Perioperative complication incidence and risk factors for retroperitoneal neuroblastoma in children:analysis of 571 patients

Min He ¹Jia-Bin Cai ¹Xuan Wu ¹Yin-Bing Tang ¹Jin-Yan Wang ²Jun-Qin Mao ¹Ji-Jun Chen ¹Li-Feng Zhang ¹Zhong-Hai Guan ¹Jie-Ni Xiong ¹Wan-Xin Peng ³Jin-Hu Wang ¹Ting Tao¹

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作者信息

1. Pediatric Cancer Research Center,National Clinical Research Center for Child Health,Hangzhou,China;Department of Surgical Oncology,Children's Hospital,Zhejiang University School of Medicine,Hangzhou,China;Cancer Center,Zhejiang University,No.3333 Binsheng Rode,Hangzhou,China
2. Pediatric Cancer Research Center,National Clinical Research Center for Child Health,Hangzhou,China;Department of Surgical Oncology,Children's Hospital,Zhejiang University School of Medicine,Hangzhou,China
3. Pediatric Cancer Research Center,National Clinical Research Center for Child Health,Hangzhou,China;Cancer Center,Zhejiang University,No.3333 Binsheng Rode,Hangzhou,China
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Abstract

Background Surgery plays an important role in the treatment of neuroblastoma.Perioperative complications may impact the course of neuroblastoma treatment.To date,comprehensive analyses of complications and risk factors have been lacking.Methods Patients with retroperitoneal neuroblastoma undergoing tumor resection were retrospectively analyzed between 2014 and 2021.The data collected included clinical characteristics,operative details,operative complications and postopera-tive outcomes.Risk factors for perioperative complications of retroperitoneal neuroblastoma were analyzed.Results A total of 571 patients were enrolled in this study.Perioperative complications were observed in 255(44.7％)patients.Lymphatic leakage(28.4％),diarrhea(13.5％),and injury(vascular,nerve and organ;7.5％)were the most frequent compli-cations.There were three operation-related deaths(0.53％):massive hemorrhage(n=1),biliary tract perforation(n=1)and intestinal necrosis(n=1).The presence of image-defined risk factors(IDRFs)[odds ratio(OR)=2.09,P＜0.01],high stage of the International Neuroblastoma Risk Group staging system(INRGSS)(OR=0.454,P=0.04),retroperitoneal lymph node metastasis(OR=2.433,P=0.026),superior mesenteric artery encasement(OR=3.346,P=0.003),and inferior mesenteric artery encasement(OR=2.218,P=0.019)were identified as independent risk factors for perioperative complications.Conclusions Despite the high incidence of perioperative complications,the associated mortality rate was quite low.Perio-perative complications of retroperitoneal neuroblastoma were associated with IDRFs,INRGSS,retroperitoneal lymph node metastasis and vascular encasement.Patients with high-risk factors should receive more serious attention during surgery but should not discourage the determination to pursue total resection of neuroblastoma.

Key words

Complication/Neuroblastoma/Risk factors/Surgery

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基金项目

国家自然科学基金面上项目(32270853)

Key Program of Natural Science Foundation of Zhejiang Province(HDMZ23H160029)

出版年

2024

世界儿科杂志(英文版)

CSTPCD

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参考文献量25

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