Histopathologic findings of advanced neuroblastoma after intensive induction chemotherapy

• Published in: Journal of pediatric surgery Vol. 32; no. 11; pp. 1620 - 1623
• Main Authors: Miyauchi, J, Matsuoka, K, Oka, T, Kamii, Y, Honna, T, Bessho, F, Sasaki, S, Melanowska, J, Tsuchida, Y
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Philadelphia, PA Elsevier Inc 01.11.1997; Elsevier
• Subjects: Abdominal Neoplasms - drug therapy; Abdominal Neoplasms - mortality; Abdominal Neoplasms - pathology; Abdominal Neoplasms - surgery; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Chemotherapy; Child; Cisplatin - administration & dosage; Cyclophosphamide - administration & dosage; Decision Making; Doxorubicin - administration & dosage; Doxorubicin - analogs & derivatives; Humans; Japan - epidemiology; Lymph Node Excision; Medical sciences; Neoplasm Metastasis; Neuroblastoma - drug therapy; Neuroblastoma - mortality; Neuroblastoma - pathology; Neuroblastoma - surgery; Pharmacology. Drug treatments; Retrospective Studies; Survival Rate; Time Factors; Japan; histopathology; radical surgical dissection; Neuroblastoma; chemotherapy; lymph node; Human; Antineoplastic agent; Nervous system diseases; Lymph node; Malignant tumor; Case study; Pathology; Chemotherapy; Histopathology; Treatment; Surgery; Influence; Advanced stage; Pretreatment; Timing; Autonomic neuropathy; Dissection; Child
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/S0022-3468(97)90467-X

Background: Histopathologic findings of advanced neuroblastoma after intensive induction chemotherapy have not been studied well. Methods: In the present study, all of the surgical specimens from 19 patients who had advanced abdominal neuroblastoma and were pretreated intensively with the protocol of the Study Group of Japan were reviewed. The authors found that dissection of the contralateral lymph nodes is mandatory in advanced neuroblastoma when the goal is the complete dissection of the abdominal disease. Effects of chemotherapy were graded histologically according to the ratio of viable residual neuroblastoma tissue to total areas of the tumor, including neuroblastoma, ganglioneuroblastoma, ganglioneuroma, hemorrhage, necrosis and fibrosis, in five ranks from (+++) to (−). Conclusions: The newly introduced, highly cytotoxic regimen of the Japanese protocol, designated “A 3”, appears to be more effective histologically than the conventional regimen, designated “A 1” or “new A 1.” Effects designated (+++) or (++) were prerequisites for survival in stage IV disease, but some stage III patients with the (+) effect survived.