The impact of early resection of primary neuroblastoma on the survival of children older than 1 year of age with stage 4 disease

The St. Jude children's research hospital experience

Lisa McGregor, Bhaskar N. Rao, Andrew M. Davidoff, Catherine A. Billups, Suradej Hongeng, Victor M. Santana, D. Ashley Hill, Christine Fuller, Wayne L. Furman

Research output: Contribution to journalReview article

28 Citations (Scopus)

Abstract

BACKGROUND. It remains unclear whether primary tumor resection benefits patients with metastatic neuroblastoma. The authors assessed the impact of extent and timing of resection on outcome in these patients. METHODS. The authors reviewed the records of 124 patients > 1 year of age at diagnosis of International Neuroblastoma Staging System Stage 4 neuroblastoma. The survival estimates of those who did and did not have a gross total resection (GTR) and of those who had initial versus delayed GTR were compared. Surgical complications were reviewed. RESULTS. The 5-year survival estimates were comparable for the 90 patients who had a GTR and the 17 who underwent surgery but did not have a GTR (29.9% ± 5.1% [standard error] vs. 29.4% ± 10.1%). The 7 patients who underwent GTR at the time of diagnosis had a higher 5-year survival estimate than the 83 patients who had a GTR after induction chemotherapy (83.3% ± 13.9% vs. 25.2% ± 5.0%) (P = 0.001). Five-year event-free survival estimates were similarly higher in the initial-GTR group (57.1% ± 18.7% vs. 14.5% ± 4.2%) (P = 0.002). These two groups did not differ significantly in age at diagnosis (P = 0.118), site of primary tumor (P = 0.34), MYCN amplification status (P = 1), serum lactate dehydrogenase activity at diagnosis (P = 0.34), or treatment protocol (P = 0.22). Twenty-two (21%) patients had a surgical complication. CONCLUSIONS. In this small cohort of patients with metastatic neuroblastoma, GTR at the time of diagnosis offered a survival benefit. Further prospective studies are warranted before this approach can be applied to all patients with metastatic neuroblastoma.

Original languageEnglish (US)
Pages (from-to)2837-2846
Number of pages10
JournalCancer
Volume104
Issue number12
DOIs
StatePublished - Dec 15 2005

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Neuroblastoma
Survival
Research
Induction Chemotherapy
Clinical Protocols
Disease-Free Survival
Neoplasms
Prospective Studies
Serum

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

McGregor, Lisa ; Rao, Bhaskar N. ; Davidoff, Andrew M. ; Billups, Catherine A. ; Hongeng, Suradej ; Santana, Victor M. ; Hill, D. Ashley ; Fuller, Christine ; Furman, Wayne L. / The impact of early resection of primary neuroblastoma on the survival of children older than 1 year of age with stage 4 disease : The St. Jude children's research hospital experience. In: Cancer. 2005 ; Vol. 104, No. 12. pp. 2837-2846.
@article{f210137793544f54a875ab22ce84dfa4,
title = "The impact of early resection of primary neuroblastoma on the survival of children older than 1 year of age with stage 4 disease: The St. Jude children's research hospital experience",
abstract = "BACKGROUND. It remains unclear whether primary tumor resection benefits patients with metastatic neuroblastoma. The authors assessed the impact of extent and timing of resection on outcome in these patients. METHODS. The authors reviewed the records of 124 patients > 1 year of age at diagnosis of International Neuroblastoma Staging System Stage 4 neuroblastoma. The survival estimates of those who did and did not have a gross total resection (GTR) and of those who had initial versus delayed GTR were compared. Surgical complications were reviewed. RESULTS. The 5-year survival estimates were comparable for the 90 patients who had a GTR and the 17 who underwent surgery but did not have a GTR (29.9{\%} ± 5.1{\%} [standard error] vs. 29.4{\%} ± 10.1{\%}). The 7 patients who underwent GTR at the time of diagnosis had a higher 5-year survival estimate than the 83 patients who had a GTR after induction chemotherapy (83.3{\%} ± 13.9{\%} vs. 25.2{\%} ± 5.0{\%}) (P = 0.001). Five-year event-free survival estimates were similarly higher in the initial-GTR group (57.1{\%} ± 18.7{\%} vs. 14.5{\%} ± 4.2{\%}) (P = 0.002). These two groups did not differ significantly in age at diagnosis (P = 0.118), site of primary tumor (P = 0.34), MYCN amplification status (P = 1), serum lactate dehydrogenase activity at diagnosis (P = 0.34), or treatment protocol (P = 0.22). Twenty-two (21{\%}) patients had a surgical complication. CONCLUSIONS. In this small cohort of patients with metastatic neuroblastoma, GTR at the time of diagnosis offered a survival benefit. Further prospective studies are warranted before this approach can be applied to all patients with metastatic neuroblastoma.",
author = "Lisa McGregor and Rao, {Bhaskar N.} and Davidoff, {Andrew M.} and Billups, {Catherine A.} and Suradej Hongeng and Santana, {Victor M.} and Hill, {D. Ashley} and Christine Fuller and Furman, {Wayne L.}",
year = "2005",
month = "12",
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doi = "10.1002/cncr.21566",
language = "English (US)",
volume = "104",
pages = "2837--2846",
journal = "Cancer",
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The impact of early resection of primary neuroblastoma on the survival of children older than 1 year of age with stage 4 disease : The St. Jude children's research hospital experience. / McGregor, Lisa; Rao, Bhaskar N.; Davidoff, Andrew M.; Billups, Catherine A.; Hongeng, Suradej; Santana, Victor M.; Hill, D. Ashley; Fuller, Christine; Furman, Wayne L.

In: Cancer, Vol. 104, No. 12, 15.12.2005, p. 2837-2846.

Research output: Contribution to journalReview article

TY - JOUR

T1 - The impact of early resection of primary neuroblastoma on the survival of children older than 1 year of age with stage 4 disease

T2 - The St. Jude children's research hospital experience

AU - McGregor, Lisa

AU - Rao, Bhaskar N.

AU - Davidoff, Andrew M.

AU - Billups, Catherine A.

AU - Hongeng, Suradej

AU - Santana, Victor M.

AU - Hill, D. Ashley

AU - Fuller, Christine

AU - Furman, Wayne L.

PY - 2005/12/15

Y1 - 2005/12/15

N2 - BACKGROUND. It remains unclear whether primary tumor resection benefits patients with metastatic neuroblastoma. The authors assessed the impact of extent and timing of resection on outcome in these patients. METHODS. The authors reviewed the records of 124 patients > 1 year of age at diagnosis of International Neuroblastoma Staging System Stage 4 neuroblastoma. The survival estimates of those who did and did not have a gross total resection (GTR) and of those who had initial versus delayed GTR were compared. Surgical complications were reviewed. RESULTS. The 5-year survival estimates were comparable for the 90 patients who had a GTR and the 17 who underwent surgery but did not have a GTR (29.9% ± 5.1% [standard error] vs. 29.4% ± 10.1%). The 7 patients who underwent GTR at the time of diagnosis had a higher 5-year survival estimate than the 83 patients who had a GTR after induction chemotherapy (83.3% ± 13.9% vs. 25.2% ± 5.0%) (P = 0.001). Five-year event-free survival estimates were similarly higher in the initial-GTR group (57.1% ± 18.7% vs. 14.5% ± 4.2%) (P = 0.002). These two groups did not differ significantly in age at diagnosis (P = 0.118), site of primary tumor (P = 0.34), MYCN amplification status (P = 1), serum lactate dehydrogenase activity at diagnosis (P = 0.34), or treatment protocol (P = 0.22). Twenty-two (21%) patients had a surgical complication. CONCLUSIONS. In this small cohort of patients with metastatic neuroblastoma, GTR at the time of diagnosis offered a survival benefit. Further prospective studies are warranted before this approach can be applied to all patients with metastatic neuroblastoma.

AB - BACKGROUND. It remains unclear whether primary tumor resection benefits patients with metastatic neuroblastoma. The authors assessed the impact of extent and timing of resection on outcome in these patients. METHODS. The authors reviewed the records of 124 patients > 1 year of age at diagnosis of International Neuroblastoma Staging System Stage 4 neuroblastoma. The survival estimates of those who did and did not have a gross total resection (GTR) and of those who had initial versus delayed GTR were compared. Surgical complications were reviewed. RESULTS. The 5-year survival estimates were comparable for the 90 patients who had a GTR and the 17 who underwent surgery but did not have a GTR (29.9% ± 5.1% [standard error] vs. 29.4% ± 10.1%). The 7 patients who underwent GTR at the time of diagnosis had a higher 5-year survival estimate than the 83 patients who had a GTR after induction chemotherapy (83.3% ± 13.9% vs. 25.2% ± 5.0%) (P = 0.001). Five-year event-free survival estimates were similarly higher in the initial-GTR group (57.1% ± 18.7% vs. 14.5% ± 4.2%) (P = 0.002). These two groups did not differ significantly in age at diagnosis (P = 0.118), site of primary tumor (P = 0.34), MYCN amplification status (P = 1), serum lactate dehydrogenase activity at diagnosis (P = 0.34), or treatment protocol (P = 0.22). Twenty-two (21%) patients had a surgical complication. CONCLUSIONS. In this small cohort of patients with metastatic neuroblastoma, GTR at the time of diagnosis offered a survival benefit. Further prospective studies are warranted before this approach can be applied to all patients with metastatic neuroblastoma.

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U2 - 10.1002/cncr.21566

DO - 10.1002/cncr.21566

M3 - Review article

VL - 104

SP - 2837

EP - 2846

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 12

ER -