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

Identifikátory výsledku

  • Kód výsledku v 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>

  • Nalezeny alternativní kódy

    RIV/00064203:_____/20:10412716

  • Výsledek na webu

    <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>

Alternativní jazyky

  • Jazyk výsledku

    angličtina

  • Název v původním jazyce

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

  • Popis výsledku v původním jazyce

    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.

  • Název v anglickém jazyce

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

  • Popis výsledku anglicky

    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.

Klasifikace

  • Druh

    J<sub>imp</sub> - Článek v periodiku v databázi Web of Science

  • CEP obor

  • OECD FORD obor

    30204 - Oncology

Návaznosti výsledku

  • Projekt

  • Návaznosti

    I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Ostatní

  • Rok uplatnění

    2020

  • Kód důvěrnosti údajů

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

Údaje specifické pro druh výsledku

  • Název periodika

    Journal of Clinical Oncology

  • ISSN

    0732-183X

  • e-ISSN

  • Svazek periodika

    38

  • Číslo periodika v rámci svazku

    25

  • Stát vydavatele periodika

    US - Spojené státy americké

  • Počet stran výsledku

    14

  • Strana od-do

    2902-2915

  • Kód UT WoS článku

    000567569100006

  • EID výsledku v databázi Scopus

    2-s2.0-85090079587