Resectability and operative morbidity after chemotherapy in neuroblastoma patients with encasement of major visceral arteries

Barrie S. Rich, Maureen P. McEvoy, Natasha E. Kelly, Edwin Oh, Sara J. Abramson, Anita P. Price, Nai Kong V. Cheung, Michael P. La Quaglia

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


Background/Purpose: Image-defined vessel encasement is a significant risk factor for surgical complications and incomplete resection for intermediate-risk tumors. We sought to examine the impact of vessel encasement on complications or resectability in intermediate-risk or high-risk patients after neoadjuvant chemotherapy. Methods: We retrospectively reviewed 207 consecutive patients with circumferential encasement of the renal vessels, celiac axis, and/or superior mesenteric artery (SMA) who underwent resection between 1991 and 2009. Specifically, we evaluated resection rates, complications, and outcome. Results: Median age at diagnosis was 3.0 years, and 79% of patients had stage 4 disease. Of known MYCN status, 23.4% had MYCN amplification. Vessel encasement included renal vessels, celiac axis, or SMA alone in 107, 7, and 4 patients, respectively. Both the renal vessels and celiac axis were encased in 5 patients, renal vessels and SMA in 7 patients, and celiac axis and SMA in 14 patients. Sixty-three patients had all 3 vessels encased. The gross total resection (GTR) rate was 94%. No operative or postoperative deaths occurred. The overall complication rate was 34.8% (n = 72). Overall 5-year survival (±SEM) was 67.4% (±7.4%). Conclusion: Encasement of major visceral arteries in patients with neuroblastoma who have received chemotherapy does not preclude gross total resection.

Original languageEnglish (US)
Pages (from-to)103-107
Number of pages5
JournalJournal of Pediatric Surgery
Issue number1
StatePublished - Jan 1 2011
Externally publishedYes


  • Neuroblastoma
  • Resectability
  • Vessel encasement

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health


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