title: Histological features of primary tumors after induction or high-dose chemotherapy in high-risk neuroblastoma.
abstract: OBJECTIVE
  In the recent years in Japan, an increasing number of patients with neuroblastoma (NB) are being treated by the "delayed local treatment (DL)" policy, undergoing surgery after the completion of high-dose chemotherapy with hematopoietic stem cell rescue (HDC). We reviewed the histopathological findings of second-look operations, including those of patients treated with DL.
  
  
  METHODS
  From 1998 to 2013, 26 patients with high-risk NB underwent radical operation following chemotherapy. Surgery was performed after induction chemotherapy in 17 cases (standard; STD), whereas 9 cases completed induction chemotherapy and HDC before undergoing tumor resection (DL). The amount of necrosis and the degree of differentiation within the post-treatment tumor were assessed.
  
  
  RESULTS
  Eighty-eight percent of the tumors showed necrosis in more than 1/3 of the specimen. Two DL cases showed complete disappearance of viable tumor cells. Amount of necrosis did not affect the prognosis of the patient. Tumors with immature, poorly differentiated phenotypes showed an extremely aggressive thereafter. Though not statistically proven, (123)I-MIBG (metaiodobenzylguanidine) uptake may be correlated with the amount of viable cells remaining within the tumor, but not with the degree of differentiation.
  
  
  CONCLUSIONS
  Our results support the previous reports advocating that tumors that sustain unfavorable histology after chemotherapy behave aggressively thereafter.
authors: Department of Pediatric Surgery, Chiba Children's Hospital, 579-1 Heta-cho, Midori-ku, Chiba, 266-0007, Japan, hishiki-tmr@umin.ac.jp.
authors: Tomoro
authors: T
authors: Hishiki
authors: Hiroshi
authors: H
authors: Horie
authors: Yasuyuki
authors: Y
authors: Higashimoto
authors: Katsumi
authors: K
authors: Yotsumoto
authors: Shugo
authors: S
authors: Komatsu
authors: Yuri
authors: Y
authors: Okimoto
authors: Harumi
authors: H
authors: Kakuda
authors: Yuichi
authors: Y
authors: Taneyama
authors: Takeshi
authors: T
authors: Saito
authors: Keita
authors: K
authors: Terui
authors: Tetsuya
authors: T
authors: Mitsunaga
authors: Mitsuyuki
authors: M
authors: Nakata
authors: Hidemasa
authors: H
authors: Ochiai
authors: Moeko
authors: M
authors: Hino
authors: Kumiko
authors: K
authors: Ando
authors: Hideo
authors: H
authors: Yoshida
authors: Jun
authors: J
authors: Iwai
mesh_terms: D019797:3-Iodobenzylguanidine; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods*; D007223:Infant; D007564:Japan; D008297:Male; D009447:Neuroblastoma / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000601:surgery; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D024162:Second-Look Surgery / Q000379:methods; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine