: Dept. of Pediatrics, Sapporo National Hospital.
authors.forename: H
authors.initials: H
authors.lastname: Nakadate
authors.forename: T
authors.initials: T
authors.lastname: Kishino
authors.forename: Y
authors.initials: Y
authors.lastname: Ogawa
authors.forename: Y
authors.initials: Y
authors.lastname: Hatayama
authors.forename: Y
authors.initials: Y
authors.lastname: Hatae
authors.forename: T
authors.initials: T
authors.lastname: Takeda
authors.forename: H
authors.initials: H
authors.lastname: Naitoh
authors.forename: M
authors.initials: M
authors.lastname: Sasaki
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008479:Mediastinal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D009362:Neoplasm Metastasis; D009447:Neuroblastoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012186:Retroperitoneal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D015996:Survival Rate