Long-Term Outcomes of Surgical Treatment of Pediatric Neuroblastic Tumors
Bildiriler > Tam Metin Bildiri · 2022
Yazarlar: Hilmican Ulman, Egemen Öztürk, Eda ATASEVEN, Bengü Demirağ, Deniz Kızmazoğlu, Ülküm Zafer DÖKÜMCÜ, Yeşim ERTAN, Ahmet ÇELİK, Hatice Nur Olgun, Nur Olgun
8th International Tübingen-Symposium on Pediatric Solid Tumors - Neuroblastoma, Almanya, Tübingen, Uluslararası, Sözlü Sunum, Tam Metin Bildiri, 2022-2022, ss 12-12
Özet
<p><strong>Long-Term Outcomes of Surgical Treatment of Pediatric Neuroblastic Tumors</strong></p><p><strong>Hilmican Ulman, Egemen Öztürk, Eda Ataseven, Bengü Demirağ, Deniz Kızmazoğlu, Zafer Dökümcü, Yeşim Ertan, Nur Olgun, Ahmet Çelik</strong></p><p><strong>Purpose:</strong> To reveal the long-term results of the surgical treatment of neuroblastic tumors and to identify the effect of prognostic factors on survival and complications.</p><p><strong>Methods:</strong> The patients treated surgically for neuroblastoma, ganglioneuroblastoma and ganglioneuroma according to Turkish Pediatric Oncology Group (TPOG) protocols in our center between January 2003 and June 2020 were included. Surgical and oncological data were gathered retrospectively.</p><p><strong>Results:</strong> Of 174 patients, 137 (78.7%) were diagnosed with neuroblastoma, 13 (7.5%) ganglioneuroblastoma, and 24 (13.8%) ganglioneuroma. Neuroblastomas and ganglioneuroblastomas were evaluated together (n=150) according to the protocol. The mean age of patients (88M:62F) at diagnosis was 30.3±29.1 months, and mean follow-up period was 5.1±3.3 years. Primary surgery was performed in 49 (32.7%) patients, whereas 101 (67.3%) patients underwent delayed primary surgery. Minimally invasive surgery was performed in 36 (24.0%) patients and treatment success was 100% in this group. Complications: need for blood transfusion (18.0%), chylothorax (2.7%), nephrectomy (2.7%), unilateral renal ischemia (0.7%), need for dialysis (0.7%), massive bleeding (0.7%), transient Horner syndrome (0.7%), intraoperative vascular injury repaired primarily (5.2%). >18 months of age, N-MYC positivity, NSE >77μg/L, INPC (Shimada) classification, metastatic disease, large tumors (>205cm3 at diagnosis and >37cm3 preoperatively) were associated with decreased survival. DNA aberrations (1p-del, 11q-del, 17q-gain) were found to have no effect on survival (p>.05). In low-risk, early-stage tumors, the success of treatment with surgery alone is 100%. Survival after relapse is 25%, even lower than high-risk tumors.</p><p><strong>INSS</strong></p><p><strong>Survival</strong></p><p><br></p><p><strong>Risk Groups</strong></p><p><strong>Survival</strong></p><p><strong>Stage1</strong></p><p>%100</p><p><br></p><p>Low</p><p>%100</p><p><strong>Stage2</strong></p><p>%100</p><p><br></p><p>Intermediate-favorable histology</p><p>%100</p><p><strong>Stage3</strong></p><p>%93,1</p><p><br></p><p>Intermediate-unfavorable histology</p><p>%93,5</p><p><strong>Stage4/M</strong></p><p>%55,6</p><p><br></p><p>High</p><p>%52,9</p><p><strong>Stage4s/MS</strong></p><p>%100</p><p><br></p><p> </p><p><strong>Conclusions:</strong> Treatment of neuroblastic tumors is bound to improve with current multidisciplinary approaches. Preoperative prognostic factors are used to predict operative difficulties and complications.</p><p><strong>Keywords:</strong> Neuroblastoma; IDRF; Ganglioneuroblastoma; Intraoperative Complications; Risk Factors; Prognosis; Child</p>