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Kazuaki Tokiwa, MD, PhD; Shigehisa Fumino, MD; Shigeru Ono, MD, PhD; Naomi Iwai, MD, PhD

Arch Surg. 2003;138:711-715.

Hypothesis  Adequate locoregional surgical treatment prevents local relapse of abdominal neuroblastoma.

Design  A retrospective review of a consecutive series of patients who underwent surgical excision for abdominal neuroblastoma.

Setting  University hospital.

Patients  Forty-seven patients with abdominal neuroblastomas whose primary tumor site was restricted to the adrenal gland or the adjoining sympathetic ganglia.

Intervention  Complete excision of the primary tumor and retroperitoneal lymphadenectomy.

Main Outcome Measures  Surgical intervention, postoperative complications, survival, and local recurrence.

Results  The average duration of surgery was 5 hours 28 minutes; the mean intraoperative blood loss was 27.7 g/kg of body weight. We had no intraoperative major complications leading to visceral insufficiency or perioperative deaths. The following 15 postoperative complications were observed in 12 patients; these complications included diarrhea (8 patients), renal atrophy (3 patients), intestinal obstruction (2 patients), chylous ascites (1 patient), and wound infection (1 patient). The mean follow-up period for the entire patient population was 8.5 years. All 30 patients with Evans stage I, II, III, or IV-S and 8 of the 17 patients with Evans stage IV were alive without evidence of disease. Eight patients died of progressive disease; 1 died of cytomegalovirus infection. No local recurrence was detected within the lymphadenectomy field in any of the patients.

Conclusion  Complete excision of the primary tumor and retroperitoneal lymphadenectomy can be done safely and provides excellent locoregional control for patients with abdominal neuroblastoma.

From the Division of Surgery, Children's Research Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan.

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