» Articles » PMID: 34215956

Impact of Neoadjuvant Chemotherapy on Image-Defined Risk Factors in High-Risk Neuroblastoma

Overview
Journal Ann Surg Oncol
Publisher Springer
Specialty Oncology
Date 2021 Jul 3
PMID 34215956
Citations 9
Authors
Affiliations
Soon will be listed here.
Abstract

Purpose: Image-defined risk factors (IDRFs) are associated with surgical risks in neuroblastoma. We sought to evaluate the impact of neoadjuvant therapy on IDRFs and associated ability to achieve gross total resection (GTR) of locoregional disease in patients with high-risk neuroblastoma.

Methods: We retrospectively reviewed charts of patients treated on four consecutive high-risk neuroblastoma protocols over a 20-year period at a single institution. The number of IDRFs at diagnosis and just prior to surgery, and the percent decrease of tumor volume from just prior to surgery to the end of induction were determined.

Results: Eighty-eight patients were included. There were 438 IDRFs (average 5.0 ± 3.1 per patient) at diagnosis and 198 (average 2.3 ± 1.9 per patient) after neoadjuvant chemotherapy (p < 0.01). A reduction in IDRFs was seen in 81.8% of patients with average decrease of 2.9 ± 2.5 per patient. The average percent reduction in tumor volume was 89.8 ± 18.9% and correlated with the number of IDRFs present after chemotherapy (p < 0.01). Three or fewer IDRFs prior to surgery was associated with the highest odds ratio for > 90% GTR at 9.33 [95% confidence interval 3.14-31.5].

Conclusion: Neoadjuvant chemotherapy reduced the number of IDRFs in the majority of patients with high-risk neuroblastoma. The number of IDRFs present after neoadjuvant therapy correlated with the extent of resection.

Citing Articles

Quantitative MRI in Childhood Neuroblastoma: Beyond the Assessment of Image-defined Risk Factors.

Wang H, Cai J Radiol Imaging Cancer. 2024; 6(6):e240089.

PMID: 39485111 PMC: 11615636. DOI: 10.1148/rycan.240089.


Image-defined risk factors associated with MYCN oncogene amplification in neuroblastoma and their association with overall survival.

Wang H, Li T, Ni X, Chen X, He L, Cai J Abdom Radiol (NY). 2024; 49(6):1949-1960.

PMID: 38436700 DOI: 10.1007/s00261-024-04196-w.


Association of image-defined risk factors with clinical features, tumor biology, and outcomes in neuroblastoma: a single-center retrospective study.

Yang D, Liu C, Gao J, Hu Q, Liang Y, Liu J Eur J Pediatr. 2023; 182(5):2189-2196.

PMID: 36856889 DOI: 10.1007/s00431-023-04899-0.


High-Risk Neuroblastoma: A Surgical Perspective.

Jacobson J, Clark R, Chung D Children (Basel). 2023; 10(2).

PMID: 36832517 PMC: 9955866. DOI: 10.3390/children10020388.


The Use of Cavitron Ultrasonic Surgical Aspirator for High-Risk Neuroblastoma with Image-Defined Risk Factors in Children.

Pio L, Guerin F, Martucci C, Martelli H, Gauthier F, Branchereau S Children (Basel). 2023; 10(1).

PMID: 36670640 PMC: 9857095. DOI: 10.3390/children10010089.


References
1.
Tsuchida Y, Yokoyama J, Kaneko M, Uchino J, IWAFUCHI M, Makino S . Therapeutic significance of surgery in advanced neuroblastoma: a report from the study group of Japan. J Pediatr Surg. 1992; 27(5):616-22. DOI: 10.1016/0022-3468(92)90461-f. View

2.
Monclair T, Brodeur G, Ambros P, Brisse H, Cecchetto G, Holmes K . The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report. J Clin Oncol. 2008; 27(2):298-303. PMC: 2650389. DOI: 10.1200/JCO.2008.16.6876. View

3.
La Quaglia M . The role of primary tumor resection in neuroblastoma: When and how much?. Pediatr Blood Cancer. 2015; 62(9):1516-7. DOI: 10.1002/pbc.25585. View

4.
Mody R, Naranjo A, Van Ryn C, Yu A, London W, Shulkin B . Irinotecan-temozolomide with temsirolimus or dinutuximab in children with refractory or relapsed neuroblastoma (COG ANBL1221): an open-label, randomised, phase 2 trial. Lancet Oncol. 2017; 18(7):946-957. PMC: 5527694. DOI: 10.1016/S1470-2045(17)30355-8. View

5.
Davidoff A, Corey B, Hoffer F, Santana V, Furman W, Shochat S . Radiographic assessment of resectability of locoregional disease in children with high-risk neuroblastoma during neoadjuvant chemotherapy. Pediatr Blood Cancer. 2004; 44(2):158-62. DOI: 10.1002/pbc.20041. View