Long term outcomes after concurrent ipsilateral nephrectomy versus kidney-sparing surgery for high-risk, intraabdominal neuroblastoma
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In brief
In brief
Retrospective study of 58 high-risk intraabdominal neuroblastoma patients comparing concurrent nephrectomy (n=6) versus kidney-sparing surgery (n=52). While nephrectomy reduced long-term kidney function (eGFR 90 vs 127 ml/min/1.73m²), it showed no survival advantage or difference in recurrence rates, supporting kidney preservation when feasible.
Written by the GCMD Library team from the article.
Purpose
The impact of the extent of surgical resection including nephrectomy for high-risk neuroblastoma patients is controversial. In this study, we compared the renal late effects and long-term survival for patients who underwent kidney-sparing surgery (KSS) versus concurrent ipsilateral nephrectomy (CIN) for high-risk, intraabdominal neuroblastoma (HRIN).
Methods
A retrospective analysis of patients diagnosed with HRIN between Jan 1998 and Dec 2008 in a tertiary referral center was performed. Demographics, preoperative features, surgical resection extent and outcomes were analyzed.
Results
Of 58 patients who underwent surgical management of HRIN, 6 underwent CIN and 52 underwent KSS. Renal image-defined risk factors (IDRFs) were more common in patients who underwent CIN. Operating time was longer and EBL higher in CIN patients.
There was no difference in recurrence or overall survival between the groups. Estimated GFR (eGFR) was comparable between the groups preoperatively, but was reduced postoperatively and at long-term follow-up in patients who underwent CIN.
Conclusion
Compared to KSS, CIN is not associated with an increase in local recurrence or inferior survival but does lead to reduced kidney function (eGFR of 90 ml/min/1.73 m2 for CIN versus 127 ml/min/1.73 m2 for KSS, p = 0.03) but without significant impact on clinical outcome.
Levels of evidence
III (Retrospective comparative study).