Image defined risk factor(s) and outcomes for abdominal neuroblastoma: a surgical perspective from a Thailand National Cancer Centre.
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PURPOSE: To evaluate the impact of IDRFs on surgical outcomes, complications, and survival in abdominal neuroblastoma (ANB). METHOD: Retrospective study of patients (< 15 years) with ANB stage L2 or higher treated over two decades at a university centre in Thailand. RESULTS: Among fifty patients, 94% had high-risk neuroblastoma. Preoperative tumour encasement of the celiac axis (CA) or origin of SMA was more frequent in incomplete resection (33% vs. 9%, p = 0.04). Complications were greater in children with abdominal aorta/IVC tumour encasement (58% vs. 27%, p < 0.03) and adjacent organ infiltrative tumours (42% vs. 7%, p < 0.04). Visceral organ injuries correlated with vascular/infiltrating IDRFs. Tumours invading CA/SMA carried less risk (%) of vascular injury (r =- 0.28, p = 0.04). Only tumour encasement of the SMA at the mesenteric root predicted disease progression (r = 0.35, p = 0.01). Incomplete resection was associated with higher risks (%) of disease progression. Two- and five-year survival rates were 80.6% and 52.1%, respectively. CONCLUSION: Vascular IDRFs especially mesenteric root encasement were linked to risk of visceral organ injury and disease progression. Awareness of risks may reduce vascular injury during operation though incomplete resection influenced disease progression. Survival outcomes are comparable to Southeast Asia Regions.