Long-term follow-up status of patients with neuroblastoma after undergoing either aggressive surgery or chemotherapy--a single institutional study.
OBJECTIVE
Before adopting a national protocol of aggressive chemotherapy for patients with advanced neuroblastoma in 1985, the treatment strategies in use varied considerably among the institutions in Japan. An aggressive surgical resection was the treatment of choice at the authors' institution before 1985. To better understand treatment-related complications, the authors retrospectively investigated the long-term morbidity of patients who had reached adulthood.


METHODS
Sixteen patients with neuroblastoma currently 18 years of age or older were incorporated into the study. All were non-mass screening cases, and 13 of the patients had undergone aggressive surgery, whereas the remaining 3 cases had received aggressive chemotherapy.


RESULTS
In the 13 patients who had undergone aggressive surgical treatment, a unilateral atrophy of the kidney was noted in 2 cases of adrenal and retroperitoneal neuroblastomas, respectively. Dry ejaculation was noted in one case of a giant presacral neuroblastoma. A maldevelopment of the unilateral lower extremity was also noted in another case with a presacral tumor, which had been resected by abdominal and sacral approaches. In the 3 patients who had undergone aggressive chemotherapy, severe hearing loss occurred in 2 cases. However, social adaptation was well preserved in all 16 cases.


CONCLUSIONS
Treatment-specific complications were found in both the aggressive surgery and chemotherapy groups. These results should, therefore, be taken into account when developing future treatment protocols.
Kubota
Masayuki
M
Department of Pediatric Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Yagi
Minoru
M
Kanada
Satoshi
S
Okuyama
Naoki
N
Kinoshita
Yoshiaki
Y
Yamazaki
Satoru
S
Asami
Keiko
K
Ogawa
Atsushi
A
Watanabe
Teruhiro
T
D000310:Adrenal Gland Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D000315:Adrenalectomy; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001284:Atrophy; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage; D004542:Ejaculation; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000139:chemically induced; D006801:Humans; D007223:Infant; D007668:Kidney / Q000473:pathology; D007870:Leg Length Inequality / Q000209:etiology; D008197:Lymph Node Excision; D009447:Neuroblastoma / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D010386:Pelvic Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D011832:Radiation Injuries; D018714:Radiotherapy, Adjuvant; D012074:Remission Induction; D012186:Retroperitoneal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D017741:Survivors; D016896:Treatment Outcome
D004317:Doxorubicin; D002945:Cisplatin