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Pediatric Surgery International
Published in: Pediatric Surgery International 4/2020

01-04-2020 | Neuroblastoma | Original Article

The importance of local control management in high-risk neuroblastoma in South Africa

Authors: Jaques van Heerden, Mariana Kruger, Tonya Esterhuizen, Marc Hendricks, Jennifer Geel, Ané Büchner, Gita Naidu, Jan du Plessis, Barry Vanemmenes, Ronelle Uys, G. P. Hadley, For the South African Children’s Cancer Study Group

Published in: Pediatric Surgery International | Issue 4/2020

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Abstract

Purpose

To investigate the impact of local therapies on high-risk neuroblastoma (HR-NB) outcomes in South Africa.

Methods

Data from 295 patients with HR-NB from nine pediatric oncology units between 2000 and 2014 were analysed. All patients received chemotherapy. Five-year overall (OS) and event free survival (EFS) were determined for patients who had received local therapy, either surgery or radiotherapy or both.

Results

Surgery was performed in only 35.9% (n = 106/295) patients. Surgical excision was done for 34.8% (n = 85/244) of abdominal primaries, 50.0% (n = 11/22) of thoracic primaries; 22.2% (n = 2/9) neck primaries and 66.7% (n = 8/12) of the paraspinal primaries. Only 15.9% (n = 47/295) of all patients received radiotherapy. Children, who had surgery, had an improved five-year OS of 32.1% versus 5.9% without surgery (p < 0.001). Completely resected disease had a five-year OS of 30.5%, incomplete resections 31.4% versus no surgery 6.0% (p < 0.001). Radiated patients had a five-year OS of 21.3% versus 14.2% without radiotherapy (p < 0.001). Patients who received radiotherapy without surgical interventions, had a marginally better five-year OS of 12.5% as opposed to 5.4% (p < 0.001). Patients who underwent surgery had a longer mean overall survival of 60.9 months, while patients, who were irradiated, had a longer mean overall survival of 7.9 months (p < 0.001). On multivariate analysis, complete metastatic remission (p < 0.001), surgical status (p = 0.027), and radiotherapy status (p = 0.040) were significant predictive factors in abdominal primaries.

Conclusion

Surgery and radiotherapy significantly improve outcomes regardless of the primary tumor site, emphasizing the importance of local control in neuroblastoma.
Appendix
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Metadata
Title
The importance of local control management in high-risk neuroblastoma in South Africa
Authors
Jaques van Heerden
Mariana Kruger
Tonya Esterhuizen
Marc Hendricks
Jennifer Geel
Ané Büchner
Gita Naidu
Jan du Plessis
Barry Vanemmenes
Ronelle Uys
G. P. Hadley
For the South African Children’s Cancer Study Group
Publication date
01-04-2020
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 4/2020
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-020-04627-x

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