Spinal Canal Involvement in Neuroblastoma

Trahair, Toby N.; Sorrentino, Stefania; Russell, Susan; Sampaio, Hugo; Selek, Laurent; Plantaz, Dominique; Freyçon, Claire; Simon, Thorsten; Kraal, Kathelijne C.J.M.; Beck‐Popovic, Maja; Haupt, Riccardo; Ash, Susan; Bernardi, Bruno

doi:10.1016/j.jpeds.2017.05.051

Cited by 12 publications

(16 citation statements)

References 48 publications

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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 . Six patients had metastatic disease at diagnosis (18.7%), a proportion not quite different from that in previous reports, which ranged from 11% to 25% .…”

Section: Discussionsupporting

confidence: 92%

“…Neurological sequelae should be analyzed according to the symptoms at diagnosis, delay, and nature of treatment (chemotherapy vs surgery). Severe impairment at presentation has been associated with an increased risk of poor functional recovery and long‐term sequelae . Similar to the median incidence observed in the literature, we reported 48.2% of neurological sequelae, three linked to spinal cord ischemia and six to the involvement of roots by the tumor and/or sacrifice required for resection—two different mechanisms that should be differentiated.…”

Section: Discussionsupporting

confidence: 86%

“…These results confirmed the specificity of NBL arising from the paravertebral sympathetic chain or extending in the spinal canal through the foramina, which are associated with a favorable biology and good outcome in terms of OS and event‐free survival . The prognosis of dumbbell NBL is largely linked to functional sequelae resulting from SCC or the involvement of nerve roots and/or of spinal deformities associated with the neurosurgical approach …”

Section: Discussionsupporting

confidence: 69%

“…While numerous reports confirm the validity of this oncological approach, the burden of dumbbell NBL remains high . In addition, preoperative chemotherapy does not ensure regression of the IDRF .…”

Section: Introductionmentioning

confidence: 99%

“…While numerous reports confirm the validity of this oncological approach, the burden of dumbbell NBL remains high. [5][6][7][8][9] In addition, preoperative chemotherapy does not ensure regression of the IDRF. [10][11][12][13][14] Furthermore, there are currently no international guidelines regarding the surgical treatment of residual tumor after neoadjuvant chemotherapy, particularly concerning the intraspinal component.…”

mentioning

confidence: 99%

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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%

Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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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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Relationship between the timing of chemotherapy and surgical complications following surgical biopsy in children with malignant solid tumors

Hayashi

Mori

Sanmoto

et al. 2022

Pediatric Blood & Cancer

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Background: Biopsies for diagnosis before chemotherapy is common in children with malignant solid tumors. Wound healing is delayed by chemotherapy; however, the ideal interval between biopsy and chemotherapy remains unknown. We aimed to summarize the relationship between chemotherapy timing and postoperative surgical complications. Procedure:We retrospectively reviewed patients with malignant solid tumors who underwent chemotherapy after surgical biopsy at our institution between January 2014 and August 2020. The primary outcomes were postoperative surgical complications (within 30 days) and the timing of chemotherapy.Results: Forty-three patients were analyzed. The types of tumors were neuroblastoma (n = 20), hepatoblastoma (n = 10), Ewing sarcoma (n = 5), germ cell tumor (n = 3), angiosarcoma (n = 1), clear cell sarcoma (n = 1), ganglioneuroblastoma (n = 1), rhabdoid tumor (n = 1), and rhabdomyosarcoma (n = 1). The operative procedures were thoracoscopy (n = 5), laparotomy (n = 17), laparoscopy (n = 14), and superficial (n = 7).The median time [range] to chemotherapy after biopsy was 4 [0-21] days. No surgical complications occurred before chemotherapy, and two (4.7%) patients experienced complications after chemotherapy. These included postoperative hemorrhage (grade 3) and surgical site infection (grade 1). Chemotherapy was initiated 1 and 6 days after biopsy, respectively, in these cases. Complications occurred 10 and 23 days after biopsy, respectively. Conclusion:The rate of postoperative surgical complications related to biopsy seems acceptable, even when chemotherapy was initiated in the early postoperative period.Early initiation of chemotherapy after biopsy may be a suitable option, particularly in children with bulky or symptomatic malignant solid tumors.

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