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

Neuroblastoma

“…Multiple prospective studies have shown that tumours <5 cm in diameter are likely to regress spontaneously. [35][36][37][38] Surgery is the initial treatment of choice for patients with localised disease who are able to have more than 50% of their tumour safely removed as determined by image-defined risk • Stage 3: Unresectable unilateral tumour infiltrating across the midline (beyond the opposite side of the vertebral column) with or without regional lymph node involvement, or localised unilateral tumour with contralateral regional lymph node involvement, or midline tumour with bilateral extension via infiltration (unresectable) or lymph node involvement • Stage 4: Any primary tumour with dissemination to distant lymph nodes, bone, bone marrow, liver, skin, and/or other organs (except as defined for stage 4S disease)…”

“…Although a portion of these patients will have disease progression after surgery, they can be salvaged with surgery or chemotherapy, or both, and achieve overall survival rates comparable to those of similar patients whose disease did not progress. [30][31][32][33][34][35][36][37][38][39][40] Observation, with serial ultrasound scans every three to six weeks, is a reasonable alternative in the following patient groups:…”

Prenatal detection and evaluation of an extralobar pulmonary sequestration in the posterior mediastinum

“…It was felt preoperatively that neuroblastoma was a possibility in this case, but unlikely owing to the increased echogenicity of the mass, lack of calcifications and apparent pliability of the mass during ultrasound evaluation, as well as normal urine catecholamines. Close observation of prenatally detected neuroblastomas and those detected by mass screening has recently been advocated because of their usual excellent outcome and occasional spontaneous regression 9,10 . However, because malignant neuroblastoma could not be definitely excluded preoperatively, and because of recent reports of the prognosis of prenatally diagnosed mediastinal masses, early surgical exploration was undertaken 11 .…”

Retroperitoneal ganglioneuroblastoma resected 8 years after mass screening: a case report

“…These cases were followed conservatively and all tumors showed spontaneous regression with the tumor markers decreasing to the reference range. However, none of the tumors completely disappeared [3]. Nishihira et al reported that of 26 MSpositive tumors, 19 cases were managed by the wait-and-see policy.…”

“…A recent report has also shown that NB detected by MS may regress spontaneously [2]. Some investigators advocated a conservative management without treatment for selected patients with NB detected by MS [3,4]. However, regressed tumors did not always disappear completely, and the natural history of these tumors is not known.…”