Surgical treatment for neuroblastoma: Complications during 15 years' experience

Clinical significance of intensive surgery with intraoperative radiation for advanced neuroblastoma: does it really make sense?

“…20 The results suggest the importance of surgical eradication in advanced neuroblastoma and, therefore, that aggressive surgery with IORT should be justified, even though some researchers have pointed out the high incidence of complications after extensive surgery and recommended less radical surgery for advanced neuroblastoma. 1,2,10,14,15 This finding is supported also by the results of Kaplan-Meier analysis. In the current series, statistically significant differences in the survival curves were shown only between the patients with total surgical resection and those with macroscopic residual, whereas known prognostic factors such as the amplification of N-myc oncogene did not significantly alter the survival rate.…”

“…Renal vascular problems and other major complications were reported after extensive surgical resection of neuroblastoma. 1,2 In addition, neuroblastoma cells in the peripheral blood were recently detected, suggesting that the tumor cells may be spread through the systemic circulation in advanced disease. [3][4][5][6] However, the efficacy of intraoperative irradiation therapy (IORT) has been reported in advanced neuroblastoma.…”

Intraoperative radiation therapy for advanced neuroblastoma: the problem of securing the IORT field

“…The clinical significance of intensive surgical therapy as a means to control the local lesion has been controversial in the treatment of advanced neuroblastoma [8,9]. Renal vascular problems and other major complications were reported after extensive surgical resection of neuroblastoma [10,11]. To prevent the major complications of the surgical treatment and excessive lymphadenectomy, we have been doing IORT.…”

Surgical challenges associated with intensive treatment protocols for high-risk neuroblastoma

“…The most common metastatic sites for both groups were bone and bone marrow. There was no difference in overall metastatic rate; however, if the groups are compared by individual site, there is a 15 (17) 3 (14) .0042 Lung [n (%)] 0 3 (14) .041 Optic nerve [n (%)] 0 2 (9) .10 significant difference in bone marrow ( P = .0033), liver ( P = .0042), and lung metastases ( P = .041).…”

“…In the literature, surgical complication rates for patients with NB have ranged from 3% to 57% [3,[10][11][12][13]. Incidental nephrectomy, operative hemorrhage (includes surgical procedures performed before and after chemotherapy started), postoperative intussusception, and injury to major vessels or nerves are some of the more common complications associated with high-stage tumors [13][14][15][16].…”