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Fritsch, P; Kerbl, R; Lackner, H; Urban, C.
Wait and see strategy in localized neuroblastoma in infants: an option not only for cases detected by mass screening.
PEDIATR BLOOD CANCER. 2004; 43(6): 679-682. Doi: 10.1002/pbc.20126
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Führende Autor*innen der Med Uni Graz
Fritsch Peter
Urban Ernst-Christian
Co-Autor*innen der Med Uni Graz
Kerbl Reinhold
Lackner Herwig
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Abstract:
Neuroblastomas in infants may regress or mature spontaneously. Consequently, some authors have applied a "wait and see" strategy for tumors found by urinary mass screening. Recently, improved technique and increasing frequency of ultrasound examinations have led to an increase of neuroblastoma cases in pre- and post-natal period. We describe five cases, four diagnosed by routine ultrasound examination and one detected by urinary mass screening, who were monitored with a "wait and see" strategy in order to spare surgery. Median age at diagnosis was 4 months (range 2-10 months). All tumors were adrenal neuroblastomas. All patients met the following criteria: localized tumors, tumor size less than 5 cm in diameter, absence of invasive growth, vanillylmandelic acid (VMA) and homovanillic acid (HVA) less than 50 microg/mg creatinine, and informed consent of parents. Monitoring was performed by monthly ultrasound examinations and urine catecholamine analysis. Median follow-up is 14 months (5-28 months). Three tumors showed spontaneous regression, one is still under observation. In one patient the tumor increased in size and was resected after 14 months of observation displaying favorable histology, but chromosome 1p imbalance. Previous reports describe the adoption of a "wait and see" strategy in selected cases of localized neuroblastoma detected by mass screening. Our study confirms that this strategy may be similarly applied in incidentally or clinically detected cases. However, possible benefit has to be carefully balanced against possible risks.
Find related publications in this database (using NLM MeSH Indexing)
Disease Progression -
Disease-Free Survival -
Follow-Up Studies -
Humans -
Infant -
Kidney - ultrasonography
Mass Screening - ultrasonography
Neuroblastoma - diagnosis
Prognosis - diagnosis
Risk Assessment - diagnosis
Spleen - ultrasonography
Time Factors - ultrasonography

Find related publications in this database (Keywords)
neuroblastoma
screening
spontaneous regression
ultrasound
"wait and see" strategy
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