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• W2890125824 abstract "Despite the development of new treatment options, the prognosis of high-risk neuroblastoma patients is still poor. Many studies designed to elaborate the association between the extent of resection (EOR) and outcome have reported conflicting results. We performed a meta-analysis to assess whether greater EOR is associated with improved overall survival (OS) and event-free survival (EFS) in patients with high-risk neuroblastoma.Embase, PubMed, Cochrane library, and conference proceedings were searched between March 10 and October 1, 2017. Studies of pediatric patients with newly diagnosed high-risk neuroblastoma comparing various EOR and presenting objective overall or event-free survival data were included. Primary outcomes were relative risk (RR) for mortality at 3 and 5 years. Secondary outcomes were 3-year and 5-year EFS rates.19 retrospective studies including a total of 2358 cases were identified. Compared with subtotal resection (STR), patients who underwent gross total resection (GTR) had significantly decreased mortality at 3 years (RR, 0.69; 95% CI, 0.58-0.82; P < 0.001; I2 = 27%) and 5 years (RR, 0.70; 95% CI, 0.60-0.82; P < 0.001; I2 = 38%). A similar decrease was revealed in the 3-year risk for mortality for STR compared with biopsy (RR, 0.71; 95% CI, 0.53-0.95; P = 0.02; I2 = 0%). When comparing any resection with biopsy, resection group also showed a decreased risk for mortality at 3 years (RR, 0.66; 95% CI, 0.53-0.83; P < 0.001; I2 = 8%) and 5 years (RR, 0.67; 95% CI, 0.50-0.91; P = 0.009; I2 = 61%). With respect to the risk ratio for EFS, there were no significant differences in any comparisons.This literature highlights the importance of extent of resection in treating high-risk neuroblastoma, and when feasible, the currently available evidences in favor of the use of GTR for high-risk neuroblastoma for reducing 3- and 5-year mortality.3A." @default.
• W2890125824 created "2018-09-27" @default.
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• W2890125824 date "2019-07-01" @default.
• W2890125824 modified "2023-10-18" @default.
• W2890125824 title "Impact of extent of resection on survival in high-risk neuroblastoma: A systematic review and meta-analysis" @default.
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• W2890125824 doi "https://doi.org/10.1016/j.jpedsurg.2018.08.046" @default.
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