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Journal of pediatric hematology/oncology
01, 2020;42 (1): 1-7.

The Role of Surgery in High-risk Neuroblastoma.

Anne L Ryan, Adesola Akinkuotu, Agostino Pierro, Daniel A Morgenstern, Meredith S Irwin
Author Information
  1. Anne L Ryan: Department of Paediatrics, Division of Hematology/Oncology.
  2. Adesola Akinkuotu: Department of Surgery, Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, ON, Canada.
  3. Agostino Pierro: Department of Surgery, Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, ON, Canada.
  4. Daniel A Morgenstern: Department of Paediatrics, Division of Hematology/Oncology.
  5. Meredith S Irwin: Department of Paediatrics, Division of Hematology/Oncology.
PMID: 31599856 DOI: 10.1097/MPH.0000000000001607

Abstract

Although intensive multimodal treatment has improved outcomes for patients with high-risk neuroblastoma, the specific role of primary tumor resection remains controversial. Many studies have been designed to determine whether the extent of surgical resection impacts survival; however, these reports have demonstrated conflicting results. There is also ongoing debate regarding the timing of primary tumor resection, with subtle differences in the approach between the large pediatric oncology cooperative consortia. Most of the published literature to date has been approached from a surgical viewpoint. Although most evidence supports surgery as part of the local control approach for high-risk neuroblastoma, recommendations for timing and extent of surgical resection are not consistent. This review summarizes our current understanding from the perspectives of both the pediatric oncologist and pediatric surgeons and discusses how the objectives of neuroblastoma primary surgical resection are different from that of other malignancies. Furthermore, this commentary will address how retrospective surgical outcome data may be interpreted in the setting of modern era high-risk neuroblastoma treatment.

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MeSH Term

Disease-Free Survival
Humans
Neoplasm Staging
Neuroblastoma
Retrospective Studies
Journal Article Review
Article has an altmetric score of 6

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