Influence of Surgical Excision on the Survival of Patients With Stage 4 High-Risk Neuroblastoma: A Report From the HR-NBL1/SIOPEN Study

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11130%2F20%3A10412716" target="_blank" >RIV/00216208:11130/20:10412716 - isvavai.cz</a>

Alternative codes found

RIV/00064203:_____/20:10412716

Result on the web

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=K.dBqoV1Hf" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=K.dBqoV1Hf</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1200/JCO.19.03117" target="_blank" >10.1200/JCO.19.03117</a>

Result language

angličtina

Original language name

Influence of Surgical Excision on the Survival of Patients With Stage 4 High-Risk Neuroblastoma: A Report From the HR-NBL1/SIOPEN Study

Original language description

PURPOSE: To evaluate the impact of surgeon-assessed extent of primary tumor resection on local progression and survival in patients in the International Society of Pediatric Oncology Europe Neuroblastoma Group High-Risk Neuroblastoma 1 trial. PATIENTS AND METHODS: Patients recruited between 2002 and 2015 with stage 4 disease &gt; 1 year or stage 4/4S with MYCN amplification &lt; 1 year who had completed induction without progression, achieved response criteria for high-dose therapy (HDT), and had no resection before induction were included. Data were collected on the extent of primary tumor excision, severe operative complications, and outcome. RESULTS: A total of 1,531 patients were included (median observation time, 6.1 years). Surgeon-assessed extent of resection included complete macroscopic excision (CME) in 1,172 patients (77%) and incomplete macroscopic resection (IME) in 359 (23%). Surgical mortality was 7 (0.46%) of 1,531. Severe operative complications occurred in 142 patients (9.7%), and nephrectomy was performed in 124 (8.8%). Five-year event-free survival (EFS) +- SE (0.40 +- 0.01) and overall survival (OS; 0.45 +- 0.02) were significantly higher with CME compared with IME (5-year EFS, 0.33 +- 0.03; 5-year OS, 0.37 +- 0.03; P &lt; .001 and P = .004). The cumulative incidence of local progression (CILP) was significantly lower after CME (0.17 +- 0.01) compared with IME (0.30 +- 0.02; P &lt; .001). With immunotherapy, outcomes were still superior with CME versus IME (5-year EFS, 0.47 +- 0.02 v 0.39 +- 0.04; P = .038); CILP was 0.14 +- 0.01 after CME and 0.27 +- 0.03 after IME (P &lt; .002). A hazard ratio of 1.3 for EFS associated with IME compared with CME was observed before and after the introduction of immunotherapy (P = .030 and P = .038). CONCLUSION: In patients with stage 4 high-risk neuroblastoma who have responded to induction therapy, CME of the primary tumor is associated with improved survival and local control after HDT, local radiotherapy (21 Gy), and immunotherapy.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30204 - Oncology

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2020

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Journal of Clinical Oncology

ISSN

0732-183X

e-ISSN

—

Volume of the periodical

38

Issue of the periodical within the volume

25

Country of publishing house

US - UNITED STATES

Number of pages

14

Pages from-to

2902-2915

UT code for WoS article

000567569100006

EID of the result in the Scopus database

2-s2.0-85090079587