Multidisciplinary surgical strategy for dumbbell neuroblastoma: A single‐center experience of 32 cases

Autor: Michel Zerah, Louise Galmiche-Rolland, Hervé Brisse, Luc Joyeux, Sabine Irtan, Christophe Glorion, Jean Michon, Caroline Harte, Sabine Sarnacki, Timothé de Saint Denis, Luca Pio, T. Odent, Dominique Valteau-Couanet, Thomas Blanc
Rok vydání: 2019
Předmět:
Male
medicine.medical_treatment
Pediatrics
Neurosurgical Procedures
pediatric surgical oncology
surgery
Neuroblastoma
0302 clinical medicine
Prospective Studies
Spinal Cord Neoplasms
Child
Ganglioneuroblastoma
INTRASPINAL EXTENSION
COMPLICATIONS
Hematology
CHEMOTHERAPY
Prognosis
TUMORS
Neurosurgical Procedure
LAMINECTOMY
medicine.anatomical_structure
Oncology
Child
Preschool
030220 oncology & carcinogenesis
Female
Neurosurgery
Life Sciences & Biomedicine
dumbbell
medicine.medical_specialty
Adolescent
SPINAL-CORD COMPRESSION
Laminotomy
neuroblastoma
03 medical and health sciences
Spinal cord compression
medicine
Humans
Spinal canal
Ganglioneuroma
Retrospective Studies
Science & Technology
business.industry
Infant
spinal cord
medicine.disease
Surgery
Spinal decompression
Pediatrics
Perinatology and Child Health
DEFINED RISK-FACTORS
business
Follow-Up Studies
030215 immunology
Zdroj: Pediatric Blood & Cancer. 66
ISSN: 1545-5017
1545-5009
Popis: INTRODUCTION: Prognosis of dumbbell neuroblastoma (NBL) is mainly determined by the sequelae induced by the tumor itself and the neurosurgical approach. However, after primary chemotherapy, surgical management of the residual tumor, especially the spinal canal component, remains controversial. METHODS: We conducted a single-center retrospective cohort study over the last 15 years (2002-2017) including patients treated for NBL with spinal canal extension focusing on timing and type of surgery, complications, and functional and oncological follow-up. RESULTS: Thirty-two children (14 M, 18 F) were managed for NBL, with the majority (26) presenting with NBL stroma poor while four had ganglioneuroblastoma intermixed, one nodular, and one ganglioneuroma. All but two patients received neoadjuvant chemotherapy. Upfront laminotomy for spinal cord decompression was performed in two patients; nine patients had extraspinal surgery with a follow-up neurosurgical procedure in seven cases; eight patients had initial neurosurgery followed by an extraspinal procedure, while six patients underwent a combined multidisciplinary approach. With a median follow up of 3.6 years (0.1-14.9), 29 patients (90.6) are alive and two out of three (19, 65.5%) have functional sequelae. CONCLUSION: Patients with NBL with persistent spinal canal extension of the tumor after neoadjuvant chemotherapy treated at our center had outcomes that compare favorably with the literature. This is likely due to the multidisciplinary approach to optimal surgical strategy and continuous evaluation of the respective risks of tumor progression. Neurological disability results from initial spinal cord compression or the radicular sacrifice required for tumor resection. ispartof: PEDIATRIC BLOOD & CANCER vol:66 ispartof: location:United States status: published
Databáze: OpenAIRE
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