Surgery Doesn't Up Pediatric Neuroblastoma Outcomes
(HealthDay News) – For pediatric patients with stage 4 neuroblastoma, surgery of the primary tumor site has no impact on outcomes, according to a study published online Jan. 2 in the Journal of Clinical Oncology.
Thorsten Simon, MD, from the University of Cologne in Germany, and colleagues reviewed operation notes and imaging reports from 278 patients with stage 4 neuroblastoma (age ≥18 months at diagnosis) participating in a prospective clinical trial.
The researchers found that at diagnosis there were image-defined risk factors that were significantly predictive for the extent of tumor resection at first and best operation. Before chemotherapy, 6.1% of participants underwent complete resection, 5% underwent incomplete resection, and 88.5% underwent biopsy or no surgery. Following induction chemotherapy, 54.7%, 30.6%, and 13.3% underwent complete resection, incomplete resection, and only biopsy or no surgery of the primary tumor, respectively. The extent of first or best operation had no effect on event-free survival, local progression-free survival, or overall survival.
"In conclusion, the results of this study do not justify aggressive surgery in patients undergoing high-intensity multimodal treatment for metastatic neuroblastoma," the authors write. "Future trials are required to determine whether even less surgery might be adequate in high-intensity multimodal treatment of metastatic neuroblastoma and if biologic factors are correlated with the respectability of the primary tumor."