The clinical management and outcomes of cervical neuroblastic tumors

Jackson, Jeremy R.; Tran, Hung C.; Stein, James E.; Shimada, Hiroyuki; Patel, Ankur M.; Marachelian, Araz; Kim, Eugene

doi:10.1016/j.jss.2016.04.030

Cited by 18 publications

(16 citation statements)

References 15 publications

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“…This finding was consistent with other head and neck cancers reported in the literature, including cervical adenoid cystic carcinoma, ENB, and cervical unknown primary site of squamous cell carcinoma [ 19 – 21 ]. Additionally, a more minimally aggressive surgical approach was suggested for patients with cervical neuroblastic tumors [ 11 ]. Notably, cervical primary site diseases are clinically and biologically more favorable than abdominal neurogenic tumors [ 14 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, there is no consensus on the influence of lymph node dissection (LND) on the survival of patients with head and neck neurogenic tumors. A previous study showed that survival was not affected by the extent of resection of cervical neuroblastic tumors [ 11 ]. Moreover, Kuan et al declared that the function of elective management of the cervical lymph nodes remains controversial in ENB [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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A population-based analysis of clinical features and lymph node dissection in head and neck malignant neurogenic tumors

et al. 2021

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Background The influence of lymph node dissection (LND) on survival in patients with head and neck neurogenic tumors remains unclear. We aimed to determine the effect of LND on the outcomes of patients with head and neck neurogenic tumors. Methods Data of patients with surgically treated head and neck neurogenic tumors were identified from the Surveillance, Epidemiology, and End Results (SEER) database (1975–2016) to investigate the relationship between LND and clinical outcomes by survival analysis. Subgroup analysis was performed in IVa and IVb group. Results In total, 662 head and neck neurogenic tumor patients (median age: 49.0 [0–91.0] years) met the inclusion criteria, of whom 13.1% were in the IVa group and 86.9% were in the IVb group. The median follow-up time was 76.0 months (range: 6.0–336.0 months), and the 5-year and 10-year overall survival was 82.4% (95% CI, 0.79–0.85) and 69.0% (95% CI, 0.64–0.73). Cox regression analysis revealed older age (P < .001), advanced stage (P = .037), African American race (P = .002), diagnosis before 2004 (P < .001), and chemotherapy administration (P < .001) to be independent negative predictors of overall survival. Kaplan-Meier analysis demonstrated that LND was not a predictor of clinical nodal negativity (cN0) in either IVa or IVb patients. Conclusions In head and neck neurogenic patients, LND may not impact the outcome of cN0 in either IVa or IVb group. These data can be recommended in guiding surgical plan and future studies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A population-based analysis of clinical features and lymph node dissection in head and neck malignant neurogenic tumors

et al. 2021

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“…Primary cervical neuroblastoma covers approximately 3 to 5% of all locations, additional cases can be the result of metastatic spreading to neck lymph nodes [ 3 ]. The primary disease usually arises from the superior cervical ganglion of the sympathetic chain.…”

Section: Surgical Approaches and Anesthesia Considerationsmentioning

confidence: 99%

Anesthesia in Children with Neuroblastoma, Perioperative and Operative Management

et al. 2021

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Neuroblastoma (NB) is the most common extracranial, solid, pediatric malignancy and, despite the constant progress of treatment and development of innovative therapies, remains a complex, challenging disease causing major morbidity and mortality in children. There is significant variability in the management of neuroblastoma, partially due to the heterogeneity of the clinical and biological behavior, and partially secondary to the different approaches between treating institutions. Anesthesia takes an integral part in the multidisciplinary care of patients with NB, from diagnosis to surgery and pain control. This paper aims to review and discuss the critical steps of the perioperative and operative management of children undergoing surgery for neuroblastoma. Anesthesia and analgesia largely depend on tumor location, surgical approach, and extension of the surgical dissection. Attention should be paid to the physio-pathological changes on cardiovascular, gastrointestinal, and immune systems induced by the tumor or by chemotherapy. At the time of surgery meticulous patient preparation needs to be carried out to optimize intraoperative monitoring and minimize the risk of complications. The cross-sectional role of anesthesia in cancer care requires effective communication between all members of the multidisciplinary team.

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“…Cervical ganglioneuromas originate from Schwann cells of cervical sympathetic ganglia or are related to vagus/hypoglossal nerves; they need to be differentiated from head and neck tumors of soft tissue (34). The confirmation comes after tumor removal and consecutive histological report, as seen in adrenal ganglioneuroma (35). Excision is necessary despite the slow rate of growth, because of compressive local symptoms such as Claude-Bernard-Horner syndrome (ptosis, myosis, facial anhidrosis and flushing) (36).…”

Section: Extra-adrenal Ganglioneuromamentioning

confidence: 99%

Adrenal ganglioneuroma: Prognostic factors (Review)

et al. 2021

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Ganglioneuroma, a rare neural crest-derived tumor, exhibits a benign profile in contrast to other neuroblastic tumors (neuroblastoma/ganglioneuroblastoma). Ganglioneuromas can be found anywhere autonomic ganglia are located, mostly abdominal/pelvic sites followed by the adrenal glands (one-third of cases), mediastinum/thorax and cervical area. Affecting especially children more than 10 years of age, Ganglioneuroma is either asymptomatic or may cause local compressive effects; rarely inducing nonspecific abdominal complains or arterial hypertension related to oversecretion of epinephrine/norepinephrine/dopamine. Despite a good prognosis, adrenalectomy is necessary in order to rule out a malignancy. Open procedure represents the standard therapeutic option; alternatively, centers with large laparoscopic pediatric experience and good stratification protocols have reported successful procedures. High uptake of I 123 -MIBG is associated with a more severe outcome in cases with increased mitotic index. In neuroblastic tumors, neuron-specific enolase >33 ng/ml, age at diagnosis <49 months, and blood vessel invasion indicate a poor prognosis. Concurrent extra-adrenal/adrenal ganglioneuroma is associated with a more severe prognosis; post-surgical complications are more frequent in non-adrenal vs. adrenal ganglioneuroma. Exceptionally, immune-mediated paraneoplastic neurologic syndromes have been reported: anti-N-methyl-D-aspartate receptor encephalitis and opsoclonus-myoclonus-ataxia syndrome. ROHHAD syndrome is the underlying cause in 40-56% of cases of neuroendocrine tumors including ganglioneuroma; 70% of tumors are diagnosed within the first 24 months after hypothalamic obesity onset, associated with a severe prognosis due to hypoventilation, sleep apnea, and dysautonomia. Recently, the PKB/AKT/mTOR/S6 pathway was identified as a tumorigenic pathway in pediatric ganglioneuroma, not in neuroblastoma; mTOR inhibitors are a potential option for pre-operatory tumor shrinkage. Pediatric adrenal ganglioneuroma has a good prognosis if adequately treated; its recognition requires adrenalectomy. Further development of specific biomarkers is needed. In the present article, we aimed to introduce a review of the literature involving adrenal ganglioneuroma based on a practical, multidisciplinary perspective of prognostic factors.

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The clinical management and outcomes of cervical neuroblastic tumors

Cited by 18 publications

References 15 publications

A population-based analysis of clinical features and lymph node dissection in head and neck malignant neurogenic tumors

A population-based analysis of clinical features and lymph node dissection in head and neck malignant neurogenic tumors

Anesthesia in Children with Neuroblastoma, Perioperative and Operative Management

Adrenal ganglioneuroma: Prognostic factors (Review)

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