Complete surgical resection plus chemotherapy prolongs survival in children with stage 4 neuroblastoma

Chee Chee Koh, Jin Cherng Sheu, Der Cherng Liang, Shu Huey Chen, Hsi Che Liu

Research output: Contribution to journalReview articlepeer-review

26 Citations (Scopus)


The factors that affect survival in patients with stage 4 neuroblastoma vary. Several prospective and retrospective studies have provided conflicting conclusions regarding the benefit of combining aggressive chemotherapy with complete surgical resection. We analyzed our experience to evaluate the effect of complete surgical resection of the primary tumor on survival when disseminated disease has been controlled by chemotherapy. We retrospectively reviewed the medical records of 44 consecutive children with neuroblastoma treated between 1990 and 2000. Twenty-six children with stage 4 disease were enrolled. Most were treated with surgical resection combined with chemotherapy. The survival rate was compared based on the timing (primary versus delayed until chemotherapy had been given) and results of surgery (complete tumor resection, microscopic residual disease, and gross residual disease). The mean survival (52.8 months) of children with delayed complete surgical resection (CSR) was statistically superior to that of those with microscopic residual (20.8 months, p = 0.0111) or gross residual tumor (12.2 months, p = 0.0141). In the CSR group, 1-, 2-, 3-, and 5-year survival rates were 88%, 77%, 77%, and 65%, respectively, vs. 80%, 40%, 20%, and 0% in the microscopic residual group. In conclusion, complete resection of the primary tumor with no residual disease was associated with improved survival in children with advanced neuroblastoma whose metastatic disease had been controlled by chemotherapy.

Original languageEnglish
Pages (from-to)69-72
Number of pages4
JournalPediatric Surgery International
Issue number2
Publication statusPublished - Feb 2005
Externally publishedYes


  • Chemotherapy
  • Complete surgical resection
  • Neuroblastoma

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery


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