Development of a New Score Based on Image Defined Risk Factors to Standardize Surgical Risk in Neuroblastoma Resection - A SIOPEN Collaborative Study
Issued Date
2025-03-01
Resource Type
ISSN
00223468
eISSN
15315037
Scopus ID
2-s2.0-85212957701
Journal Title
Journal of Pediatric Surgery
Volume
60
Issue
3
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Pediatric Surgery Vol.60 No.3 (2025)
Suggested Citation
Avanzini S., Sarnacki S., Urla C., Parodi S., Palo F., Benissad M., Crocoli A., Buconi I., Flores P., Bordallo Vazquez M., Irtan S., Hompes D., Virgone C., Metzelder M., Matthyssens L., Gabra H., Jauquier N., Fuchs J., Losty P.D., Dall'Igna P. Development of a New Score Based on Image Defined Risk Factors to Standardize Surgical Risk in Neuroblastoma Resection - A SIOPEN Collaborative Study. Journal of Pediatric Surgery Vol.60 No.3 (2025). doi:10.1016/j.jpedsurg.2024.162108 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/102767
Title
Development of a New Score Based on Image Defined Risk Factors to Standardize Surgical Risk in Neuroblastoma Resection - A SIOPEN Collaborative Study
Author's Affiliation
Ramathibodi Hospital
Université Paris Cité
Universitair Ziekenhuis Gent
Hospital Universitari i Politècnic La Fe
KU Leuven– University Hospital Leuven
Azienda Ospedale Università Padova
Centre Hospitalier Universitaire Vaudois
IRCCS Ospedale Pediatrico Bambino Gesù
Eberhard Karls Universität Tübingen
Istituto Giannina Gaslini
Hôpital Armand-Trousseau
Hospital de Pediatria SAMIC Prof. Dr. Juan P. Garrahan
Medizinische Universität Wien
Newcastle University
Institute of Systems Molecular and Integrative Biology University of Liverpool
Ospedale Pediatrico Giovanni XXIII - Azienda Ospedaliero-Universitaria Consorziale-Policlinico
Université Paris Cité
Universitair Ziekenhuis Gent
Hospital Universitari i Politècnic La Fe
KU Leuven– University Hospital Leuven
Azienda Ospedale Università Padova
Centre Hospitalier Universitaire Vaudois
IRCCS Ospedale Pediatrico Bambino Gesù
Eberhard Karls Universität Tübingen
Istituto Giannina Gaslini
Hôpital Armand-Trousseau
Hospital de Pediatria SAMIC Prof. Dr. Juan P. Garrahan
Medizinische Universität Wien
Newcastle University
Institute of Systems Molecular and Integrative Biology University of Liverpool
Ospedale Pediatrico Giovanni XXIII - Azienda Ospedaliero-Universitaria Consorziale-Policlinico
Corresponding Author(s)
Other Contributor(s)
Abstract
Background and aims: Image Defined Risk Factors (IDRFs) assess surgical risk in neuroblastoma (NB) and guide neoadjuvant therapy. Despite chemotherapy IDRFs may persist in 70 % of cases. Several studies have suggested that not all IDRFs hold equal significance and that the presence of an IDRF does not inherently signify unresectability. This current study seeks to stratify and assign a score to each IDRF based on its impact on surgical risk. Methods: This collaborative study entailed retrospective collection of patient data from NB operations conducted between 2016 and 2020, together with the computation of a Surgical Complexity Index (SCI) for every patient. The SCI values obtained were correlated with preoperatively identified IDRFs. Mann–Whitney statistical test was employed to assign a relevance score to the association between individual IDRFs and SCI. Results: 14 centers contributed 427 neuroblastoma index cases meeting study inclusion criteria. 303 patients had 1 or more IDRFs. The presence and number of IDRFs in all patients significantly correlated with the SCI value (p < 0.0001). The most frequently encountered IDRF was renal pedicle involvement. There was a significant association observed between clusters of abdominal IDRFs and the occurrence of post-operative complications (p < 0.05), while a weak association link was found with intra-operative complications. A relevance score for individual IDRFs allowed their stratification based on surgical risk. The most relevant IDRFs were extension within two anatomical body compartments, infiltration of the hepato-pancreatic block, encasement of the superior mesenteric artery and coeliac axis, and tumor compressing the trachea. Conclusions: This current study has facilitated the assignment of a relevance score to each IDRF, correlating it with surgical risks. Considering this stratification of surgical risk alongside oncologic risk as defined by the neuroblastoma treatment patient risk grouping should facilitate a more precise definition of surgical objectives and the optimal conditions favoring gross tumor resection. Type of Study: Clinical Research - Study of Diagnostic Test. Level of Evidence: III.