Eur J Pediatr Surg 2011; 21(05): 314-317
DOI: 10.1055/s-0031-1280824
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Significance of Image-defined Risk Factors for Surgical Complications in Patients with Abdominal Neuroblastoma

P. Günther
1  University of Heidelberg, Division of Pediatric Surgery, Heidelberg, Germany
,
S. Holland-Cunz
1  University of Heidelberg, Division of Pediatric Surgery, Heidelberg, Germany
,
C.J. Schupp
1  University of Heidelberg, Division of Pediatric Surgery, Heidelberg, Germany
,
C. Stockklausner
2  University of Heidelberg, Department of Pediatric Oncology, Hematology and Immunology, Heidelberg, Germany
,
U. Hinz
3  University of Heidelberg, Unit for Documentation and Statistics of the Surgery, Heidelberg, Germany
,
J.-P. Schenk
4  University of Heidelberg, Department of Diagnostic and International Radiology, Division of Pediatric Radiology, Heidelberg, Germany
› Author Affiliations
Further Information

Publication History

received 28 April 2011

accepted after revision 14 May 2011

Publication Date:
21 July 2011 (online)

Abstract

Introduction

Neuroblastoma (NB) is one of the most common malignant tumors in infancy. The commonly used International Neuroblastoma Staging System is not suitable for determining the surgical risks. To address this, we aimed to evaluate the correlation between so-called image-defined risk factors (IDRFs) and the surgical risks in abdominal neuroblastoma.

Material and methods

We evaluated 60 cases who underwent surgical intervention and examined the pre-surgical radiological imaging to look for IDRFs and surgical complications in children with abdominal neuroblastoma.

Results

The MRI- and CT-scans showed a total of 122 IDRFs in 39 cases. Complete resection was carried out in 50%, partial excision in 32%, and biopsy in 18% of cases. Total resection was possible in 100% of cases with no IDRF. Where IDRFs were present, total resection was only possible in 26% of cases (p<0.0001). We found a highly significant, negative correlation between the number of IDRFs and the possibility of performing complete resection of NB (p<0.0001). 7 (11.6%) complications were detected, all in patients who showed at least one IDRF previously.

Conclusion

Our findings indicate that IDRFs are useful indicators for predicting surgical risk and surgical outcome and thus should be taken into account when planning surgery.