Value of surgical resection in children with high‐risk neuroblastoma |
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Authors: | Brian R. Englum MD Kristy L. Rialon MD Paul J. Speicher MD Brian Gulack MD Timothy A. Driscoll MD Susan G. Kreissman MD Henry E. Rice MD |
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Affiliation: | 1. Department of Surgery, Duke University School of Medicine, Durham, North Carolina;2. Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina |
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Abstract: | Background The value of gross total resection (GTR) for children with high‐risk neuroblastoma (NB) is controversial. We hypothesized that patients undergoing GTR would demonstrate improved overall survival (OS) compared those having Methods Using a single institutional database, we reviewed the medical records of all children with high‐risk NB undergoing hematopoietic stem cell transplantation (HSCT) as part of multimodality therapy from 1990 to 2012. Children had received surgical care at multiple institutions (n = 14) prior to HSCT and were divided into two groups based on extent of surgical resection: GTR (no visible or palpable disease at end of operation) and Results One hundred four children underwent HSCT, and 87 (83.6%) had adequate data for analysis. Thirty eight percent had GTR while 62% had P = 0.49). Post‐hoc analysis demonstrated a survival advantage for patients undergoing >90% resection compared to <90% resection (P = 0.008). Multivariable Cox models confirmed these findings with improved survival in children undergoing >90% vs. <90% resection but no difference in GTR vs. Conclusion Gross total resection prior to HSCT in high‐risk NB patients is not associated with improved OS compared to 90% resection is associated with improved OS compared to less than 90% resection. Pediatr Blood Cancer 2015;62:1529–1535. © 2015 Wiley Periodicals, Inc. |
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Keywords: | BMT for malignant conditions neuroblastoma sickle cell Surgery |
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