[Impact of complete resection on survival of patients with large neuroblastoma].
The aim of our study is to assess the role of complete resection after chemotherapy in stage 3 and 4 (INSS) neuroblastoma.


METHODS
We treated in the period 1990-1997 a group of 71 infants and children with neural tumors. There were 63 neuroblastomas (median age: 24.8 +/- 25 months, median 18). 47 were abdominal, 13 thoracic, 2 pelvic and 1 cervical. Survival rate (Kaplan-Meier) in patients with or without complete resection of the tumor were assessed (Mantel Cox).


RESULTS
14 of 17 patients with stage 3 tumors and only 8 of 23 with stage 4 survive. All patients with stage 3 undergoing complete resection are alive, whereas only 4 of 7 with incomplete resection survive (p < 0.01). In contrast, the effort and risk of resection do not appear to be worth in stage 4. Two kidneys, one spleen and a portion of the pancreas were removed to perform complete tumor removal.


CONCLUSIONS
Complete resection in stage 3 neuroblastoma after chemotherapy improves survival, and radical surgery seems justified even if neighboring structures have to be removed. Radical surgery does not seem to be useful in stage 4 neuroblastoma.
Lobato
R
R
Departamento de Cirugía Pediátrica, Hospital Infantil La Paz, Madrid.
Queizán
A
A
Martínez
L
L
Díaz
M
M
Gámez
M
M
Tovar
J A
JA
D002675:Child, Preschool; D005729:Ganglioneuroma / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate