THE EFFECT OF IMAGE DERIVED RISK FACTORS ON LONG TERM RESULTS OF THE SURGICAL TREATMENT OF PEDIATRIC NEUROBLASTIC TUMORS
Project no. 23870 · Status: Kapanmış (Yayın bekleniyor) · 2022
Summary
<p><strong>Aim: </strong>To reveal the effect of Image Derived Risk Factors (IDRF) on the long-term results of the surgical treatment of neuroblastic tumors.</p><p><strong>Method:</strong> The patients operated for neuroblastoma in our center between January 2003 and June 2020 were included. The cross-sectional images of the patients were re-evaluated by a single radiologist for IDRFs. Surgical and oncological data were gathered retrospectively.</p><p><strong>Results:</strong> IDRFs of 137 neuroblastoma and 13 ganglioneuroblastoma patients (n=150) were evaluated. The most common IDRF was renal pedicle invasion and the chemosensitivity of individual IDRFs were diverse. Mean number of IDRFs per patient dropped from 2,1 to 1,4 with chemotherapy (p<.0001). With chemotherapy, 17 (21.5%) patients became IDRF-negative, while a partial decline was observed in 39 (49.4%). No new IDRF arose during chemotherapy. IDRFs most sensitive to chemotherapy were spinal canal infiltration, and involvement of SMA branches. Complications: need for blood transfusion (18.0%), chylothorax (2.7%), nephrectomy (2.7%), massive bleeding (0.7%), transient Horner's syndrome (0.7%), vascular injury repaired primarily (5.2%). Pre-operative IDRFs were associated with surgical complications (p=.033). Presence of IDRF at diagnosis and pre-operatively was associated with lower survival (p=.01). Vascular type IDRFs were found to be the type with the most negative impact on survival. In patients who were IDRF negative and underwent minimally invasive surgery, no complications were observed except for the need for erythrocyte transfusion in 2 (8.0%) patients, transient Horner's syndrome in 1 (4.0%) patient, and conversion to open in 1 (4.0%) thoracoscopic case. Complete resection was performed in all patients (100%) who underwent minimally invasive surgery. </p><p><strong>Conclusion:</strong> IDRFs and other prognostic factors can be used to predict long-term outcomes and possible complications in the surgical treatment of neuroblastic tumors. Complications related to minimally invasive surgery are very rare in IDRF-negative patients and treatment success is high.</p><p><strong> </strong></p><p><strong>Keywords: </strong>Neuroblastoma; IDRF; Intraoperative Complications; Risk Factors; Prognosis; Child</p>