Neuroblastoma with symptomatic epidural compression in the infant: The AIEOP experience

Bernardi, Bruno; Quaglietta, Lucia; Haupt, Riccardo; Castellano, Aurora; Tirtei, Elisa; Luksch, Roberto; Viscardi, Elisabetta; Indolfi, Paolo; Cellini, Monica; Tamburini, Angela; Erminio, Giovanni; Sorrentino, Stefania; Vetrella, Simona; Gigliotti, Anna Rita

doi:10.1002/pbc.25028

Cited by 26 publications

(53 citation statements)

References 25 publications

(39 reference statements)

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“…NB with spinal canal involvement represents about 10% of overall NB treated in our institution, which is in line with previous data reported by De Bernardi in 2014 . As expected, the locations were mainly thoracic and tumors were mostly localized .…”

Section: Discussionsupporting

confidence: 92%

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Multidisciplinary surgical strategy for dumbbell neuroblastoma: A single‐center experience of 32 cases

Pio

Blanc

Denis

et al. 2019

Pediatric Blood & Cancer

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Introduction Prognosis of dumbbell neuroblastoma (NBL) is mainly determined by the sequelae induced by the tumor itself and the neurosurgical approach. However, after primary chemotherapy, surgical management of the residual tumor, especially the spinal canal component, remains controversial. Methods We conducted a single‐center retrospective cohort study over the last 15 years (2002–2017) including patients treated for NBL with spinal canal extension focusing on timing and type of surgery, complications, and functional and oncological follow‐up. Results Thirty‐two children (14 M, 18 F) were managed for NBL, with the majority (26) presenting with NBL stroma poor while four had ganglioneuroblastoma intermixed, one nodular, and one ganglioneuroma. All but two patients received neoadjuvant chemotherapy. Upfront laminotomy for spinal cord decompression was performed in two patients; nine patients had extraspinal surgery with a follow‐up neurosurgical procedure in seven cases; eight patients had initial neurosurgery followed by an extraspinal procedure, while six patients underwent a combined multidisciplinary approach. With a median follow up of 3.6 years (0.1–14.9), 29 patients (90.6) are alive and two out of three (19, 65.5%) have functional sequelae. Conclusion Patients with NBL with persistent spinal canal extension of the tumor after neoadjuvant chemotherapy treated at our center had outcomes that compare favorably with the literature. This is likely due to the multidisciplinary approach to optimal surgical strategy and continuous evaluation of the respective risks of tumor progression. Neurological disability results from initial spinal cord compression or the radicular sacrifice required for tumor resection.

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Section: Discussionsupporting

confidence: 92%

“…Neuroblastoma (NB) originating from the paravertebral sympathetic chain may infiltrate the adjacent intervertebral foramina and enter the spinal canal. Representing a specific entity also called dumbbell NB (NBL), they account for 5–10% of all NBL …”

Section: Introductionmentioning

confidence: 99%

Multidisciplinary surgical strategy for dumbbell neuroblastoma: A single‐center experience of 32 cases

Pio

Blanc

Denis

et al. 2019

Pediatric Blood & Cancer

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“…However, multivariate analysis indicated a significant association between motor sequela and neurosurgery . The evidence on the role of the symptom–diagnosis interval in the occurrence of late motor deficit is ambiguous; three studies report a significant better outcome with shorter symptom–diagnosis interval, while two studies found no association between the two parameters …”

Section: Resultsmentioning

confidence: 96%

“…None of the studies reported that the outcome was assessed by an investigator who was blinded for the treatment status of the patients. Eight studies (28.6%) assessed the influence of prognostic/risk factors on survival, neurological outcome, and/or long‐term health problems . Only two studies (7.1%) adjusted for possible confounders in a multivariate analysis …”

Section: Resultsmentioning

confidence: 99%

“…Besides, treatment‐related spinal deformity is accompanied by tumor‐induced destruction of spinal anatomy making elucidation of each relative role hard, if not impossible. Three of the more recent studies found no significant difference between chemotherapy and neurosurgery in the ability to relieve neurological motor deficit . Due to small sample sizes and consequent limited statistical power, differences found were often not significant.…”

Section: Discussionmentioning

confidence: 98%

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Treatment and outcome of neuroblastoma with intraspinal extension: A systematic review

Kraal

Blom

Noesel

et al. 2017

Pediatric Blood & Cancer

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We performed a systematic review to define the long-term health problems and optimal treatment strategy for patients with neuroblastoma with intraspinal extension. Of 685 identified studies, 28 were included in this review. The burden of long-term health problems is high; a median of 50% of patients suffered from neurological motor deficit, 34% from sphincter dysfunction, and 30% from spinal deformity. The currently available literature remains suboptimal as a guide for treatment of NBL with intraspinal extension. More well-designed, prospective studies are needed to determine the optimal treatment strategy.

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Spinal Canal Involvement in Peripheral Neuroblastic Tumors

et al. 2019

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Neuroblastoma with symptomatic epidural compression in the infant: The AIEOP experience

Abstract: Both neurosurgery and chemotherapy provide unsatisfactory results once paraplegia has been established. Sequelae developed in the majority of study patients and were severe in a half of them. Greater awareness by parents and physicians regarding SEC is warranted.

Cited by 26 publications

References 25 publications

Multidisciplinary surgical strategy for dumbbell neuroblastoma: A single‐center experience of 32 cases

Multidisciplinary surgical strategy for dumbbell neuroblastoma: A single‐center experience of 32 cases

Treatment and outcome of neuroblastoma with intraspinal extension: A systematic review

Spinal Canal Involvement in Peripheral Neuroblastic Tumors

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