title: A sequential treatment algorithm for infants with stage 4s neuroblastoma and massive hepatomegaly.
abstract: Infants with 4s neuroblastoma (NB) and massive hepatomegaly have a guarded prognosis and mortality approaches 30%. We report on eight patients with 4s NB and massive hepatomegaly treated with multiple modalities. One patient had spontaneous tumor regression. Three patients had progressive disease and responded to chemotherapy. Four patients progressed despite intravenous chemotherapy, of whom two died, and two were salvaged with hepatic intra-arterial chemoembolization. Treatment of infants with stage 4s NB with massive hepatomegaly should be individualized based on disease course. A sequential approach with observation, intravenous chemotherapy, and intra-arterial chemoembolization, may improve the outcome of these infants.
authors.affiliation: Department of Pediatric Hematology-Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. michaelw@hadassah.org.il
authors.forename: Michael
authors.initials: M
authors.lastname: Weintraub
authors.forename: Elisha
authors.initials: E
authors.lastname: Waldman
authors.forename: Benjamin
authors.initials: B
authors.lastname: Koplewitz
authors.forename: Allan I
authors.initials: AI
authors.lastname: Bloom
authors.forename: Eitan
authors.initials: E
authors.lastname: Gross
authors.forename: Arnold I
authors.initials: AI
authors.lastname: Freeman
authors.forename: Shoshana
authors.initials: S
authors.lastname: Revel-Vilk
mesh_terms: D000465:Algorithms; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006529:Hepatomegaly / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies