Do the radiological criteria with the use of risk factors impact the forecasting of abdominal neuroblastic tumor resection in children?

Do the radiological criteria with the use of risk factors impact the forecasting of abdominal neuroblastic tumor resection in children?

Alternative title Critérios radiológicos impactam a previsão de ressecabilidade em neuroblastomas abdominais na criança com o uso de fatores de risco?
Author Soares Penazzi, Ana Claudia Autor UNIFESP Google Scholar
Tostes, Vivian Siqueira Google Scholar
Barros Duarte, Alexandre Alberto Autor UNIFESP Google Scholar
Lederman, Henrique Manoel Autor UNIFESP Google Scholar
Monteiro Caran, Eliana Maria Autor UNIFESP Google Scholar
Vieira Abib, Simone de Campos Autor UNIFESP Google Scholar
Abstract Background: The treatment of neuroblastoma is dependent on exquisite staging

is performed postoperatively and is dependent on the surgeon's expertise. The use of risk factors through imaging on diagnosis appears as predictive of resectability, complications and homogeneity in staging. Aim: To evaluate the traditional resectability criteria with the risk factors for resectability, through the radiological images, in two moments: on diagnosis and in pre-surgical phase. Were analyzed the resectability, surgical complications and relapse rate. Methods: Retrospective study of 27 children with abdominal and pelvic neuroblastoma stage 3 and 4, with tomography and/or resonance on the diagnosis and pre-surgical, identifying the presence of risk factors. Results: The mean age of the children was 2.5 years at diagnosis, where 55.6% were older than 18 months, 51.9% were girls and 66.7% were in stage 4. There was concordance on resectability of the tumor by both methods (INSS and IDRFs) at both moments of the evaluation, at diagnosis (p=0.007) and post-chemotherapy (p=0.019)

In this way, all resectable patients by IDRFs in the post-chemotherapy had complete resection, and the unresectable ones, 87.5% incomplete. There was remission in 77.8%, 18.5% relapsed and 33.3% died. Conclusions: Resectability was similar in both methods at both pre-surgical and preoperative chemotherapy

preoperative chemotherapy increased resectability and decreased number of risk factors, where the presence of at least one IDRF was associated with incomplete resections and surgical complications

relapses were irrelevant.

Racional: O tratamento do neuroblastoma é dependente de estadiamento primoroso, realizado no pós-cirúrgico e dependente da expertise do cirurgião. O uso de fatores de risco através da imagem ao diagnóstico surge como preditivo de ressecabilidade, complicações e homogeneidade no estadiamento. Objetivos: Avaliar o critério de ressecabilidade tradicional com os fatores de risco para ressecabilidade, através das imagens radiológicas, em dois momentos no diagnóstico e no pré-cirúrgico analisando a ressecabilidade, complicações cirúrgicas e índice de recidiva. Métodos: Estudo retrospectivo em 27 crianças com neuroblastoma estádios 3 e 4 em abdome e pelve, e com tomografia e/ou ressonância no diagnóstico e pré-cirúrgico, identificando-se a presença de fatores de risco. Resultados: A idade média das crianças foi de 2,5 anos ao diagnóstico, onde 55,6% estavam acima dos 18 meses, 51,9% eram meninas e 66,7% tinham estádio 4. Houve concordância da ressecabilidade do tumor pelos dois métodos avaliados (INSS e IDRFs) e em ambos os momentos da avaliação, ao diagnóstico (p=0,007) e pós-quimioterapia (p=0,019). Desta forma todos pacientes ressecáveis por IDRFs no pós-quimioterapia tiveram ressecção completa; já nos irressecáveis, 87,5% tiveram ressecção incompleta. Houve remissão em 77,8%, 18,5% recaíram e 33,3% morreram. Conclusões: A ressecabilidade foi semelhante em ambos os métodos tanto no diagnóstico como no pré-cirúrgico. A quimioterapia pré-operatória aumentou a ressecabilidade e diminuição do número de fatores de risco, onde a presença de ao menos um IDRF associou-se às ressecções incompletas e complicações cirúrgicas. As recidivas foram irrelevantes
Keywords Neuroblastoma
Neoplasm staging
Risk factors
Neuroblastoma
Estadiamento de neoplasias
Fatores de risco
xmlui.dri2xhtml.METS-1.0.item-coverage Sao Paulo Sp
Language English
Portuguese
Date 2017
Published in Abcd-Arquivos Brasileiros De Cirurgia Digestiva-Brazilian Archives Of Digestive Surgery. Sao Paulo Sp, v. 30, n. 2, p. 88-92, 2017.
ISSN 0102-6720 (Sherpa/Romeo, impact factor)
Publisher Colegio Brasileiro Cirurgia Digestiva-Cbcd
Extent 88-92
Origin http://dx.doi.org/10.1590/0102-6720201700020003
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000416611600003
SciELO ID S0102-67202017000200088 (statistics in SciELO)
URI https://repositorio.unifesp.br/handle/11600/54730

Show full item record




File

Name: S0102-67202017000200088-en.pdf
Size: 572.5Kb
Format: PDF
Description:
Open file
Name: S0102-67202017000200088-pt.pdf
Size: 485.6Kb
Format: PDF
Description:
Open file

This item appears in the following Collection(s)

Search


Browse

Statistics

My Account