cancerspЮжно-Российский онкологический журнал/ South Russian Journal of CancerSouth Russian Journal of Cancer2686-9039АНО "Перспективы онкологии"10.37748/2686-9039-2022-3-1-3cancersp-141Research ArticleОригинальная статьяORIGINAL ARTICLEХирургическое лечение нейробластом забрюшинной локализации у детей. Опыт клиникиSurgical treatment of retroperitoneal neuroblastoma in children. Clinical experienceКузнецовС. А.KuznetsovS. A.

Кузнецов Сергей Алексеевич – к.м.н., заведующий отделением детской онкологии №2

SPIN: 4104-3755, AuthorID: 736961

г. Ростов-на-Дону

Sergey A. Kuznetsov – Cand. Sci. (Med.), head of the Department of Pediatric Oncology No. 2

SPIN: 4104-3755, AuthorID: 736961

Rostov-on-Don

kuznecov1978@mail.ruhttps://orcid.org/0000-0001-9749-709XКолесниковЕ. Н.KolesnikovE. N.

Колесников Евгений Николаевич – д.м.н., заведующий отделением Абдоминальной онкологии №1

SPIN: 8434-6494, AuthorID: 347457

г. Ростов-на-Дону

Evgenii N. Kolesnikov – Dr. Sci. (Med.), head of the Department of abdominal Oncology No. 1

SPIN: 8434-6494, AuthorID: 347457

Rostov-on-Don

https://orcid.org/0000-0002-9468-134XШевченкоА. Н.ShevchenkoA. N.

Шевченко Алексей Николаевич – д.м.н., профессор, заведующий отделением онкоурологии

SPIN: 2748-2638, AuthorID: 735424

г. Ростов-на-Дону

Aleksei N. Shevchenko — Dr. Sci. (Med.), Professor, head of the Department of Oncourology

SPIN: 2748-2638, AuthorID: 735424

Rostov-on-Don

https://orcid.org/0000-0002-6681-3253КозельЮ. Ю.KozelYu. Yu.

Козель Юлия Юрьевна – д.м.н., профессор, заведующая отделением детской онкологии №1

SPIN: 6923-7360, AuthorID: 732882

г. Ростов-на-Дону

Yuliya Yu. Kozel – Dr. Sci. (Med.), professor, head of the department of pediatric Oncology No. 1

SPIN: 6923-7360, AuthorID: 732882

Rostov-on-Don

МкртчянГ. А.MkrtchyanG. A.

Мкртчян Гульнара Агабалаевна – к.м.н., врач-детский хирург отделения детской онкологии №2

SPIN: 1861-5165, AuthorID: 794720

г. Ростов-на-Дону

Gulnara A. Mkrtchyan – Cand. Sci. (Med.), pediatric surgeon of the department of pediatric oncology No. 2

SPIN: 1861-5165, AuthorID: 794720

Rostov-on-Don

СтаржецкаяМ. В.StarzhetskayaM. V.

Старжецкая Мария Владимировна – к.м.н., врач-детский онколог консультативно-диагностического отделения

SPIN: 7855-2512, AuthorID: 794721

г. Ростов-на-Дону

Maria V. Starzhetskaya – Cand. Sci. (Med.), pediatric oncologist of the consultative and diagnostic department

SPIN: 7855-2512, AuthorID: 794721

Rostov-on-Don

БеспаловаА. И.BespalovaA. I.

Беспалова Александра Ивановна – врач-детский онколог отделения детской онкологии №2

SPIN: 6779-1744, AuthorID: 899997

г. Ростов-на-Дону

Aleksandra I. Bespalova – pediatric oncologist of the Department of Pediatric Oncology No. 2

SPIN: 6779-1744, AuthorID: 899997

Rostov-on-Don

ПакЕ. Е.PakE. E.

Пак Елена Ермаковна – к.м.н., врач-детский онколог отделения детской онкологии №2

SPIN: 8750-9120, AuthorID: 935968

г. Ростов-на-Дону

Elena E. Pak – Cand. Sci. (Med.), pediatric oncologist of the Department of Pediatric Oncology No. 2

SPIN: 8750-9120, AuthorID: 935968

Rostov-on-Don

ЮрченкоД. Ю.YurchenkoD. Yu.

Юрченко Дарья Юрьевна – врач-детский онколог отделения детской онкологии №2

SPIN: 8008-0113, AuthorID: 1012112

г. Ростов-на-Дону

Darya Yu. Yurchenko – pediatric oncologist of the Department of Pediatric Oncology No. 2

SPIN: 8008-0113, AuthorID: 1012112

Rostov-on-Don

ПоповянО. П.PopovyanO. P.

Поповян Ольга Петровна – врач-детский онколог отделения детской онкологии №2

SPIN: 5191-3429, AuthorID: 940288

г. Ростов-на-Дону

Olga P. Popovyan – pediatric oncologist of the Department of Pediatric Oncology No. 2

SPIN: 5191-3429, AuthorID: 940288

Rostov-on-Don

НМИЦ онкологииРоссияNational Medical Research Centre for OncologyRussian Federation202221022022312230Copyright © Кузнецов С.А., Колесников Е.Н., Шевченко А.Н., Козель Ю.Ю., Мкртчян Г.А., Старжецкая М.В., Беспалова А.И., Пак Е.Е., Юрченко Д.Ю., Поповян О.П., 20222022Кузнецов С.А., Колесников Е.Н., Шевченко А.Н., Козель Ю.Ю., Мкртчян Г.А., Старжецкая М.В., Беспалова А.И., Пак Е.Е., Юрченко Д.Ю., Поповян О.П.Kuznetsov S.A., Kolesnikov E.N., Shevchenko A.N., Kozel Y.Y., Mkrtchyan G.A., Starzhetskaya M.V., Bespalova A.I., Pak E.E., Yurchenko D.Y., Popovyan O.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.cancersp.com/jour/article/view/141Цель исследования

Цель исследования. Проанализировать собственный опыт хирургического лечения нейробластом забрюшинного пространства у детей и влияние радикальности хирургического лечения на исход заболевания.

Материалы и методы

Материалы и методы. В исследование включены 35 пациентов, проходивших лечение в отделении детской онкологии ФГБУ «НМИЦ онкологии» Минздрава России с 2016 по 2018 гг. с нейробластомами забрюшинного пространства. Средний возраст пациентов составил 3,3 года. Из них было 14 девочек и 21 мальчик. Хирургическое лечение проведено 32 пациентам. У 3 больных отмечена прогрессия заболевания на фоне проводимой неоадъювантной ПХТ. Изначально оперативное вмешательство было выполнено 5 больным, остальным пациентам проводилась чрескожная трепанбиопсия с иммуногистохимическим исследованием и последующей неоадъювантной полихимиотерапией. В раннем послеоперационном периоде осложнений не отмечено ни у одного пациента. В статье нами представлен собственный опыт хирургического лечения пациентов детского возраста с нейробластомами забрюшинного пространства.

Результаты

Результаты. Пациенты наблюдаются в сроках от 12 до 24 мес. Из 28 пациентов, прооперированных радикально, живы без признаков рецидива и прогрессии заболевания 23. У 2 больных возник рецидив опухоли, им проведена противорецидивная ПХТ и ДГТ. В настоящее время пациенты находятся в ремиссии. У 3 пациентов отмечалась системная прогрессия заболевания, связанная с первично-генерализованным процессом

Заключение

Заключение. Применение современных хирургических техник и инструментария позволяет в большом проценте случаев добиться радикального хирургического лечения при местно-распространенных формах нейробластомы.

Purpose of the study

Purpose of the study. Was to analyze our experience of surgical treatment of retroperitoneal neuroblastoma in children and the influence of radical surgical treatment on the disease outcomes.

Materials and methods

Materials and methods. The study included 35 patients (14 girls and 21 boys, mean age 3.3 years) receiving treatment for retroperitoneal neuroblastoma at the Department of Pediatric Oncology, National Medical Research Centre for Oncology, in 2016–2018. 32 patients underwent surgical treatment. The disease progression during neoadjuvant polychemotherapy was registered in 3 patients. Initially, surgery was performed in 5 patients; the rest of the patients underwent percutaneous trepan biopsy with immunohistochemical testing and subsequent neoadjuvant polychemotherapy. No patients developed complications in the early postoperative period. In the article, we present our experience in the surgical treatment of pediatric patients with retroperitoneal neuroblastomas.

Results

Results. Patients have been observed during 12 to 24 months. 23 of 28 radically operated patients are alive and have no signs of the disease recurrence or progression. 2 patients developed tumor recurrence and received anti-recurrence PCT and DGT. Currently the patients are in remission. 3 patients showed systemic progression due to primarily advanced disease.

Conclusion

Conclusion. Administration of modern surgical techniques and instrumentation allows radical surgical treatment for a large percentage of patients with locally advanced neuroblastoma.

пациенты детского возрастанейробластомы забрюшинного пространствахирургическое лечениенеоадъювантная полихимиотерапиярадикальное удаление опухолипрогрессияpediatric patientsretroperitoneal neuroblastomassurgical treatmentneoadjuvant polychemotherapyradical tumor removalprogressionReferencesПролесковская И. В., Назарук С. И., Конопля Н. Е. Локальный контроль для пациентов с нейробластомами группы высокого риска: в рамках протокола NB2004M (Республика Беларусь). Онкологический журнал. 2017;11(2(42)):21–27.Proleskovskaya IV, Nazaruk SI, Konoplya NE. Local control for patients with high-risk neuroblastoma: within the NB2004M protocol (Republic of Belarus). Oncological Journal. 2017;11(2(42)):21–27. (In Russ.).Казанцев А. П. Нейробластома. Современные представления о стадировании и прогнозе. Вестник ФГБНУ «РОНЦ им. Н.Н. Блохина». 2015;26(3):3–22.Kazantsev AP. Neuroblastoma. Modern ideas about staging and forecasting. Bulletin of the FGBNU "N. N. Blokhin RSC". 2015;26(3):3–22. (In Russ.).Дурнов Л. А. Злокачественные опухоли у детей раннего возраста. М., Мед., 1984.Durnov LA. Malignant tumors in young children. Moscow, Med., 1984. (In Russ.).Howlader N, Noone A, Krapcho M, Neyman N, Aminou R, Altekruse S, et al. SEER Cancer Statistics Review, 1975-2009 (Vintage 2009 Populations). National Cancer Institute, Bethesda, 2012.Howlader N, Noone A, Krapcho M, Neyman N, Aminou R, Altekruse S, et al. SEER Cancer Statistics Review, 1975-2009 (Vintage 2009 Populations). National Cancer Institute, Bethesda, 2012.Gurney JG, Ross JA, Wall DA, Bleyer WA, Severson RK, Robison LL. Infant cancer in the U.S.: histology-specific incidence and trends, 1973 to 1992. J Pediatr Hematol Oncol. 1997 Oct;19(5):428–432. https://doi.org/10.1097/00043426-199709000-00004Gurney JG, Ross JA, Wall DA, Bleyer WA, Severson RK, Robison LL. Infant cancer in the U.S.: histology-specific incidence and trends, 1973 to 1992. J Pediatr Hematol Oncol. 1997 Oct;19(5):428–432. https://doi.org/10.1097/00043426-199709000-00004Esiashvili N, Anderson C, Katzenstein HM. Neuroblastoma. Curr Probl Cancer. 2009 Dec;33(6):333–360. https://doi.org/10.1016/j.currproblcancer.2009.12.001Esiashvili N, Anderson C, Katzenstein HM. Neuroblastoma. Curr Probl Cancer. 2009 Dec;33(6):333–360. https://doi.org/10.1016/j.currproblcancer.2009.12.001Nuchtern JG, London WB, Barnewolt CE, Naranjo A, McGrady PW, Geiger JD, et al. A prospective study of expectant observation as primary therapy for neuroblastoma in young infants: a Children’s Oncology Group study. Ann Surg. 2012 Oct;256(4):573–580. https://doi.org/10.1097/SLA.0b013e31826cbbbdNuchtern JG, London WB, Barnewolt CE, Naranjo A, McGrady PW, Geiger JD, et al. A prospective study of expectant observation as primary therapy for neuroblastoma in young infants: a Children’s Oncology Group study. Ann Surg. 2012 Oct;256(4):573–580. https://doi.org/10.1097/SLA.0b013e31826cbbbdHero B, Simon T, Spitz R, Ernestus K, Gnekow AK, Scheel-Walter H-G, et al. Localized infant neuroblastomas often show spontaneous regression: results of the prospective trials NB95-S and NB97. J Clin Oncol. 2008 Mar 20;26(9):1504–1510. https://doi.org/10.1200/JCO.2007.12.3349Hero B, Simon T, Spitz R, Ernestus K, Gnekow AK, Scheel-Walter H-G, et al. Localized infant neuroblastomas often show spontaneous regression: results of the prospective trials NB95-S and NB97. J Clin Oncol. 2008 Mar 20;26(9):1504–1510. https://doi.org/10.1200/JCO.2007.12.3349Хижников А. В., Казанцев А. П. Лечение пациентов с нейробластомой группы высокого риска. Онкопедиатрия. 2017;4(2):131–140. https://doi.org/10.15690/onco.v4i2.1707Khizhnikov AV, Kazantsev AP. Treatment of high-risk neuroblastoma. Oncopediatrics. 2017;4(2):131–140. (In Russ.). https://doi.org/10.15690/onco.v4i2.1707Garaventa A, Bellagamba O, Lo Piccolo MS, Milanaccio C, Lanino E, Bertolazzi L, et al. 131I-metaiodobenzylguanidine (131I-MIBG) therapy for residual neuroblastoma: a mono-institutional experience with 43 patients. Br J Cancer. 1999 Dec;81(8):1378–1384. https://doi.org/10.1038/sj.bjc.6694223Garaventa A, Bellagamba O, Lo Piccolo MS, Milanaccio C, Lanino E, Bertolazzi L, et al. 131I-metaiodobenzylguanidine (131I-MIBG) therapy for residual neuroblastoma: a mono-institutional experience with 43 patients. Br J Cancer. 1999 Dec;81(8):1378–1384. https://doi.org/10.1038/sj.bjc.6694223Hutchinson RJ, Sisson JC, Miser JS, Zasadny KR, Normolle DP, Shulkin BL, et al. Long-term results of [131I]metaiodobenzylguanidine treatment of refractory advanced neuroblastoma. J Nucl Biol Med. 1991 Dec;35(4):237–240.Hutchinson RJ, Sisson JC, Miser JS, Zasadny KR, Normolle DP, Shulkin BL, et al. Long-term results of [131I]metaiodobenzylguanidine treatment of refractory advanced neuroblastoma. J Nucl Biol Med. 1991 Dec;35(4):237–240.Pasqualini C, Dufour C, Goma G, Raquin M-A, Lapierre V, Valteau-Couanet D. Tandem high-dose chemotherapy with thiotepa and busulfan-melphalan and autologous stem cell transplantation in very high-risk neuroblastoma patients. Bone Marrow Transplant. 2016 Feb;51(2):227–231. https://doi.org/10.1038/bmt.2015.264Pasqualini C, Dufour C, Goma G, Raquin M-A, Lapierre V, Valteau-Couanet D. Tandem high-dose chemotherapy with thiotepa and busulfan-melphalan and autologous stem cell transplantation in very high-risk neuroblastoma patients. Bone Marrow Transplant. 2016 Feb;51(2):227–231. https://doi.org/10.1038/bmt.2015.264Sung KW, Son MH, Lee SH, Yoo KH, Koo HH, Kim JY, et al. Tandem high-dose chemotherapy and autologous stem cell transplantation in patients with high-risk neuroblastoma: results of SMC NB-2004 study. Bone Marrow Transplant. 2013 Jan;48(1):68–73. https://doi.org/10.1038/bmt.2012.86Sung KW, Son MH, Lee SH, Yoo KH, Koo HH, Kim JY, et al. Tandem high-dose chemotherapy and autologous stem cell transplantation in patients with high-risk neuroblastoma: results of SMC NB-2004 study. Bone Marrow Transplant. 2013 Jan;48(1):68–73. https://doi.org/10.1038/bmt.2012.86Кит О. И., Кузнецов С. А., Колесников Е. Н., Мкртчян Г. А., Старжецкая М. В., Беспалова А. И. и др. Опыт хирургического лечения местно-распространенных форм нейробластомы забрюшинного пространства. Российский журнал детской гематологии и онкологии. 2019;6(S1):127.Kit OI, Kuznetsov SA, Kolesnikov EN, Mkrtchyan GA, Starzhetskaya MV, Bespalova AI, et al. Experience in surgical treatment of locally common forms of retroperitoneal neuroblastoma. Russian Journal of Pediatric Hematology and Oncology. 2019;6(S1):127. (In Russ.).La Quaglia MP, Kushner BH, Su W, Heller G, Kramer K, Abramson S, et al. The impact of gross total resection on local control and survival in high-risk neuroblastoma. J Pediatr Surg. 2004 Mar;39(3):412–417. https://doi.org/10.1016/j.jpedsurg.2003.11.028La Quaglia MP, Kushner BH, Su W, Heller G, Kramer K, Abramson S, et al. The impact of gross total resection on local control and survival in high-risk neuroblastoma. J Pediatr Surg. 2004 Mar;39(3):412–417. https://doi.org/10.1016/j.jpedsurg.2003.11.028Adkins ES, Sawin R, Gerbing RB, London WB, Matthay KK, Haase GM. Efficacy of complete resection for high-risk neuroblastoma: a Children’s Cancer Group study. J Pediatr Surg. 2004 Jun;39(6):931–936. https://doi.org/10.1016/j.jpedsurg.2004.02.041Adkins ES, Sawin R, Gerbing RB, London WB, Matthay KK, Haase GM. Efficacy of complete resection for high-risk neuroblastoma: a Children’s Cancer Group study. J Pediatr Surg. 2004 Jun;39(6):931–936. https://doi.org/10.1016/j.jpedsurg.2004.02.041La Quaglia MP, Kushner BH, Heller G, Bonilla MA, Lindsley KL, Cheung NK. Stage 4 neuroblastoma diagnosed at more than 1 year of age: gross total resection and clinical outcome. J Pediatr Surg. 1994 Aug;29(8):1162–1165. https://doi.org/10.1016/0022-3468(94)90301-8La Quaglia MP, Kushner BH, Heller G, Bonilla MA, Lindsley KL, Cheung NK. Stage 4 neuroblastoma diagnosed at more than 1 year of age: gross total resection and clinical outcome. J Pediatr Surg. 1994 Aug;29(8):1162–1165. https://doi.org/10.1016/0022-3468(94)90301-8Kushner BH, Kramer K, LaQuaglia MP, Modak S, Yataghene K, Cheung N-KV. Reduction from seven to five cycles of intensive induction chemotherapy in children with high-risk neuroblastoma. J Clin Oncol. 2004 Dec 15;22(24):4888–4892. https://doi.org/10.1200/JCO.2004.02.101Kushner BH, Kramer K, LaQuaglia MP, Modak S, Yataghene K, Cheung N-KV. Reduction from seven to five cycles of intensive induction chemotherapy in children with high-risk neuroblastoma. J Clin Oncol. 2004 Dec 15;22(24):4888–4892. https://doi.org/10.1200/JCO.2004.02.101Tsuchida Y, Kaneko M. Surgery in pediatric solid tumors with special reference to advanced neuroblastoma. Acta Paediatr Taiwan. 2002 Apr;43(2):67–71.Tsuchida Y, Kaneko M. Surgery in pediatric solid tumors with special reference to advanced neuroblastoma. Acta Paediatr Taiwan. 2002 Apr;43(2):67–71.Von Schweinitz D, Hero B, Berthold F. The impact of surgical radicality on outcome in childhood neuroblastoma. Eur J Pediatr Surg. 2002 Dec;12(6):402–409. https://doi.org/10.1055/s-2002-36952Von Schweinitz D, Hero B, Berthold F. The impact of surgical radicality on outcome in childhood neuroblastoma. Eur J Pediatr Surg. 2002 Dec;12(6):402–409. https://doi.org/10.1055/s-2002-36952Castel V, Tovar JA, Costa E, Cuadros J, Ruiz A, Rollan V, et al. The role of surgery in stage IV neuroblastoma. J Pediatr Surg. 2002 Nov;37(11):1574–1578. https://doi.org/10.1053/jpsu.2002.36187Castel V, Tovar JA, Costa E, Cuadros J, Ruiz A, Rollan V, et al. The role of surgery in stage IV neuroblastoma. J Pediatr Surg. 2002 Nov;37(11):1574–1578. https://doi.org/10.1053/jpsu.2002.36187Simon T, Häberle B, Hero B, von Schweinitz D, Berthold F. Role of surgery in the treatment of patients with stage 4 neuroblastoma age 18 months or older at diagnosis. J Clin Oncol. 2013 Feb 20;31(6):752–758. https://doi.org/10.1200/JCO.2012.45.9339Simon T, Häberle B, Hero B, von Schweinitz D, Berthold F. Role of surgery in the treatment of patients with stage 4 neuroblastoma age 18 months or older at diagnosis. J Clin Oncol. 2013 Feb 20;31(6):752–758. https://doi.org/10.1200/JCO.2012.45.9339Monclair T, Brodeur GM, Ambros PF, Brisse HJ, Cecchetto G, Holmes K, et al. The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report. J Clin Oncol. 2009 Jan 10;27(2):298–303. https://doi.org/10.1200/JCO.2008.16.6876Monclair T, Brodeur GM, Ambros PF, Brisse HJ, Cecchetto G, Holmes K, et al. The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report. J Clin Oncol. 2009 Jan 10;27(2):298–303. https://doi.org/10.1200/JCO.2008.16.6876Казанцев А. П., Хижников А. В., Матинян Н. В., Давыдов М. И. Ганглионейробластома правого гемиторакса у ребенка 2 лет. Вестник РОНЦ им. Н. Н. Блохина РАМН. 2015;26(3):88–91.Kazantsev AP, Khizhnikov AV, Matinyan NV, Davydov MI. Ganglioneuroblastoma of the right gemithorax in a 2 years old child. Journal of N. N. Blokhin Russian Cancer Research Center RAMS. 2015;26(3):88–91. (In Russ.).Häberle B, Hero B, Berthold F, von Schweinitz D. Characteristics and outcome of thoracic neuroblastoma. Eur J Pediatr Surg. 2002 Jun;12(3):145–150. https://doi.org/ 10.1055/s-2002-32721Häberle B, Hero B, Berthold F, von Schweinitz D. Characteristics and outcome of thoracic neuroblastoma. Eur J Pediatr Surg. 2002 Jun;12(3):145–150.Horiuchi A, Muraji T, Tsugawa C, Nishijima E, Satho S, Takamizawa S, et al. Thoracic neuroblastoma: outcome of incomplete resection. Pediatr Surg Int. 2004 Sep;20(9):714–718. https://doi.org/10.1007/s00383-003-1049-7Horiuchi A, Muraji T, Tsugawa C, Nishijima E, Satho S, Takamizawa S, et al. Thoracic neuroblastoma: outcome of incomplete resection. Pediatr Surg Int. 2004 Sep;20(9):714–718. https://doi.org/10.1007/s00383-003-1049-7Akgun B, Ates D, Kaplan M. Ganglioneuroblastoma of the thoracic spinal cord: a very rare case report. Acta Medica (Hradec Kralove). 2012;55(1):50–52. https://doi.org/10.14712/18059694.2015.76Akgun B, Ates D, Kaplan M. Ganglioneuroblastoma of the thoracic spinal cord: a very rare case report. Acta Medica (Hradec Kralove). 2012;55(1):50–52. https://doi.org/10.14712/18059694.2015.76

The authors declare that there are no conflicts of interest present.