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Year : 2018  |  Volume : 131  |  Issue : 19  |  Page : 2332-2337

Advances in the Surgical Treatment of Neuroblastoma

Department of Pediatric Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan 450052, China

Correspondence Address:
Dr. Jia-Xiang Wang
Department of Pediatric Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan 450052
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0366-6999.241803

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Objective: This study was to review the efficacy of surgical resections in different clinical situations for a better understanding of the meaning of surgery in the treatment of neuroblastoma (NB). Data Sources: The online database ScienceDirect (201–2018) was utilized. The search was conducted using the keywords “neuroblastoma,” “neuroblastoma resection,” “neuroblastoma surgery,” and “high-risk neuroblastoma.” Study Selection: We retrospectively analyzed of patients who underwent surgical resections in different clinical situations. The article included findings from selected relevant randomized controlled trials, systematic reviews, and meta-analyses or good-quality observational studies. Abstracts only, letters, and editorial notes were excluded. Full-text articles and abstracts were extracted and reviewed to identify key articles discussing surgery management of NB, which were then selected for critical analysis. Results: A total of 7800 English language articles were found containing references to NB (201–2018). The 163 articles were searched which were related to the surgical treatment of NB (201–2018). Through the analysis of these important articles, we found that the treatments of NB at low- and intermediate-risk groups were basically the same. High-risk patients remained controversial. Conclusions: NB prognosis varies tremendously based on the stage and biologic features of the tumor. After reviewing the relevant literature, patients with low-risk disease are often managed with surgical resection or observation alone with tumors likely to spontaneously regress that are not causing symptoms. Intermediate patients are treated with chemotherapy with the number of cycles depending on their response as well as surgical resection of the primary tumor. High-risk patients remain controversial. Multidisciplinary intensive treatment is essential, especially for patients who received subtotal tumor resection. Minimally invasive surgery for the treatment of NBs without image-defined risk factors in low- to high-risk patients is safe and feasible and does not compromise the treatment outcome. We conclude that ≥90% resection of the primary tumor is both feasible and safe in most patients with high-risk NB. New targeted therapies are crucial to improve survival.


 Abstract in Chinese




数据资料:在ScienceDirect 数据库中我们通过使用关键词“神经母细胞瘤”、“神经母细胞瘤切除术”、“神经母细胞瘤手术”和“高危组神经母细胞瘤”检索从2016到2018有关神经母细胞的文章。




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