https://scholars.lib.ntu.edu.tw/handle/123456789/136487
標題: | The Influence of Biologic Factors on the Surgical Decision in Advanced Neuroblastoma | 作者: | Hsu, Wen-Ming Jen, Yung-Ming Lee, Hsinyu Kuo, Min-Liang Tsao, Po-Nien Chen, Chiung-Nien DAR-MING LAI Lin, Ming-Tsan Lai, Hong-Shiee Chen, Wei-Jao FON-JOU HSIEH |
關鍵字: | Child Child;Preschool Decision Making Female Humans Infant | 公開日期: | 2006 | 卷: | v.13 | 期: | n.2 | 起(迄)頁: | 238-244 | 來源出版物: | Annals of Surgical Oncology | 摘要: | BACKGROUND: Molecular markers greatly affect the outcome of neuroblastoma. This study evaluated the influence of Trk-A and myelocytomatosis viral-related oncogene, neuroblastoma- derived (MYCN) on the role of surgery in advanced neuroblastoma. METHODS: Ten stage 3 and 35 stage 4 neuroblastoma patients were included. Tumor resection was classified into gross total resection (GTR) and incomplete resection. Patients were classified into three biological risk groups according to Trk-A expression and myelocytomatosis viral-related oncogene, neuroblastoma- derived (MYCN) status in tumor tissues studied by immunohistochemistry and fluorescence in situ hybridization, respectively: low risk (positive Trk-A and normal MYCN), intermediate risk (negative Trk-A and normal MYCN), and high risk (positive or negative Trk-A and MYCN amplification). The effect of tumor resection on prognosis was studied and stratified according to the risk grouping. RESULTS: GTR was achieved in 21 patients (46.7%) with a higher complication rate (33% vs. 8% in the incomplete resection group, P = .036 ). GTR was easier to achieve in low-risk tumors than in intermediate- or high-risk tumors (12 of 13, 4 of 17, and 5 of 15, respectively; P < .001). GTR predicted a favorable prognosis for intermediate-risk patients (P = .037; log-rank test), but not for low- or high-risk patients because of the overall favorable and poor prognosis, respectively. CONCLUSIONS: GTR carries a potentially higher possibility of complication. Although GTR can be achieved easily in low- risk neuroblastoma patients with a favorable prognosis, surgeons should do their best to achieve GTR for intermediate-risk patients to improve outcome. Nevertheless, sacrificing vital organs to achieve GTR for high-risk patients is not justified. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/161550 http://ntur.lib.ntu.edu.tw/bitstream/246246/161550/1/13.pdf https://www.scopus.com/inward/record.uri?eid=2-s2.0-31544443597&doi=10.1245%2fASO.2006.10.012&partnerID=40&md5=101c0714b4e343e85e14732d66d84df5 |
ISSN: | 1068-9265 | DOI: | 10.1245/ASO.2006.10.012 | SDG/關鍵字: | biological factor; cisplatin; cyclophosphamide; epirubicin; etoposide; protein tyrosine kinase A; article; cancer staging; cancer surgery; cancer tissue; clinical article; clinical protocol; controlled study; female; fluorescence in situ hybridization; high risk population; human; human tissue; immunohistochemistry; log rank test; male; myeloid leukemia; neuroblastoma; prognosis; treatment indication; virus oncogene; Child; Child, Preschool; Decision Making; Female; Humans; Infant; Male; Multivariate Analysis; Neuroblastoma; Nuclear Proteins; Oncogene Proteins; Prognosis; Proportional Hazards Models; Receptor, trkA; Risk Assessment; Survival Rate; Taiwan; Tumor Markers, Biological |
顯示於: | 生命科學系 |
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