Results of retroperitoneal-lymphadenectomy in the treatment of abdominal neuroblastoma

Hypothesis: Adequate locoregional surgical treatment prevents local relapse of abdominal neuroblastoma. Design: A retrospective review of a consecutive series of patients who underwent surgical excision for abdominal neuroblastoma. Setting: University hospital. Patients: Forty-seven patients with abdominal neuroblastomas whose primary tumor site was restricted to the adrenal gland or the adjoining sympathetic ganglia. Intervention: Complete excision of the primary tumor and retroperitoneal lymphadenectomy. Main Outcome Measures: Surgical intervention, postoperative complications, survival, and local recurrence. Results: The average duration of surgery was 5 hours 28 minutes; the mean intraoperative blood loss was 27.7 g/kg of body weight. We had no intraoperative major complications leading to visceral insufficiency or perioperative deaths. The following 15 postoperative complications were observed in 12 patients; these complications included diarrhea (8 patients), renal atrophy (3 patients), intestinal obstruction (2 patients), chylous ascites (1 patient), and wound infection (1 patient). The mean follow-up period for the entire patient population was 8.5 years. All 30 patients with Evans stage I, II, III, or IV-S and 8 of the 17 patients with Evans stage IV were alive without evidence of disease. Eight patients died of progressive disease; 1 died of cytomegalovirus infection. No local recurrence was detected within the lymphadenectomy field in any of the patients. Conclusion: Complete excision of the primary tumor and retroperitoneal lymphadenectomy can be done safely and provides excellent locoregional control for patients with abdominal neuroblastoma.