儿童腹膜后神经母细胞瘤的手术治疗。临床经验

S. A. Kuznetsov, E. Kolesnikov, A. N. Shevchenko, Y. Kozel, G. Mkrtchyan, M. V. Starzhetskaya, A. I. Bespalova, E. E. Pak, D. Yurchenko, O. P. Popovyan
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摘要

研究目的:目的分析小儿腹膜后神经母细胞瘤的手术治疗经验及根治性手术治疗对预后的影响。材料和方法。该研究纳入了2016-2018年在国家肿瘤医学研究中心儿科肿瘤科接受腹膜后神经母细胞瘤治疗的35例患者(14名女孩和21名男孩,平均年龄3.3岁)。32例患者接受手术治疗。3例患者在新辅助化疗期间出现疾病进展。最初,5例患者进行了手术;其余患者行经皮穿刺活检、免疫组织化学检测和随后的新辅助多化疗。术后早期无并发症发生。在这篇文章中,我们介绍了手术治疗小儿腹膜后神经母细胞瘤的经验。观察患者12至24个月。28例接受根治性手术的患者中有23例存活,没有疾病复发或进展的迹象。2例肿瘤复发,分别行抗复发PCT和DGT治疗。目前,患者病情有所缓解。3例患者主要因疾病晚期而出现全身性进展。现代外科技术和仪器的管理允许根治性手术治疗大部分局部晚期神经母细胞瘤患者。
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Surgical treatment of retroperitoneal neuroblastoma in children. Clinical experience
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. 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. 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. Administration of modern surgical techniques and instrumentation allows radical surgical treatment for a large percentage of patients with locally advanced neuroblastoma.
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