Nöroblastomda tek merkez deneyimi, cerrahi sonuçlar ve komplikasyonlar

Year 2025, Volume: 15 Issue: 5, 238 - 244, 30.09.2025

İlknur Banlı Cesur , Zerrin Özçelik , Gunay Ekberli , Begül Yağcı-küpeli

https://doi.org/10.16899/jcm.1699324

Abstract

Özet
Arka Plan/Amaçlar: Nöroblastom (NB), periferik sinir sisteminin embriyonal nöroendokrin tümörüdür. Çocukluk çağının en sık görülen ekstrakraniyal solid tümörüdür ve yaşamın ilk yılında en sık görülür. İyi huylu bir seyirden ölümcül bir hastalığa kadar değişen değişken bir seyir gösterir
Yöntemler: Ocak 2012 ile Aralık 2021 arasında merkezimizde nöroblastom nedeniyle cerrahi rezeksiyon geçiren 18 yaş altı kırk hasta çalışmaya dahil edildi. Hastaların demografik verileri, ameliyat öncesi kesitsel ve fonksiyonel görüntüleme, cerrahi prosedürler, cerrahi komplikasyonlar ve patolojik evreleme retrospektif olarak analiz edildi.

Sonuçlar: Bu retrospektif çalışmada 48 hasta analiz edildi. 48 hastanın %52,5'i erkek ve %47,5'i kadındı. Hastaların %82,5'inde elle muayene edilebilen abdominal kitle tespit edildi. 0 hasta nöroblastoma, 10 hasta ganglionöroblastoma ve 8 hasta ganglionöroma idi. Ganglionöroma olan sekiz hasta çalışmadan hariç tutuldu. Analiz 40 hasta arasında yapıldı.
Sonuçlar: NB klinik davranışta heterojendir. Hastalığın evresi, hastanın yaşı ve risk faktörleri dikkate alınarak, pediatrik cerrah tarafından minimal komplikasyonlarla tedavi edilir. Tümör sempatik sinir sisteminden kaynaklandığı ve çevredeki büyük damarları ve çevre dokuları istila ettiği için, ameliyattan sonra agresif kemoterapi ve lokal bölgesel radyoterapi gerekebilir. Ameliyatı kişiselleştirerek ciddi komplikasyonlardan kaçınmak mümkün olabilir.

Keywords

nöroblastom, , cerrahi , klinik davranış

Project Number

yok

Single center experience in neuroblastoma, surgical results and complications

Abstract

Abstract
Background/Aims: Neuroblastoma (NB) is an embryonal neuroendocrine tumor of the peripheral nervous system. It is the most common extracranial solid tumor of childhood and the most common in the first year of life.It has a variable course ranging from a benign course to a fatal disease
Methods: Forty patients under the age of 18 who underwent surgical resection in our center due to neuroblastoma between January 2012 and December 2021 were included in to the study. Demographic data of the patients, preoperative cross-sectional and functional imaging, surgical procedures, surgical complications and pathological staging were analyzed retrospectively.

Results: In this retrospective study, 48 patients were analyzed. Of 48 patients 52.5% were male and 47.5% were female. palpable abdominal mass detected in 82.5% of the patients. 0 patients were neuroblastoma, 10 patients were ganglioneuroblastoma, and 8 patients were ganglioneuromas. Eight patients with ganglioneuroma were excluded from the study. Analysis was performed among 40 patients.
Conclusions: NB is heterogeneous in clinical behavior. It is treated by the pediatric surgeon with minimal complications, taking into account the stage of the disease, the age of the patient, and risk factors. Since the tumor originates from the sympathetic nervous system and invades surrounding large vessels and surrounding tissues, aggressive chemotherapy and local regional radiotherapy may be required after surgery. It may be possible to avoid serious complications by customizing the surgery.

Keywords

neuroblastoma , surgery , clinical behavior , survival

Ethical Statement

24.03.2022/ karar no:1849

Supporting Institution

yok

Project Number

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Thanks

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References

• 1.London WB, Castleberry RP, Matthay KK, Look AT, Seeger RC, Shimada H, et al. Evidence for an age cutoff greater than 365 days for neuroblastoma risk group stratification in the Children’s Oncology Group. J Clin Oncol. 2005;23:6459-65.
• 2.Maris JM. Recent advances in neuroblastoma. N Engl J Med. 2010;362:1202-11.
• 3.Li J, Thompson TD, Miller JW, et al. Cancer incidence among children and adolescents in the United States, 2001-2003. Paediatrics. 2008;121:1470-77.
• 4.Vo KT, et al. Clinical, biologic, and prognostic differences on the basis of primary tumour site in neuroblastoma: a report from the international neuroblastoma risk group Project. J Clin Oncol. 2014;32:3169-76.
• 5.Brodeur GM, Maris JM, Yamashiro DJ, et al. Neuroblastoma. In: Pizzo PA, Poplack DG, eds. Principles and Practice of Paediatric Oncology. 7th ed. Lippincott Williams & Wilkins; 2015:704-747.
• 6.Cohn SL, Pearson AD, London WB, et al. The International Neuroblastoma Risk Group (INRG) classification system: an INRG Task Force report. J Clin Oncol. 2009;27:289-97.
• 7.Morgenstem DA, et al. Prognostic significance of pattern and burden of metastatic disease in patients with stage 4 neuroblastoma: A Study from the International Neuroblastoma Risk Group database. Eur J Cancer. 2016;65:1-10.
• 8.Wen Z, Zhang L, Zhuang H. Roles of PET/Computed Tomography in the Evaluation of Neuroblastoma. PET Clin. 2020;15:321-31.
• 9.Monclair T, Brodeur GM, Ambros PF, et al. The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report. J Clin Oncol. 2009;27:298-303.
• 10.D'Angio GJ, Evans AE, Koop CE. International Neuroblastoma Staging System (INSS): a new staging system for neuroblastoma. J Clin Oncol. 1988;6:146-150.
• 11.Chung C, Boterberg T, Lucas J, Panoff J, Valteau-Couanet D, Bagatell R. Neuroblastoma. Pediatr Blood Cancer. 2021;68:e28473.
• 12.Croteau N, Nuchtern J, LaQuaglia MP. Management of Neuroblastoma in Paediatric Patients. Surg Oncol Clin N Am. 2021;30:291-304.
• 13.Swift CC, Eklund MJ, Kraveka K, Basu Emi Roberts S, Hammond E, et al. Management and Treatment of Neuroblastoma. Radiographics. 2018;38:566-80.
• 14.Rubie H, et al. Survival and prognosis in localised and metastatic neuroblastoma treated according to the European Neuroblastoma Study Group (ENGS) guidelines. Cancer Res. 2010;70(24 Suppl):Abstract 4656.
• 15.Yao W, Li K, Dong KR, Zheng S, Xiaom XM. Long-term prognosis of low-risk neuroblastoma treated by surgery alone: an experience from a single institution of China. World J Pediatr. 2019;15:148-52.
• 16.De Bernardi B, Di Cataldo A, Garaventa A, et al. Stage 4S neuroblastoma: features, management and outcome of 268 cases from the Italian Neuroblastoma Registry. Ital J Pediatr. 2019;45:8.
• 17.Dindo D, Demartines N, Clavien PA. Classification of Surgical Complications: A New Proposal With Evaluation in a Cohort of 6336 Patients and Results of a Survey. Ann Surg. 2004;240(2):205-213.
• 18.Clavien PA, Barkun J, de Oliveira PL, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250(2):187-196.
• 19.Ratio A, Rice MJ, Mullassery D, Losty PD. Stage 4S Neuroblastoma: What are the outcomes? A systematic Review of published studies. Eur J Pediatr Surg. 2021;31:385-89.
• 20.Wang Z, Sun H, Li K. et al. Prognostic factor analysis of stage 4S neuroblastoma in infant patients: a single centre study. J Pediatr Surg. 2019;54:2585-88.
• 21.Schilling FH, Spix C, Berthold F, et al. Neuroblastoma screening at one year of age. N Engl J Med. 2002;346:1047-53.
• 22.Nakagawara A, Li Y, Izumi H, Muramori K, Inada H, Nishi M. Jpn J Clin Oncol. 2018;48:214-41.
• 23.Du L, Liu L, Zhang C, et al. Role of surgery in the treatment of patients with high-risk neuroblastoma who have a poor response to induction chemotherapy. J Pediatr Surg. 2014;49:528-33.
• 24.Davidoff AM. The current role of surgery in neuroblastoma. Semin Pediatr Surg. 2012;21(3):233-241.
• 25.Kim ES, et al. The clinical significance of viable tumour cells in post-chemotherapy resected neuroblastoma. J Korean Surg Soc. 2012;83(5):298-304. 26.Von Allmen D, Davidoff AM, London WB, et al. Impact of extent of resection on local control and survival in patients from the COG A3973 study with high-risk neuroblastoma. J Clin Oncol. 2017;35:208-16. 27.Bagatell R, McHugh K, Naranjo A, et al. Assessment of primary site response in children with high-risk neuroblastoma: an international multicentre study. J Clin Oncol. 2016;34:740-746