title: Late sequelae of symptomatic epidural compression in children with localized neuroblastoma.
abstract: BACKGROUND
  To describe late sequelae and their correlation with presenting clinical features and tumor treatment in children with symptomatic epidural compression (EC) secondary to localized neuroblastoma.
  
  
  METHODS
  A total of 98 evaluable children diagnosed with neuroblastoma and EC, who survived a minimum of 2 years were identified in two Italian and French neuroblastoma series.
  
  
  RESULTS
  Symptoms of EC at diagnosis included motor deficit in 94 cases and sphincter deficits in 33. Initial treatment was chemotherapy in 66 cases, neurosurgical decompression in 29 and radiotherapy in 3. Chemotherapy was chosen more frequently for younger children and for those with stage 3 disease. Overall treatment consisted of chemotherapy alone in 44 cases, neurosurgery and chemotherapy in 38, radiotherapy and chemotherapy, with or without neurosurgery, in 16. After a median follow-up of 7.3 years, 57 children (58.2%) had one or more sequelae. Motor sequelae involved 50/57 of these children and correlated with age and severity of motor deficit at diagnosis and neurosurgical treatment. Spine deformities involved 27/57 children and were more frequent in those with severe motor deficit at diagnosis, or who were treated by neurosurgery or radiotherapy. Sphincter dysfunctions involved 31/57 children and were more frequent among children who presented with sphincter symptoms and severe motor deficit.
  
  
  CONCLUSIONS
  Fifty-eight percent of the children with localized neuroblastoma and symptomatic EC registered in this study developed late sequelae. The severity of motor deficit at diagnosis was the main risk factor.
authors.affiliation: Department of Hematology-Oncology, Giannina Gaslini Children's Hospital, Genova, Italy. paola.angelini@sickkids.ca
authors.forename: Paola
authors.initials: P
authors.lastname: Angelini
authors.forename: Dominique
authors.initials: D
authors.lastname: Plantaz
authors.forename: Bruno
authors.initials: B
authors.lastname: De Bernardi
authors.forename: Jean-Guy
authors.initials: JG
authors.lastname: Passagia
authors.forename: Hervé
authors.initials: H
authors.lastname: Rubie
authors.forename: Guido
authors.initials: G
authors.lastname: Pastore
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018450:Disease Progression; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019957:Motor Skills Disorders; D009447:Neuroblastoma / Q000150:complications* / Q000473:pathology / Q000628:therapy; D012042:Registries; D012307:Risk Factors; D013117:Spinal Cord Compression / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy