Effect of excision extension of primary tumors on local control and survival of stage IV neuroblastoma
10.3969/j.issn.1000-8179.20141222
- VernacularTitle:4期神经母细胞瘤手术切除范围对预后的影响
- Author:
Pengfei LI
;
Juncheng LIU
;
Zijun ZHEN
;
Zhuowei LIU
;
Yuanhong GAO
;
Jia ZHU
;
Juan WANG
;
Suying LU
;
Feifei SUN
;
Fei ZHANG
;
Ruiqing CAI
;
Xiaofang GUO
;
Xiaofei SUN
- Publication Type:Journal Article
- Keywords:
neuroblastoma;
stage IV;
surgery;
survival rate;
extent of surgical resection
- From:
Chinese Journal of Clinical Oncology
2014;(24):1568-1572
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the effect of gross total resection on the local control and survival of patients with stage IV neuroblastoma (NB) and analyze the extent of surgical resection of primary tumors that affects patient survival. Methods: A total of 96 patients with stage Ⅳ NB who were admitted to the Sun Yat-Sen University Cancer Center between January 2000 and December 2011 were analyzed. The patients were treated with combined-modality therapy, including chemotherapy, surgery, and/or radiotherapy. The patients were divided according to the extent of surgical resection of primary tumor into the following groups: group A, biopsy or tumor removal of less than 50% of the primary lesion; group B, incomplete resection of more than 50% but less than 90% of the lesion; group C, removal of more than 90% of the lesion; and group D, complete resection with or without macroscopic residual tumors. The survival rates of each group were analyzed. Results: The median age of the 96 patients was 4.4 years, ranging from 1.2-18.8 years. The overall 3-year progression-free survival (PFS) and overall survival (OS) of the total patients were 32.8% and 36.7%, respectively. A total of 24 cases were assigned in group A, 10 in group B, 23 in group C, and 39 in group D. Subgroup analysis revealed that the 3-year PFS rate was 17.5% for group A, 20.0% for group B, 45.1% for group C, and 40.5% for group D. The PFS rates were not statistically significant-ly different between groups A and B (P=0.352) and between groups C and D (P = 0.792). However, the OS was higher in groups C and D than that in groups A and B. The 3-year PFS rates were 42.2% and 17.8% for groups C and D (P<0.001), respectively. Conclu-sion: Resection extension of more than 90% of the primary tumor combined with chemotherapy and (or) radiation therapy can improve the survival of patients with stage Ⅳ NB. However, this treatment modality does not affect the treatment outcomes for minimal gross tu-mor residuals.
