title: Implications of surgical intervention in the treatment of neuroblastomas: 20-year experience of a single institution.
abstract: OBJECTIVE
  The implications of surgical intervention for neuroblastomas were assessed in one institution.
  
  
  METHODS
  We analyzed the clinical characteristics and extension of resection in 123 pediatric patients with neuroblastoma diagnosed between 1985 and 2004.
  
  
  RESULTS
  The 5-year survival rate of the 82 patients under 12 months of age, 59 of whom were treated with complete resection of the primary tumor, was 97%. The 5-year survival rate of the 41 patients over 12 months of age did not differ significantly according to whether complete (n = 19) or incomplete resection (n = 22) was performed (46 vs. 38%, respectively). No local recurrence was observed in ten patients over 12 months of age with stage 4 disease who underwent complete resection of the primary tumor; however, four of these ten patients died of metastatic recurrence.
  
  
  CONCLUSIONS
  Considering that the majority of infantile neuroblastomas in this study had favorable biology, complete resection might be unnecessary for patients under 12 years of age. For advanced neuroblastomas in patients over 12 months of age, the main treatment for metastasis is systemic chemotherapy, although extirpation of the primary tumor without extensive surgery might prevent local recurrence when combined with radiation therapy.
authors.affiliation: Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. taji@pedsurg.med.kyushu-u.ac.jp
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Tajiri
authors.forename: Ryota
authors.initials: R
authors.lastname: Souzaki
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kinoshita
authors.forename: Yuhki
authors.initials: Y
authors.lastname: Koga
authors.forename: Aiko
authors.initials: A
authors.lastname: Suminoe
authors.forename: Toshiro
authors.initials: T
authors.lastname: Hara
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Taguchi
mesh_terms: D000367:Age Factors; D014408:Biomarkers, Tumor / Q000378:metabolism; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D000071447:N-Myc Proto-Oncogene Protein; D009447:Neuroblastoma / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality / Q000601:surgery*; D009687:Nuclear Proteins / Q000378:metabolism; D015513:Oncogene Proteins / Q000378:metabolism; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; C459801:MYCN protein, human; D000071447:N-Myc Proto-Oncogene Protein; D009687:Nuclear Proteins; D015513:Oncogene Proteins