title: Validity of image-defined risk factors in localized neuroblastoma: A report from two centers in Western Japan.
abstract: BACKGROUND
  Japanese Neuroblastoma Study Group (JNBSG) has been employing image-defined risk factors (IDRFs) since 2010. However, the report from INRG in 2011 supplemented description stating that isolated contact is considered to be IDRF-positive only in renal vessels. The aim of this study was to evaluate the validity of IDRFs by comparing the previous (PG) and new guidelines (NG).
  
  
  METHODS
  IDRFs of patients with localized neuroblastoma treated at two centers in Western Japan from 2002 to 2013 were retrospectively reviewed by radiologists.
  
  
  RESULTS
  47 neuroblastomas (abdomen 38, pelvis 2, mediastinum 7) were evaluated. For abdominal neuroblastomas, IDRFs were present in 15/38 (39.5%) using PG and in 31/38 (81.6%) using NG. Moreover, the IDRF-positive rate increased from 26.7% (4/15) to 80.0% (12/15) in 15 cases diagnosed during mass screening. Of the IDRF-positive cases, complete primary resection was achieved in 2/15 (13.3%) using PG and 17/31 patients (54.8%) using NG. There were two major surgical renal complications in the IDRF-positive cases based on the use of either guidelines, and the specificity decreased from 64% to 19%.
  
  
  CONCLUSIONS
  According to NG, the IDRF-positive rate increased, and the resection rate decreased. NG may overestimate surgical risks, leading to unnecessary chemotherapy and a prolonged hospital stay.
authors.affiliation: Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. Electronic address: fumin@koto.kpu-m.ac.jp.
authors.forename: Shigehisa
authors.initials: S
authors.lastname: Fumino
authors.affiliation: Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Koseki
authors.initials: K
authors.lastname: Kimura
authors.affiliation: Department of Pediatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Iehara
authors.affiliation: Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto Japan.
authors.forename: Motoki
authors.initials: M
authors.lastname: Nishimura
authors.affiliation: Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto Japan.
authors.forename: Satoaki
authors.initials: S
authors.lastname: Nakamura
authors.affiliation: Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Souzaki
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nishie
authors.affiliation: Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Taguchi
authors.affiliation: Department of Pediatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Hosoi
authors.affiliation: Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Tajiri
mesh_terms: D000008:Abdominal Neoplasms / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan; D008279:Magnetic Resonance Imaging; D008297:Male; D008479:Mediastinal Neoplasms / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000473:pathology* / Q000601:surgery; D010386:Pelvic Neoplasms / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors
keywords: IDRFs; INRG; JNBSG; Neuroblastoma; renal complication; surgery