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01-03-2016 | Original Article

Can neoadjuvant chemotherapy reduce the surgical risks for localized neuroblastoma patients with image-defined risk factors at the time of diagnosis?

Authors: Akihiro Yoneda, Masanori Nishikawa, Shuichiro Uehara, Takaharu Oue, Noriaki Usui, Masami Inoue, Masahiro Fukuzawa, Hiroomi Okuyama

Published in: Pediatric Surgery International | Issue 3/2016

Abstract

Purpose

To date, no detailed study of the changes in the image-defined risk factors (IDRFs) after neoadjuvant chemotherapy has been performed. The aim of this study was to investigate the effect of chemotherapy on IDRFs for stage L2 neuroblastomas.

Methods

Fifteen stage L2 patients treated by neoadjuvant chemotherapy were selected. Changes after chemotherapy in the number of positive IDRFs, tumor size and major surgical complications were evaluated.

Results

All IDRFs disappeared after chemotherapy in four patients (group A) and a reduction in the number of IDRFs, but not disappearance, after chemotherapy was observed in five patients (group B). No change in the number of IDRFs after chemotherapy was observed in six patients (group C). All tumors in groups A shrunk to <20 % of the pretreatment volume. Major surgical complications were observed in one of two, two of three and three of five patients who underwent tumor excision in groups A, B and C, respectively.

Conclusions

Only 27 % of the tumors with IDRFs became negative for IDRFs after chemotherapy. For negative IDRFs, tumors should shrink to <20 % of the volume at the time of diagnosis. Stage L2 tumors may have a potential risk for surgery even after neoadjuvant chemotherapy.

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Title: Can neoadjuvant chemotherapy reduce the surgical risks for localized neuroblastoma patients with image-defined risk factors at the time of diagnosis?
Authors: Akihiro Yoneda
Masanori Nishikawa
Shuichiro Uehara
Takaharu Oue
Noriaki Usui
Masami Inoue
Masahiro Fukuzawa
Hiroomi Okuyama
Publication date: 01-03-2016
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Surgery International / Issue 3/2016
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-016-3858-5

At a glance: The STEP trials

Springer Medicine

Can neoadjuvant chemotherapy reduce the surgical risks for localized neuroblastoma patients with image-defined risk factors at the time of diagnosis?

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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