The prognosis of neuroblastoma treated with multimodal therapy including bone marrow transplantation. The evaluation of surgery and IORT

Multimodal therapy (chemotherapy, surgery, and radiotherapy) including bone marrow transplantation was performed for advanced neuroblastoma. We analyzed the association between surgical resectability and relapse in primary sites. Thirteen patients were treated in our institute beginning 1986. All patients were over 1 year old, and they belonged to stage IVA: 10, IVB: 2, III: 1. They underwent delayed primary operation and IORT after aggressive chemotherapy. Though 10 patients with complete or microscopic residual resection for primary tumor showed no relapse in that site, 3 patients with macroscopic residual resection relapsed. No regional lymph node relapses were demonstrated in spite of incomplete lymph node desection. Our data suggest that more than complete or microscopic residual resection for primary tumors are necessary to achieve absence of primary site relapse. (author)