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Article: Surgical outcomes of patients with neuroblastoma in a tertiary centre in Hong Kong: A 12-year experience

TitleSurgical outcomes of patients with neuroblastoma in a tertiary centre in Hong Kong: A 12-year experience
Authors
KeywordsNeuroblastoma
Surgical excision
Survival
Issue Date2009
PublisherMedcom Limited. The Journal's web site is located at http://www.hkjpaed.org/index.asp
Citation
Hong Kong Journal of Paediatrics, 2009, v. 14 n. 3, p. 186-193 How to Cite?
AbstractIntroduction: Neuroblastoma has a heterogeneous clinical course. The prognosis varies widely depending on the age of diagnosis, extent of disease and tumour biology. However, the specific clinical outcome of this disease in Hong Kong has not been well characterised thus far. Complete tumour excision has been demonstrated to confer survival benefit on patients with advanced disease even if there is metastasis. Since year 2004, we have adopted a revised, more aggressive surgical approach in managing these patients. Here, we aim to review our experience in the management of this disease. Methods: A retrospective review was performed for the past 12 years to include all patients who presented with neuroblastoma in our institution. Data such as the survival, age at diagnosis, MYCN amplification status, the extent of tumour excision, and stage of the disease were recorded and analysed. Results: 37 patients were included in this study. Overall survival of our patients was 67.6%. Patients with Stage 1, 2 and 4S have 100% survival whereas stage 4 patients only have 41.4% survival. Since our revised surgical approach in 2004, patients who had been operated had a better survival. Survival of stage 4 patients with operation after 2004 was 57.1% whereas the survival of patients at the same stage before 2004 was only 30%. Age at diagnosis, completeness of tumour excision and stage of disease are also correlated with overall prognosis. Further, patients with the presence of MYCN gene amplification have apparently poorer survival but it is not statistically significant due to the small sample size. Conclusion: The management of patients with neuroblastoma remains a challenge. Advanced stage of disease, incomplete tumour excision and increased age at diagnosis were all associated with poor survival. We demonstrated a better survival for those who underwent a more aggressive surgical approach, though this is a technically demanding and time consuming procedure. Thus, the management of advanced neuroblastoma should be centralised in a centre with combined surgical, oncological and paediatric intensive care expertise.
Persistent Identifierhttp://hdl.handle.net/10722/92367
ISSN
2015 Impact Factor: 0.194
2015 SCImago Journal Rankings: 0.123
References

 

DC FieldValueLanguage
dc.contributor.authorChan, IHYen_HK
dc.contributor.authorWong, KKYen_HK
dc.contributor.authorChan, GCFen_HK
dc.contributor.authorTam, PKHen_HK
dc.date.accessioned2010-09-17T10:43:57Z-
dc.date.available2010-09-17T10:43:57Z-
dc.date.issued2009en_HK
dc.identifier.citationHong Kong Journal of Paediatrics, 2009, v. 14 n. 3, p. 186-193en_HK
dc.identifier.issn1013-9923en_HK
dc.identifier.urihttp://hdl.handle.net/10722/92367-
dc.description.abstractIntroduction: Neuroblastoma has a heterogeneous clinical course. The prognosis varies widely depending on the age of diagnosis, extent of disease and tumour biology. However, the specific clinical outcome of this disease in Hong Kong has not been well characterised thus far. Complete tumour excision has been demonstrated to confer survival benefit on patients with advanced disease even if there is metastasis. Since year 2004, we have adopted a revised, more aggressive surgical approach in managing these patients. Here, we aim to review our experience in the management of this disease. Methods: A retrospective review was performed for the past 12 years to include all patients who presented with neuroblastoma in our institution. Data such as the survival, age at diagnosis, MYCN amplification status, the extent of tumour excision, and stage of the disease were recorded and analysed. Results: 37 patients were included in this study. Overall survival of our patients was 67.6%. Patients with Stage 1, 2 and 4S have 100% survival whereas stage 4 patients only have 41.4% survival. Since our revised surgical approach in 2004, patients who had been operated had a better survival. Survival of stage 4 patients with operation after 2004 was 57.1% whereas the survival of patients at the same stage before 2004 was only 30%. Age at diagnosis, completeness of tumour excision and stage of disease are also correlated with overall prognosis. Further, patients with the presence of MYCN gene amplification have apparently poorer survival but it is not statistically significant due to the small sample size. Conclusion: The management of patients with neuroblastoma remains a challenge. Advanced stage of disease, incomplete tumour excision and increased age at diagnosis were all associated with poor survival. We demonstrated a better survival for those who underwent a more aggressive surgical approach, though this is a technically demanding and time consuming procedure. Thus, the management of advanced neuroblastoma should be centralised in a centre with combined surgical, oncological and paediatric intensive care expertise.en_HK
dc.languageengen_HK
dc.publisherMedcom Limited. The Journal's web site is located at http://www.hkjpaed.org/index.aspen_HK
dc.relation.ispartofHong Kong Journal of Paediatricsen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectNeuroblastomaen_HK
dc.subjectSurgical excisionen_HK
dc.subjectSurvivalen_HK
dc.titleSurgical outcomes of patients with neuroblastoma in a tertiary centre in Hong Kong: A 12-year experienceen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1013-9923&volume=14&issue=3&spage=186&epage=193&date=2009&atitle=Surgical+outcomes+of+patients+with+neuroblastoma+in+a+tertiary+centre+in+Hong+Kong:+A+12-year+experience-
dc.identifier.emailWong, KKY: kkywong@hkucc.hku.hken_HK
dc.identifier.emailChan, GCF: gcfchan@hkucc.hku.hken_HK
dc.identifier.emailTam, PKH: paultam@hkucc.hku.hken_HK
dc.identifier.authorityWong, KKY=rp01392en_HK
dc.identifier.authorityChan, GCF=rp00431en_HK
dc.identifier.authorityTam, PKH=rp00060en_HK
dc.description.naturepublished_or_final_versionen_US
dc.identifier.scopuseid_2-s2.0-71649101766en_HK
dc.identifier.hkuros160464-
dc.identifier.hkuros175235-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-71649101766&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume14en_HK
dc.identifier.issue3en_HK
dc.identifier.spage186en_HK
dc.identifier.epage193en_HK
dc.publisher.placeHong Kongen_HK
dc.identifier.scopusauthoridChan, IHY=36344597900en_HK
dc.identifier.scopusauthoridWong, KKY=24438686400en_HK
dc.identifier.scopusauthoridChan, GCF=16160154400en_HK
dc.identifier.scopusauthoridTam, PKH=7202539421en_HK

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