Management of thoracoabdominal neuroblastoma:a 13-year experience  

作　　者：Chan Hon Chui Anselm Lee 

机构地区：[1]Surgery Centre for Children,Singapore,Singapore [2]Children's Haematology and Cancer Centre,Singapore,Singapore

出　　处：《World Journal of Pediatric Surgery》2019年第2期47-52,共6页世界小儿外科杂志（英文）

摘　　要：background Thoracoabdominal neuroblastoma is a unique surgical challenge.We reviewed our experience focusing on disease patterns and corresponding surgical approaches.Methods Among 310 patients in our neuroblastoma database,30(9.7%)had thoracoabdominal neuroblastoma.Patients’clinical charts were reviewed and analyzed.Two disease patterns were identified:solitary thoracoabdominal tumor(group A,n=15)and multifocal tumors in thorax and abdomen(group B,n=15).Operative approaches were categorized based on routes of surgical access.results Thirty patients with average age of 4.1(range 0.8-12.8)years were studied.All received preoperative chemotherapy.Among 15 group A patients,four were stage 3 intermediate risk(IR)and 11 were stage 4 high risk(HR).Surgical approaches included single-incision thoracoabdominal approach(n=10),laparotomy-cum-transdiaphragmatic approach(n=3),and laparotomy-cum-thoracotomy approach(n=2).One patient had 10%residual disease and the rest achieved gross total resection.Postoperative complications included chylous ascites(n=3),intestinal obstruction(n=3),pneumonia(n=1),spinal cord infarction(n=1)scoliosis(n=2)and thoracoabdominal nerves palsy(n=3).Among 15 group B patients,all were stage 4 with five IR and 10 HR.Thoracic components were found in the posterior mediastinum(n=7),superior mediastinum(n=4),middle mediastinum(n=1),parietal pleura(n=3)and lungs(n=3).Surgical approaches included multi-incision laparotomy-cum-thoracotomy(n=14)and laparotomy-cum-transdiaphragmatic approach(n=1).Gross total resection was achieved in all surgeries.Postoperative complications included chylous ascites(n=3).Overall,all nine IR patients survived without evidence of disease and 9(42.8%)HR patients died of disease.There was no perioperative mortality.Conclusion Surgical resection of thoracoabdominal neuroblastoma is feasible and safe.Despite its complexity,thoracoabdominal neuroblastoma has comparable treatment outcomes when compared with single-compartmental disease.

关 键 词：NEUROBLASTOMA ABDOMINAL CHEMOTHERAPY 

分 类 号：R73[医药卫生—肿瘤]