Vessel adherent growth represents a major challenge in the surgical resection of neuroblastoma and is associated with adverse outcome
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In brief
In brief
Study of 100 neuroblastoma patients identifies unexpected vessel infiltration (UVIN) in 34% of cases, significantly correlating with incomplete resection, MYCN amplification, and poor outcomes. UVIN represents a major intraoperative challenge not visible on pre-operative imaging and is associated with higher complication rates and need for neoadjuvant therapy.
Written by the GCMD Library team from the article.
Purpose
Neuroblastoma (NB) is the most common extracranial, solid tumor in childhood, with a peak incidence in children under 6 years of age. Due to its variable course of disease, which ranges from spontaneous regression to metastatic spread, NB still represents a significant therapeutic challenge. Strikingly, a certain number of NBs intraoperatively show vessel adhesion and/or infiltrative growth, which is often not visible in pre-operative imaging. We proposed the term unexpected vessel infiltration of NB (UVIN) to denote this phenomenon. UVIN represents a major surgical challenge.
Methods
In this study, we determined frequency and clinical relevance of UVIN in a cohort of 100 NB-patients with subsequent correlation to several unfavorable characteristics of disease. RNA expression levels of MYCN and its co-regulated antisense transcript MYCNOS to identify markers was measured by PCR.
Results
We found UVIN to be present in 34% of cases and significantly correlated with incomplete resection, MYCN amplification, complications, neoadjuvant therapy, tumor grade and MYCNOS expression levels. MYCN expression levels showed no significant results with UVIN.
Conclusion
Collectively, our data show that UVIN represents a frequent surgical problem associated with a poor outcome in NB patients. MYCN and MYCNOS seem to be no appropriate markers for UVIN.
Type of study
Prognosis study.
Level of evidence
Level III.