Observation of untreated patients with neuroblastoma detected by mass screening: A ?wait and see? pilot study

Abstract

At least 60% of neuroblastoma cases who entered our observation program regressed spontaneously.

Profile of neuroblastoma detected by mass screening, resected after observation without treatment: results of the Wait and See pilot study

“…These findings indicate that MS has detected tumors that otherwise may have regressed spontaneously without recognition [4,5]. Therefore, we started an observation program in the limited cases to avoid overtreatment and to estimate how frequently regression occurs (Wait and See pilot study) in June 1994 [6]. Our preliminary results have shown that at least 60% of NB cases who entered our observation program regressed spontaneously [6].…”

“…Therefore, we started an observation program in the limited cases to avoid overtreatment and to estimate how frequently regression occurs (Wait and See pilot study) in June 1994 [6]. Our preliminary results have shown that at least 60% of NB cases who entered our observation program regressed spontaneously [6]. In this study, we analyzed the profile of NB resected after observation to elucidate the nature of NB detected by MS.…”

Can neoadjuvant chemotherapy reduce the surgical risks for localized neuroblastoma patients with image-defined risk factors at the time of diagnosis?

“…Although quite intensive chemotherapy is generally recommended for aggressive or advance staged neuroblastoma [13], intensive chemotherapy is occasionally not effective for differentiated neuroblastoma, which is often observed in localized neuroblastomas. As most localized neuroblastomas have a favorable prognosis [1][2][3][5][6][7], treatment complications should be minimized. Therefore, the risks of neoadjuvant chemotherapy should be compared to surgical risks in the same patient.…”

“…Several clinical trials to minimize treatment complications are currently ongoing worldwide. Preoperative chemotherapy or even the waitand-see observation strategy have been adapted for particular cases in some clinical trials [2,3,[5][6][7]. In these situations, the international neuroblastoma staging system (INSS) is unsuitable, as this system is a postoperative staging system.…”

The role of surgery in the treatment of neuroblastoma

“…26 With regard to the good survival and spontaneous regression found in some MS-detected NB, 27 a "wait and see" discipline is employed to avoid treatment-related complications, especially those of surgery. 28 This principle is also applied to cases incidentally detected by routine ultrasonography, with a similar favorable result. 1 However, the incidentally detected cases lack an accurate diagnosis due to lack of histological examinations.…”