title: The clinical management and outcomes of cervical neuroblastic tumors.
abstract: Although patients with peripheral neuroblastoma (NB; pelvic and thoracic) typically have better outcomes and less aggressive disease compared with patients with abdominal disease, little has been published with regard to the management and outcomes of patients with cervical NB. Herein, we sought to determine the characteristics of cervical neuroblastic tumors and the effect of extent of resection on survival and outcomes.
  
  
  
  We performed a retrospective review of 325 children with neuroblastic tumors at Children's Hospital Los Angeles over a 15-y period (January 1990-February 2015). Data collected from the medical record included location of tumor, age at diagnosis, age at resection, extent of resection, chemotherapy course, International Neuroblastoma Staging System stage, histologic International Neuroblastoma Pathology Classification, and MYCN amplification, a poor prognostic marker. Outcome variables included postoperative complications and overall survival.
  
  
  
  Twelve patients (3.6%) were found to have cervical neuroblastic tumors (nine NBs, one ganglioneuroblastoma, and two ganglioneuromas). All had favorable histology, and none (0/12) had MYCN amplification. Of the NB patients, four of nine patients underwent resection, whereas the other five underwent biopsy followed by chemotherapy or observation alone. Of the 12 total patients, six underwent gross total resection, four (67%) of which developed complications. At a median follow-up of 4.4 y, there were no recurrences or deaths.
  
  
  
  Cervical neuroblastic tumors represent favorable lesions with good outcomes similar to other peripheral neuroblastic tumors. In our study, survival was excellent regardless of extent of tumor resection. Based on our data, we recommend a minimally aggressive surgical approach in managing children with cervical neuroblastic tumors.
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, Children's Hospital Los Angeles, Los Angeles, California.
authors.forename: Jeremy R
authors.initials: JR
authors.lastname: Jackson
authors.affiliation: Division of Hematology-Oncology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California.
authors.forename: Hung C
authors.initials: HC
authors.lastname: Tran
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, Children's Hospital Los Angeles, Los Angeles, California.
authors.forename: James E
authors.initials: JE
authors.lastname: Stein
authors.affiliation: Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shimada
authors.affiliation: Division of Otolaryngology, Department of Surgery, Children's Hospital Los Angeles, Los Angeles, California.
authors.forename: Ankur M
authors.initials: AM
authors.lastname: Patel
authors.affiliation: Division of Hematology-Oncology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California.
authors.forename: Araz
authors.initials: A
authors.lastname: Marachelian
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, Children's Hospital Los Angeles, Los Angeles, California. Electronic address: eugeneskim@chla.usc.edu.
authors.forename: Eugene S
authors.initials: ES
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Cervical tumor; Ganglioneuroblastoma; Ganglioneuroma; Neuroblastic; Neuroblastoma