title: Case selection in minimally invasive surgical treatment of neuroblastoma.
abstract: OBJECTIVE
  The experience with minimally invasive surgery (MIS) in the treatment of neuroblastoma (NB) is anecdotal. The purpose of this study was to evaluate a retrospective cohort of NB patients who underwent MIS resection of their primary tumors.
  
  
  METHODS
  A retrospective study of NB patients who underwent MIS resection of their primary tumors over a 3-year period was undertaken. Study outcomes included complications, completeness of resection, and event-free and overall short-term survival.
  
  
  RESULTS
  Of a total of 21 children who underwent surgical resection for NB during the period of study, 8 (38%) underwent selected MIS resection. Six of the eight (75%) tumors were adrenal in origin and the remainder were located in the posterior mediastinum. Distribution by International Neuroblastoma Staging System (INSS) stage was: stage 1 (3), stage 2 (2), and stage 4 (3). One stage 4 tumor was N-myc amplified. All stage 4 patients experienced a >50% tumor volume cytoreduction in response to preoperative chemotherapy. All MIS resections were performed without need for blood transfusion, or conversion to open procedure, and there were no perioperative complications. All eight patients were alive and disease-free at a median 18-month follow-up.
  
  
  CONCLUSIONS
  With appropriate preoperative case selection based on anatomic features, MIS tumor resection in patients with NB can be performed safely and effectively.
authors: Division of Pediatric General Surgery, British Columbia Children's Hospital, Vancouver, Canada.
authors: John
authors: J
authors: Boutros
authors: Mason
authors: M
authors: Bond
authors: Paul
authors: P
authors: Beaudry
authors: Geoffrey K
authors: GK
authors: Blair
authors: Erik D
authors: ED
authors: Skarsgard
mesh_terms: D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008479:Mediastinal Neoplasms / Q000473:pathology / Q000601:surgery; D019060:Minimally Invasive Surgical Procedures; D020360:Neoadjuvant Therapy; D009447:Neuroblastoma / Q000473:pathology / Q000601:surgery*; D018579:Patient Selection; D012186:Retroperitoneal Neoplasms / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies