Factores quirúrgicos pronósticos del neuroblastoma en el Centro Regional Oriental de Oncología Pediátrica de Holguín, Cuba
DOI:
https://doi.org/10.55204/trc.v3i2.e232Palabras clave:
neuroblastoma, factores quirúrgicos pronósticos, modalidad terapéuticaResumen
Introducción: El neuroblastoma es la neoplasia sólida fuera de la cavidad craneal más frecuente en la edad pediátrica. Su particularidad se refleja en varias características clínicas y biológicas que se toman en cuenta para predecir los resultados terapéuticos.
Objetivo: Identificar los factores quirúrgicos pronósticos en los pacientes diagnosticados con neuroblastoma en el Centro Regional Oriental de Oncología Pediátrica de Holguín, Cuba, durante la etapa comprendida de enero de 2010 a diciembre del 2022.
Métodos: Se realizó un estudio descriptivo retrospectivo en 18 pacientes en los que se realizó la descripción de las variables: clínicas epidemiológicas, métodos de imágenes, diagnóstico patológico, tipo de cirugía y evolución.
Resultados: El 50 % se diagnosticó antes del año de vida, con predominio en las niñas (66,65 %), en la localización abdominal y con afectación de la suprarrenal izquierda (87 %). La ultrasonografía, en asociación con la tomografía axial computarizada, permitió el diagnóstico inicial en un 94,50 %, y resultó de gran utilidad en la identificación de factores de riesgos quirúrgicos (78 %). El diagnóstico patológico evidenció predominio de los grados indiferenciados en el 66,70 % y en estadios más avanzados III y IV (55,60 %). Se realizó cirugía primaria (28 %) y secundaria (44 %), con un 28,0 % de fallecidos.
Conclusiones: Esta enfermedad continúa siendo un desafío quirúrgico y, en ausencia de determinantes moleculares y citogenéticos, los factores clínicos e histopatológicos constituyen los de especial relevancia y correlación pronóstica. La transición estandarizada hacia la utilización de la clasificación pretratamiento de riesgo quirúrgico por imagenología es fundamental para la definición de la modalidad terapéutica a emplear.
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Pelizzo G, Veschi V, Mantelli M, Croce S, Di Benedetto V, D'Angelo P, et al. Microenvironment in neuroblastoma: isolation and characterization of tumor-derived mesenchymal stromal cells. BMC Cancer. 2018 Nov 27;18(1):1176. https://pubmed.ncbi.nlm.nih.gov/30482160
Nakagawara A, Li Y, Izumi H, Muramori K, Inada H, Nishi M. Neuroblastoma. Jpn J Clin Oncol. 2018 Mar 1;48(3):214-241. https://pubmed.ncbi.nlm.nih.gov/29378002
Cunningham RM, Walton MA, Carter PM. The Major Causes of Death in Children and Adolescents in the United States.N Engl J Med 2018; 379:2468-2475
https://doi.org/10.1056/NEJMsr1804754
Hallet A, Traunecker H. A review and update on neuroblastoma. Pediatr Child Health. 2012; 22: 103-7. https://doi.org/10.1016/j.paed.2011.08.005
Maguire LH, Thomas AR, Goldstein AM. Tumors of the neural crest: Common themes in development and cancer. DEVELOPMENTAL DYNAMICS. 2015; 244:311–322. https://doi.org/10.1002/dvdy.24226
Balis F, Green DM, Anderson C, Cook S, Dhillon J, Gow K, et al. Wilms Tumor (nephroblastoma), Version 2.2021, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2021 Aug 1; 19(8): 945-977.https://pubmed.ncbi.nlm.nih.gov/34416707
Iacob ER, Popoiu CM, Nyiredi A, et al. Mesenchymal hamartoma of the left liver lobe in an-18-month-old female patient. Romanian Journal of Morphology and Embryology. 2016; 57(2):841-847. https://pubmed.ncbi.nlm.nih.gov/27833980
Lim IIP, Bondoc AJ, Geller JI, Tiao GM. Hepatoblastoma-The Evolution of Biology, Surgery, and Transplantation. Children (Basel). 2018 Dec 21;6(1):1. https://pubmed.ncbi.nlm.nih.gov/30577683
Gerstung M, Jolly C, Leshchiner I, Dentro SC, Gonzalez S, Rosebrock D, et al. Evolution & Heterogeneity Working Group; Consortium. The evolutionary history of 2,658 cancers. Nature. 2020 Feb; 578(7793): 122-128. https://pubmed.ncbi.nlm.nih.gov/32025013
Schultz LM, Majzner R, Davis KL, Mackall C. New developments in immunotherapy for pediatric solid tumors. Curr Opin Pediatr. 2018 Feb; 30(1): 30-39. https://pubmed.ncbi.nlm.nih.gov/29189429
Matthay K, Maris J, Schleiermacher G. Neuroblastoma. Nat Rev Dis Primers 2016; 2: 16078. https://doi.org/10.1038/nrdp.2016.78
Tomolonis JA, Agarwal S, Shohet JM. Neuroblastoma pathogenesis: deregulation of embryonic neural crest development. Cell Tissue Res. 2018; 372(2):245. https://pubmed.ncbi.nlm.nih.gov/29222693
Chatten J, Sather HN, Wong KY, Siegel SE, Hammond GD. Prognostic value of histopathology in advanced neuroblastoma: a report from the Childrens Cancer Study Group. Human Pathol. 2016; 19: 1187-98.
Brodeur GM. Spontaneous regression of neuroblastoma. Cell Tissue Res. 2018 May;372(2):277-286.https://pubmed.ncbi.nlm.nih.gov/29305654
Tolbert VP, Matthay KK. Neuroblastoma: clinical and biological approach to risk stratification and treatment. Cell Tissue Res. 2018 May; 372(2): 195-209. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5918153
Wang JR, Zafereo ME, Dadu R, Ferrarotto R, Busaidy NL, Lu C, et al. Complete Surgical Resection Following Neoadjuvant Dabrafenib Plus Trametinib in BRAFV600E-Mutated Anaplastic Thyroid Carcinoma. Thyroid. 2019 Aug;29(8):1036-1043. https://pubmed.ncbi.nlm.nih.gov/31319771
Hossam E, Ahmed G, Elmenawi S, Naglaa E, Refaat A, Soliman S, et al. Survival outcome of intermediate risk neuroblastoma at Children Cancer Hospital Egypt. Journal of the Egyptian National Cancer Institute. 2018; 30(1): 21-26. https://doi.org/10.1016/j.jnci.2018.01.001
Medina D, Martínez LF, Dávalos DM, Manzi E, Rosales MC. Trasplante autólogo de células madre hematopoyéticas en pacientes con diagnóstico de neuroblastoma de alto riesgo en la Fundación Valle del Lili, Cali-Colombia. RevColombCancerol. 2017; 21(1):3-11. http://dx.doi.org/10.1016/j.rccan.2017.02.080
Palma-Padilla V, Juárez-Ocaña S, González-Miranda G, Siordia-Reyes AG, Mejía-Aranguré JM, Carreón-Cruz R, Fajardo-Gutiérrez A. Incidence and trends of neuroblastoma in Mexican children attending at Instituto Mexicano del Seguro Social. Rev Med Inst Mex Seguro Soc. 2010 Mar-Apr;48(2):151-8.https://pubmed.ncbi.nlm.nih.gov/20929618
Verdecía C. Cáncer pediátrico en Cuba, Servicio de Oncología. Hospital Pediátrico Universitario William Soler. La Habana, Cuba. Rev Cubana Pediatr.2018; (89): 56-61. https://www.researchgate.net/publication/317512304_Cancer_pediatrico_en_Cuba
Ministerio de Salud Pública. Sección Independiente de Control del Cáncer. Programa Integral para el Control del Cáncer en Cuba. Estrategia Nacional para el Control del Cáncer [Internet]. La Habana: Editorial Ciencias Médicas; 2020. http://www.bvs.sld.cu/libros/programa_integral_control_cancer_cuba/programa_control_cancer_estrategia_nacional.pdf
Ramírez A. Procedimiento Quirúrgico actual en el Diagnóstico y Tratamiento de los Tumores Sólidos Malignos en la Infancia. Servicio de Cirugía pediátrica. Enero 1996 a Diciembre 2008 (Tesis). Holguín.Hospital Pediátrico Provincial Octavio de la Concepción y de la Pedraja. 2008.
Ministerio de Salud Pública; Dirección Nacional de Estadísticas y Registros Médicos. Anuarios Estadísticos de Salud 2010-2022. La Habana. (Cuba): MINSAP; 2010-2022. https://temas.sld.cu/estadisticassalud/
Rostión CG, Jáuregui L, Broussain V. Neuroblastoma: Forma de presentación y probabilidad de resección quirúrgica. Rev. Ped. Elec. [en línea] 2005; 2 (2): 908-918. ISSN 0718-0918 http://www.revistapediatria.cl/volumenes/2005/vol2num2/pdf/Neuroblastoma.pdf
Ibañez M, Abad P. Neuroblastoma: Marcadores Biológicos, Cirugía y Evolución. CirPediatr. 2000; 13: 47-53 https://www.secipe.org/coldata/upload/revista/2000;13.47-53.pd
London WB, Castleberry RP, Matthay KK. Evidence for an age cutoff greater than 365 days for neuroblastoma risk group stratification in the Children's Oncology Group. J ClinOncol. 2005; 23 (27): 6459-65 https://pubmed.ncbi.nlm.nih.gov/16116153
Ward E, DeSantis C, Robbins A. Childhood and adolescent cancer statistics, 2017.J Clin Cancer.2014; 64 (2): 83-103 https://pubmed.ncbi.nlm.nih.gov/24488779
Carvalho V, Correa de Araujo C. Aspectos Quirúrgicos del Neuroblastoma. Rev. Ped. Elec. [en línea] 2009; 6 (3): 121-129.ISSN 0718-0918 http://www.revistapediatria.cl/volumenes/2009/vol6num3/pdf
Morosini F, Castiglioni M, Pages G, Simon E, Zuccolo S, Silveira A, et al. Neuroblastoma de Alto Riesgo en Uruguay. ¿Dónde estamos? Revista Brasileira de Cancerología 2018; 64(1): 19-26 https://www.researchgate.net/publication/328411041_Neuroblastoma_de_alto_Riesgo.
Gigliotti A, De Ioris M, De Grandis E, Podda M, Cellini M, Sorrentino S, et al. Congenital neuroblastoma with symptoms of epidural compression at birth. Pediatric Hematology and Oncology. 2016; 1: 1-9. https://pubmed.ncbi.nlm.nih.gov/26901768
Rezaimehr Y, Bhargava R. Neuroblastoma as Persistent Postprandial Emesis in a Neonate. Pediatric Emergency Care. 2007; 29: 1273-1275. https://pubmed.ncbi.nlm.nih.gov/24300469
Yeh P-J, Chen S-H, Lai J-Y, Lai M-W, Chiu C-H, Chao H-C, Et al. Rare Cases of Pediatric Vasoactive Intestinal Peptide Secreting Tumor with Literature Review: A Challenging Etiology of Chronic Diarrhea. Front. Pediatr. 2020; 8:430. https://doi.org/10.3389/fped.2020.00430
De Preter K, Mestdagh P, Vermeulen J. Expression profiling enables risk stratification in archived and fresh neuroblastoma tumor samples. Clin Cancer Res. 2011; 17:7684-92.https://doi.org/10.1158/1078-0432.CCR-11-0610
Irwin MS, Park JR. Neuroblastoma: Paradigm for precision medicine. PediatrClin North Am. 2015; 62(1):225-56. https://pubmed.ncbi.nlm.nih.gov/25435121
Csanady M, Vass G, Bartyik K, Majoros V, Rovó L. Multidisplinary management of cervical neuroblastoma in infants. International Journal of Pediatric Otorhinolaryngology. 2014; 78: 2103-2106. https://sci-hub.se/10.1016/j.ijporl.2014.09.015
Swift CC, Eklund MJ, Kraveka JM, Alazraki AL. Updates in diagnosis, management and treatment of neuroblastoma. Radiographics. 2018; 38: 566-80. https://sci-hub.se/10.1148/rg.2018170132
Pfluger T, Piccardo A. Neuroblastoma: Imaging and new tracers. SeminNucl Med. 2017; 47: 143-157. https://pubmed.ncbi.nlm.nih.gov/28237003
Brisse HJ, McCarville MB, Granata C. Guidelines for imaging and staging of neuroblastic tumors: consensus report from the International Neuroblastoma Risk Group Project. Radiology. 2011;261(1):243-57. https://pubmed.ncbi.nlm.nih.gov/21586679
Kembhavi SA, Shah S, Rangarajan V, Qureshi S, Popat P, Kurkure P. Imaging in neuroblastoma: An update. Indian J Radiol Imaging. 2015 Apr-Jun;25(2):129-36. https://pubmed.ncbi.nlm.nih.gov/25969636
Cecchetto G, Mosseri V, De Bernardi B. Surgical risk factors in primary surgery for localized neuroblastoma:the LNESG1 study of the European International Society of Pediatric Oncology Neuroblastoma Group. J ClinOncol. 2005; 23(33): 8483-9 https://pubmed.ncbi.nlm.nih.gov/16293878
Fumino S, Kimura K, Iehara T, Nishimura M, Nakamura S, Souzaki R et al. Validity of image-defined risk factors in localized neuroblastoma: A report from two centers in Western Japan. Journal of Pediatric Surgery. 2015;50(12):2102-2106. https://doi.org/10.1016/j.jpedsurg.2015.08.039
Günther P, Holland-Cunz S, Schupp CJ, Stockklausner C, Hinz U, Schenk JP. Significance of image-defined risk factors for surgical complications in patients with abdominal neuroblastoma. Eur J Pediatr Surg. 2011 Oct;21(5):314-7.
https://doi.org/10.1055/s-0031-1280824
Yang DD, Liu C, Gao J, Hu QJ, Liang Y, Liu J. Association of image-defined risk factors with clinical features, tumor biology, and outcomes in neuroblastoma: a single-center retrospective study. Eur J Pediatr. 2023 May;182(5):2189-2196.https://pubmed.ncbi.nlm.nih.gov/36856889
Liu T, Zhibao LV, Weijue X, Jiangbin L, Qingfeng S. Papel de los factores de riesgo definidos por imagen en la predicción de complicaciones quirúrgicas del neuroblastoma localizado. Pediatr Surg Int. 2020; 36: 1167-1172 https://pubmed.ncbi.nlm.nih.gov/32851471
Park JR, Bagatell R, Cohn SL, Pearson AD, Villablanca JG, Berthold F, et al. Revisions to the International Neuroblastoma Response Criteria: A Consensus Statement from the National Cancer Institute Clinical Trials Planning Meeting. J Clin Oncol. 2017 Aug 1;35(22):2580-2587.https://pubmed.ncbi.nlm.nih.gov/28471719
Peuchmaur M, d'Amore ES, Joshi V. Confirmation of favorable and unfavorable prognostic subsets in neuroblastoma. Cancer. 2003; 98 (10): 2274-81 https://pubmed.ncbi.nlm.nih.gov/14601099
Nickerson HJ, Nesbit ME, Grosfeld JL, Baehner RL, Sather H, Hammond D. Comparison of stage IV and IV-S neuroblastoma in the first year of life. Med Pediatr Oncol. 1985;13(5):261-8. https://pubmed.ncbi.nlm.nih.gov/4033540
Navarro S, Piqueras M, Villamón E, Yáñez Y, Balaguer J, Cañete A, Noguera R. New prognostic markers in neuroblastoma. Expert Opin Med Diagn. 2012 Nov;6(6):555-67. https://pubmed.ncbi.nlm.nih.gov/23480837
George RE, Perez-Atayde AR, Yao X. Tumor histology during induction therapy in patients with high-risk neuroblastoma. Pediatr Blood Cancer. 2018; 59 (3): 506-10 https://pubmed.ncbi.nlm.nih.gov/22162143
Fritsch P, Kerbl R, Lackner H. “Wait and see” strategy in localized neuroblastoma in infants: an option not only for cases detected by mass screening. PediatrBlood Cancer. 2004; 43 (6): 679-82 https://pubmed.ncbi.nlm.nih.gov/15390301
Pinto N, Applebaum M, Volchenboum S, Matthay K, London W, Ambros P, et al. Advances in Risk Classification and Treatment Strategies for Neuroblastoma. Journal of Clinical Oncology. 2015; 1: 1-11. https://pubmed.ncbi.nlm.nih.gov/26304901
Meany HJ. Non-High-Risk Neuroblastoma: Classification and Achievements in Therapy. Child Basel Switz. 2019 Jan 8;6(1). https://pubmed.ncbi.nlm.nih.gov/30626019
Luo Y-B, Cui X-C, Yang L, Zhang D, Wang J-X. Advances in the Surgical Treatment of Neuroblastoma. Chin Med J (Engl). 2018 Oct 5;131(19):2332–7. https://pubmed.ncbi.nlm.nih.gov/30246719
Monclair T, Brodeur GM, Ambros PF. The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report. J ClinOncol. 2009;27(2):298‐303. https://pubmed.ncbi.nlm.nih.gov/19047290
Avanzzini S, Pio L, Erminio G, Granata C, Holmes K, Gambart M, et al. Image-defined risk factors in unresectable neuroblastoma: SIOPEN study on incidence, chemotherapy-induced variation and impact on surgical outcomes. Cancer. 2017; 56 (12): 1548-1552 https://pubmed.ncbi.nlm.nih.gov/28440012
Zhang AA, Pan C, Xu M, Wang XX, Ye QD, Gao YJ, Tang JY. Association of image-defined risk factors, tumor resectability, and prognosis in children with localized neuroblastoma. World J Pediatr. 2019 Dec;15(6):572-579. doi: 10.1007/s12519-019-00274-y. Epub 2019 Jul 24. PMID: 31342464.https://pubmed.ncbi.nlm.nih.gov/31342464
Kraal K, Blom T, van Noesel M, Kremer L, Caron H, Tytgat G, et al. Treatment and outcome of neuroblastoma tumors: A systematic review.Pediatric Blood & Cancer. 2017; 64:1-12. https://pubmed.ncbi.nlm.nih.gov/28150396
Froeba-Pohl A, von Schweinitz D, Muehling J, Paolini M, Hubertus J. Implication of Image-Defined Risk Factors for the Extent of Surgical Resection and Clinical Outcome in Patients with Pelvic Neuroblastoma. Eur J Pediatr Surg. 2021 Aug;31(4):362-366. https://pubmed.ncbi.nlm.nih.gov/32862422
Barret D,Bagatelli R. The beginning of the end of package deal therapy for patients with high-risk neuroblastoma? Journal of Clinical Oncology. 2016;34(21):2437-9 https://pubmed.ncbi.nlm.nih.gov/27161969
Sánchez-Galán A, Barrena S, Vilanova-Sánchez A, Martín SHA, Lopez-Fernandez S, García P, et al. Ganglioneuroma: to operate or not to operate. Eur J Pediatr Surg. 2014 Feb; 24(1):25–30. https://pubmed.ncbi.nlm.nih.gov/24327216
Yang T, Huang Y, Xu T, Tan T, Yang J, Pan J, Hu C, Li J, Zou Y. Surgical management and outcomes of ganglioneuroma and ganglioneuroblastoma-intermixed. Pediatr Surg Int. 2017 Sep;33(9):955-959. https://pubmed.ncbi.nlm.nih.gov/28608056
Decarolis B, Simon T, Krug B, Leuschner I, Vokuhl C, Kaatsch P, et al. Treatment and outcome of Ganglioneuroma and Ganglioneuroblastoma intermixed. BMC Cancer. 2016 27; 16:542. 7. https://pubmed.ncbi.nlm.nih.gov/27465021
Alexander N, Sullivan K, Shaikh F, Irwin MS. Characteristics and management of ganglioneuroma and ganglioneuroblastoma-intermixed in children and adolescents. Pediatr Blood Cancer. 2018 May; 65(5): e26964. https://pubmed.ncbi.nlm.nih.gov/29369484
Twist CJ, Naranjo A, Schmidt ML, Tenney SC, Cohn SL, Meany HJ, et al. Defining Risk Factors for Chemotherapeutic Intervention in Infants with Stage 4S Neuroblastoma: A Report from Children's Oncology Group Study ANBL0531. J Clin Oncol. 2019 Jan 10;37(2):115-124. https://pubmed.ncbi.nlm.nih.gov/30444686
Strother DR, London WB, Schmidt ML, Brodeur GM, Shimada H, Thorner P, et al. Outcome after surgery alone or with restricted use of chemotherapy for patients with low-risk neuroblastoma: results of Children's Oncology Group study P9641. J Clin Oncol. 2012 May 20;30(15):1842-8. https://pubmed.ncbi.nlm.nih.gov/22529259
London WB, Zhang Y, Matthay KK, Monclair T, Ambros PF, Cohn SL, et al. Lung metastases in neuroblastoma at initial diagnosis: a report from the International Neuroblastoma Risk Group (INRG) project. Pediatr Blood Cancer. 2008;51(5):589-592 https://pubmed.ncbi.nlm.nih.gov/18649370
Taggart DR, London WB, Schmidt ML, DuBois SG. Prognostic value of the stage 4S metastatic pattern and tumor biology in patients with metastatic neuroblastoma diagnosed between birth and 18 months of age. J ClinOncol. 2011; 29(33):4358-64. https://pubmed.ncbi.nlm.nih.gov/21969516
Morgenstern DA, London WB, Stephens D, Volchenboum SL, Hero B, Di Cataldo A, Nakagawara A, Shimada H, Ambros PF, Matthay KK, Cohn SL, Pearson AD, Irwin MS. Metastatic neuroblastoma confined to distant lymph nodes (stage 4N) predicts outcome in patients with stage 4 disease: A study from the International Neuroblastoma Risk Group Database. J Clin Oncol. 2014 Apr 20;32(12):1228-35. https://pubmed.ncbi.nlm.nih.gov/24663047
DuBois SG, Bagatell R. Improving Outcomes in Children with High-Risk Neuroblastoma: The Role of Randomized Trials. J Clin Oncol. 2021 Aug 10; 39(23): 2525-2527.https://pubmed.ncbi.nlm.nih.gov/34152837
Cereceda, L. Emergencias oncológicas. Rev. Med. Clin. Condes. 2011; 22: 665-67 https://pesquisa.bvsalud.org/gim/resource/en/lil-677272
Pi J, Kang Y, Smith M, Earl M, Norigian Z, McBride A. A review in the treatment of oncologic emergencies. Journal of Oncology Pharmacy Practice. 2016; 1: 1-14. https://pubmed.ncbi.nlm.nih.gov/26447101
Burca G, Tezer M, Buyukpamukeu M, Akyuz C, Yalcin B, Varan A. Complications of neuroblastic tumors: experience of a single center. Childs Nerv Syst. 2010; 26: 359-365. https://pubmed.ncbi.nlm.nih.gov/19714340
Elston DM. Mechanisms of regression. Clin Med Res. 2004 May;2(2):85-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1069076
Bender HG, Irwin MS, Hogarty MD, Castleberry R, Maris JM, Kao PC, et al. Survival of Patients with Neuroblastoma After Assignment to Reduced Therapy Because of the 12- to 18-Month Change in Age Cutoff in Children's Oncology Group Risk Stratification. Journal of Clinical Oncology. Journal of Clinical Oncology 2023;41(17): 3149-3159. https://ascopubs.org/doi/10.1200/JCO.22.01946
Zheng DJ, Krull KR, Chen Y. Long-term psychological and educational outcomes for survivors of neuroblastoma: A report from the Childhood Cancer Survivor Study. Cancer. 2018 Aug;124(15):3220-3230. https://europepmc.org/article/MED/29888538
Li Q, Wang J, Cheng Y, Hu A, Li D, Wang X, et al. Long-Term Survival of Neuroblastoma Patients Receiving Surgery, Chemotherapy, and Radiotherapy: A Propensity Score Matching Study. J Clin Med. 2023 Jan 17;12(3):754.https://pubmed.ncbi.nlm.nih.gov/36769402
Therasse Pm, Arbuck SG,Eisenhauer EA. New guidelines to evaluate the response to treatment in solid tumors: European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000; 92:205-216. https://pubmed.ncbi.nlm.nih.gov/10655437
Eisenhauer EA, Therasse P, Bogaerts J. New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1) Eur J Cancer.2009; 45:228-247. https://pubmed.ncbi.nlm.nih.gov/19097774
Ahmed A, Zhang L, Reddivalla N and Hetherington M. Neuroblastoma in children: update on clinic pathologic and genetic prognostic factors. Pediatric Hematology and Oncology. Pediatric Hematology Oncology. 2017; 29:7-21. https://pubmed.ncbi.nlm.nih.gov/28662353
Phelps HM, Ndolo JM, Van Arendonk KJ, Chen H, Dietrich HL, Watson KD, et al. Association between image-defined risk factors and neuroblastoma outcomes. J PediatrSurg. 2019; 21 (1): 94-99 https://doi.org/10.1016/j.jpedsurg.2019.02.040
Bagatell R, McHugh K, Naranjo A.Assessment of Primary Site Response in Children with High-Risk Neuroblastoma: An International Multicenter Study. J ClinOncol. 2016; 34 (7): 740-6 https://pubmed.ncbi.nlm.nih.gov/26755515
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