Therapeutic significance of surgery in advanced neuroblastoma: A report from the study group of Japan

Tsuchida, Yoshiaki; Yokoyama, Jotaro; Kaneko, Michio; Uchino, Junichi; Iwafuchi, Makoto; Makino, Shin-ichi; Matsuyama, Shiro; Takahashi, Hideyo; Okabe, Ikuo; Hashizume, Kohhei; Hayashi, Akira; Hakada, Kohnosuke; Yokoyama, Sho; Nishihira, Hirokazu; Sasaki, Shingi; Sawada, Tadashi; Nagahara, Noboru; Okada, Akira

doi:10.1016/0022-3468(92)90461-f

Cited by 62 publications

(24 citation statements)

References 21 publications

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“…The same group of authors has reported a 72% EFS in 25 stage 111 children treated with intensive chemotherapy, surgery, and radiotherapy D91. In the same sense Tsuchida et al obtained an 89% gross complete resection in 19 stage 111 patients previously submitted to very intensive chemotherapy [21].…”

Section: Children <1 Year Old (15 Patients)mentioning

confidence: 94%

Treatment of stage III neuroblastoma with emphasis on intensive induction chemotherapy: A report from the neuroblastoma group of the spanish society of pediatric oncology

Castel

Badal

Bezanilla

et al. 1995

Med. Pediatr. Oncol.

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From October 87 to April 92, 172 children were admitted in the N-I-87 protocol of the Spanish Society of Pediatric Oncology for the diagnosis and treatment of neuroblastoma. Forty-eight were considered Evans stage III, 33 of them being older than 1 year. All children were treated with induction chemotherapy (IC) and surgery. IC consisted of three courses of high-dose cisplatin-VM-26 alternating with three further courses of cyclophosphamide-doxorubicin (CAD). Infants less than 1 year received the same drugs at lower doses. After surgery, maintenance chemotherapy was administered to all children during 14 months. It consisted of four pairs of drugs rotated every 4 weeks. Radiotherapy was administered exclusively to patients older than 1 year with residual tumor after IC and surgery. Response was evaluated after IC and surgery. In children older than 1 year, response was obtained in 28/33 (88%). Fifteen of them (47%) achieved complete remission (CR), seven (22%) good partial response (GPR), six (19%) partial response (PR); and in three patients (9%) there was progressive disease (PD). Actuarial survival at 48 months was 0.60 +/- 0.10 and EFS was 0.61 +/- 0.12. Audiologic impairment was considered the worst toxicity. In children less than 1 year the response rate to IC and surgery was 93% (14/15); nine infants obtained complete response and four had GPR. Only one patient experienced PD in the first 6 months of therapy and died. The other 14 are alive and well at a mean follow-up time of 48 months. Chemotherapy toxicity was mild and reversible.

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Section: Children <1 Year Old (15 Patients)mentioning

confidence: 94%

Treatment of stage III neuroblastoma with emphasis on intensive induction chemotherapy: A report from the neuroblastoma group of the spanish society of pediatric oncology

Castel

Badal

Bezanilla

et al. 1995

Med. Pediatr. Oncol.

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“…[4][5][6][7][8] Few of these studies have focused specifically on the role of gross total resection in achieving local control and thus contributing to overall complete response. Logically, this is where surgical impact is greatest.…”

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confidence: 99%

The impact of gross total resection on local control and survival in high-risk neuroblastoma

Quaglia

Kushner

et al. 2004

Journal of Pediatric Surgery

150

101

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“…Primary surgery can be performed in about half of these children and reported survival rates are high (De Bernardi et al, 1995). However, unresectable tumours usually have a poorer outcome, unless secondary radical excision can be performed (Rosen et al, 1984b;Haase et al, 1989;Tsuchida et al, 1992). Consequently, the efficacy of primary chemotherapy to allow subsequent resection is of outstanding importance (Garaventa et al, 1993; West et al, 1993).…”

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confidence: 99%

Unresectable localized neuroblastoma: improved survival after primary chemotherapy including carboplatin-etoposide

Michon¹,

Plantaz²,

Peyroulet³

et al. 1998

Br J Cancer

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Keywords: neuroblastoma; carboplatin; etoposide; N-myc Neuroblastoma (NB) is the most common solid tumour of early childhood (Bernstein et al, 1992). Approximately 50% of patients present with localized tumours (Hartmann et al, 1983;Rosen et al, 1984a) and radical surgical excision is generally considered as the main requirement for cure (Evans et al, 1976; Le Toumeau et al, 1985). Primary surgery can be performed in about half of these children and reported survival rates are high (De Bernardi et al, 1995). However, unresectable tumours usually have a poorer outcome, unless secondary radical excision can be performed (Rosen et al, 1984b;Haase et al, 1989;Tsuchida et al, 1992). Consequently, the efficacy of primary chemotherapy to allow subsequent resection is of outstanding importance (Garaventa et al, 1993; West et al, 1993). We previously reported the efficacy of the combination of carboplatin and etoposide (CE) in refractory or relapsed NBs (Frappaz et al, 1992) and investigated its relevance as a first line therapy in unresectable NBs.In 1990, a national prospective study (NBL 90) was initiated, registering all children with localized NBs diagnosed in the institutions of the French Society of Pediatric Oncology (SFOP). The Primary aim was to assess the efficacy and the safety of such chemotherapy as primary treatment in unresectable NBs, PATIENTS AND METHODS Patient populationUntreated children aged from 0 to 16 years were eligible. The primary tumour was evaluated using computerized tomography (CT)-scan or magnetic resonance imaging (MRI) as well as metaiodobenzylguanidine (MIBG) scintigraphy. Work-up to eliminate metastatic spread included the skeletal study by MIBG (or a 99mTc scan in the absence of MIBG uptake at the primary site), radiograph in infants and extensive bone marrow staging (at least two aspirations and two trephine biopsies). Urinary catecholamines (VMA, HVA and dopamine), serum neuron-specific enolase (NSE), ferritin and lactate dehydrogenase (LDH) levels were measured. The diagnosis of NB was always confirmed by cytological or histological documentation. The primary tumour was staged according to TNM (Beahrs, 1983) and INSS (Brodeur et al, 1993). However, those unresectable NBs did not overlap completely with INSS stage 3 tumours. Indeed, according to our definition of resectability using radiological data, those tumours were not operated first and some of them were INSS stage 2 (i.e. lateral tumours encasing regional organs or vessels and dumbbell tumours). Analysis of the N-myc oncogene (Seeger et al, 1985)

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Therapeutic significance of surgery in advanced neuroblastoma: A report from the study group of Japan

Cited by 62 publications

References 21 publications

Treatment of stage III neuroblastoma with emphasis on intensive induction chemotherapy: A report from the neuroblastoma group of the spanish society of pediatric oncology

Treatment of stage III neuroblastoma with emphasis on intensive induction chemotherapy: A report from the neuroblastoma group of the spanish society of pediatric oncology

The impact of gross total resection on local control and survival in high-risk neuroblastoma

Unresectable localized neuroblastoma: improved survival after primary chemotherapy including carboplatin-etoposide

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