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Surgical management in pediatric neuroblastoma diagnosis and treatment: a 20-year, single-center experience

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Abstract

Background

The currently utilized International Neuroblastoma Risk Group (INRG) staging system developed in 2009 uses image-defined risk factors as a measure of surgical risk, separating resectable neuroblastoma from those best preceded by chemotherapy. The previous International Neuroblastoma Staging System was based primarily on surgical findings. We hypothesized there would be a change to the role of the surgeon in neuroblastoma treatment in the more recent decade.

Methods

This is a single center 20-year retrospective analysis of 104 patients with International Classification of Diseases-9 and -10 codes for neuroblastoma. Patient demographics, tumor site, cancer treatment modality, survival, biopsy technique, surgical intervention, and pathology staging were collected. Data was analyzed by analysis of variance (ANOVA) and Student’s t test.

Results

There was a decrease in open surgeries for extra-adrenal neuroblastomas in the later decade (77%, 31%, P = 0.01). There was a narrowing of the time interval to surgery in the later cohort, likely as a result of uniformity in surgical timing on treatment protocols relying on INRG staging.

Conclusions

Our findings mirror changes in practice patterns globally. We found an increase in minimally invasive approaches but did not find a difference in the role of the surgeon under the INRG staging system.

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Data availability

The data sets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

No funding was used for this project.

Author information

Authors and Affiliations

  1. Department of Surgery, Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA

    Brianna Spencer, Robert Cilley & Christa N. Grant

  2. Pennsylvania State University College of Medicine, Hershey, PA, USA

    Akshilkumar Patel, Robert Cilley & Christa N. Grant

  3. Division of Pediatric Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA

    Robert Cilley & Christa N. Grant

Authors
  1. Brianna Spencer
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  2. Akshilkumar Patel
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  3. Robert Cilley
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  4. Christa N. Grant
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Contributions

All authors contributed to the study conception and design. SB and PA contributed to the material preparation, data collection and analysis, and wrote the first draft of the manuscript. GCN and CR contributed to review and editing as well as supervision. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Brianna Spencer.

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Conflict of interest

No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article. The authors have no conflict of interest to declare.

Ethical approval

This study was approved by the Institutional Review Board (IRB#00014901).

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Spencer, B., Patel, A., Cilley, R. et al. Surgical management in pediatric neuroblastoma diagnosis and treatment: a 20-year, single-center experience. World J Pediatr 18, 120–125 (2022). https://doi.org/10.1007/s12519-021-00490-5

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  • DOI: https://doi.org/10.1007/s12519-021-00490-5

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