Image-defined risk factors for nephrectomy in patients undergoing neuroblastoma resection

Irene Isabel P. Lim, Debra A. Goldman, Benjamin A. Farber, Jennifer M. Murphy, Sara J. Abramson, Ellen Basu, Stephen Roberts, Michael P. LaQuaglia, Anita P. Price

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Background Although nephrectomy rates are higher in children with neuroblastoma who have image-defined risk factors and/or high-risk disease who undergo resection prior to chemotherapy, no published data outline the key radiographic and clinical characteristics associated with nephrectomy. Methods With IRB approval, imaging studies of children undergoing primary resection of intraabdominal neuroblastoma between 2000 and 2014 were retrospectively reviewed. Fisher's exact and Wilcoxon rank-sum tests were used to compare categorical and continuous variables, respectively, with p-values adjusted for multiple testing using the false discovery rate approach. Results Twenty-seven of 380 consecutive patients with CT imaging obtained prior to primary neuroblastoma resection underwent partial or total nephrectomy. On preoperative imaging, renal vessel narrowing and encasement and tumor invasion of the renal hilum, pelvis, and/or parenchyma were present significantly more frequently among patients undergoing nephrectomy. Delayed renal excretion of contrast, hydronephrosis, and tumors with MYCN amplification were also more prevalent in the nephrectomy group. Conclusion Encasement and narrowing of renal vessels, delayed excretion, and tumor invasion into the kidney, particularly pelvis and capsule invasion, are significantly associated with partial or total nephrectomy at initial neuroblastoma resection. These observations provide valuable information for surgical planning as well as presurgical discussions with families prior to neuroblastoma resection.

Original languageEnglish (US)
Pages (from-to)975-980
Number of pages6
JournalJournal of Pediatric Surgery
Issue number6
StatePublished - Jun 1 2016
Externally publishedYes


  • Image defined risk factors
  • Nephrectomy
  • Neuroblastoma
  • Partial nephrectomy

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health


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