外科部;病理學科;生命科學系;毒理所;小兒部;外科;婦產科Hsu, Wen-MingWen-MingHsuJen, Yung-MingYung-MingJenLee, HsinyuHsinyuLeeKuo, Min-LiangMin-LiangKuoTsao, Po-NienPo-NienTsaoChen, Chiung-NienChiung-NienChenDAR-MING LAILin, Ming-TsanMing-TsanLinLai, Hong-ShieeHong-ShieeLaiChen, Wei-JaoWei-JaoChenFON-JOU HSIEH2009-06-242018-07-062009-06-242018-07-0620061068-9265http://ntur.lib.ntu.edu.tw//handle/246246/161550http://ntur.lib.ntu.edu.tw/bitstream/246246/161550/1/13.pdfhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-31544443597&doi=10.1245%2fASO.2006.10.012&partnerID=40&md5=101c0714b4e343e85e14732d66d84df5BACKGROUND: 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.application/pdf367902 bytesapplication/pdfen-USChild ChildPreschool Decision Making Female Humans Infant[SDGs]SDG3biological 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, Biologicaljournal article10.1245/ASO.2006.10.012164188842-s2.0-31544443597http://ntur.lib.ntu.edu.tw/bitstream/246246/161550/1/13.pdf