Role of image-defined risk factors in predicting surgical complications of localized neuroblastoma
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ORIGINAL ARTICLE
Role of image‑defined risk factors in predicting surgical complications of localized neuroblastoma Tao Liu1 · Zhibao Lv1 · Weijue Xu1 · Jiangbin Liu1 · Qingfeng Sheng1 Accepted: 12 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To explore the relationship between image-defined risk factors and surgical complications of localized neuroblastoma. Methods We retrospectively evaluated 84 patients who met the inclusion criteria at our hospitals between June 2014 and June 2019. Patients’ clinic data were collected and the common terminology criteria for adverse events were used to categorize complications as major (grade 3–4) or minor (grade 1–2). Results Four (11.8%) out of 34 stage L1 patients and 15 (30.0%) out of 50 stage L2 patients had surgical complications (P 0.05). The mean numbers of IDRFs were 2.06 and 4.29, respectively (P < 0.05). Conclusions Localized neuroblastoma patients with IDRFs have a greater surgical risk. And the number of IDRFs is not ignorable, especially in predicting major surgical complications. Keywords Neuroblastomas · IDRFS · Neoadjuvant chemotherapy · Surgical complication
Introduction Neuroblastic tumors (neuroblastomas, ganglioneuroblastomas, and ganglioneuromas) are the commonest extracranial solid tumors that afflict children [1]. To develop a consensus approach to pretreatment risk stratification, a new international neuroblastoma risk group (INRG) staging system (INRGSS) was designed to stratify patients prior to implementation of any treatment (including surgery) [1, 2]. Locoregional tumors are staged L1 or L2 based on the absence or presence of one or more of 20 image-defined risk factors (IDRFs), respectively. Stage M tumors refer to distant metastatic disease (not contiguous with the primary tumor), except when defined as stage MS. Stage MS tumors refer to metastatic disease in patients younger than 18 months * Zhibao Lv [email protected] 1
Department of General Surgery, Children’s Hospital of Shanghai, Shanghai Jiao Tong University, Shanghai 200040, China
(547 days) with metastasis confined to the skin, liver, and/ or bone marrow ( 0.05 36 (100) 70 (100)
25 (69.4) 10 (71.4) 35 (70.0)
11 (30.6) 4 (28.6) 15 (30.0)
36 (100) > 0.05 14 (100) 50 (100)
34 (94.4) 12 (85.7) 46 (92.0)
2 (5.6) 2 (14.3) 4 (8.0)
36 (100) 14 (100) 50 (100)
0.031
a
Complications referred to major and minor surgical complications
b
INRG L2 patients who underwent primary surgery
13
Table 3 Distribution of extent of surgery and the number of IDRFs among patients with stage L2 neuroblastoma
Pediatric Surgery International
Complete resection, n (%) Incomplete resection, n (%) Total, n (%) Mean number of IDRFs
Discussion In our study, the surgical complication rates were 11.8% and 30% among patients with stages L1 and L2 disease, respectively. These results are similar to the respective rates of 15.5% and 33.3% reported by Yoneda et al. [10]. Another study that emanated from Germany reported respective rates of 14.5% and 2
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