Clinical Significance of Intensive Surgery with Intraoperative Radiation for Advanced Neuroblastoma: Does it Really Make Sense?

Tatsuo Kuroda, Morihiro Saeki, Toshiro Honna, Hidekazu Masaki, Yukiko Tsunematsu

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Purpose: The aim of this study was to evaluate the significance of intensive surgery combined with intraoperative radiation therapy (IORT) in advanced neuroblastoma. Methods: Clinical features and outcome were reviewed in 33 advanced neuroblastoma patients (24 with INSS stage 4, 9 with stage 3), who had surgery (total excision 29, subtotal excision 4) with IORT (10 to 15 Gy) against the primary tumor site. Results: Three patients (8.8%) had relapse at the primary site, all of which arose from the unirradiated area after stem cell transplantation. Among 29 patients with total excision, disease-free survival was obtained in 15 (51.7%) for an average of 6.9 years, which included 5 survivors of 9 patients (55.9%) with amplified N-myc. In contrast, none of 4 patients with macroscopic residual survived. The Kaplan-Meier analysis showed significantly longer survival rates in the patients with total resection compared with those with macroscopic remnants. Conclusions: The intensive surgery with IORT dramatically increased the local eradication and improved the outcome even in advanced neuroblastoma with N-myc amplification. However, long-term survival was not obtained in patients with unresectable residual disease. These results may indicate the key role of surgical eradication in advanced neuroblastoma.

Original languageEnglish
Pages (from-to)1735-1738
Number of pages4
JournalJournal of Pediatric Surgery
Volume38
Issue number12
DOIs
Publication statusPublished - 2003 Dec
Externally publishedYes

Fingerprint

Neuroblastoma
Radiation
Radiotherapy
Kaplan-Meier Estimate
Stem Cell Transplantation
Disease-Free Survival
Survivors
Survival Rate
Recurrence
Survival
Neoplasms

Keywords

  • Intraoperative radiation therapy
  • Neuroblastoma
  • Surgical eradication

ASJC Scopus subject areas

  • Surgery

Cite this

Clinical Significance of Intensive Surgery with Intraoperative Radiation for Advanced Neuroblastoma : Does it Really Make Sense? / Kuroda, Tatsuo; Saeki, Morihiro; Honna, Toshiro; Masaki, Hidekazu; Tsunematsu, Yukiko.

In: Journal of Pediatric Surgery, Vol. 38, No. 12, 12.2003, p. 1735-1738.

Research output: Contribution to journalArticle

Kuroda, Tatsuo ; Saeki, Morihiro ; Honna, Toshiro ; Masaki, Hidekazu ; Tsunematsu, Yukiko. / Clinical Significance of Intensive Surgery with Intraoperative Radiation for Advanced Neuroblastoma : Does it Really Make Sense?. In: Journal of Pediatric Surgery. 2003 ; Vol. 38, No. 12. pp. 1735-1738.
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