{
    "abstract": "Retroperitoneal neuroblastomas predominantly encroach upon critical structures, complicating surgical intervention and yielding elevated rates of surgery-associated complications. The kidney and renal vasculature represent the organs most susceptible to retroperitoneal neuroblastoma infiltration. Prior investigations have revealed high nephrectomy incidence and a paucity of renal-preserving surgical approaches.\nA retrospective analysis was undertaken, examining patients with retroperitoneal neuroblastoma who underwent surgical procedures from January 2018 to December 2019\u00a0at Beijing Children's Hospital.\nThe study encompassed 225 patients, presenting a median age of 37 months. Concomitant nephrectomy and tumor excision were performed in 11 (4.9%) patients, while 214 (95.1%) patients successfully preserved their kidneys during surgery. Among the patients who retained their kidneys, 8 (3.5%) experienced renal atrophy postoperatively. Predominant rationales for simultaneous nephrectomy included tumor invasion into the renal hilum (n\u00a0=\u00a09), markedly diminished function of the affected kidney (n\u00a0=\u00a02), and ureteral infiltration (n\u00a0=\u00a01). Subsequent to a median follow-up duration of 43 months, the outcomes demonstrated no considerable divergence in overall survival (OS) and event-free survival (EFS) between the nephrectomy and renal-preserving cohorts among high-risk (HR) neuroblastoma patients. Among the eight HR children who underwent nephrectomy, four experienced local recurrence. The nephrectomy cohort exhibited a significantly elevated cumulative incidence of local progression (CILP) relative to the renal-preserving group.\nIn high-risk retroperitoneal neuroblastoma patients, nephrectomy does not enhance CILP, EFS, or OS. The guiding surgical tenet involves preserving the kidney while striving for gross total resection of the primary neoplasm, barring instances of severe deterioration of the affected renal function.",
    "authors": [
        {
            "affiliation": "Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.",
            "firstname": "Qinghua",
            "initials": "Q",
            "lastname": "Ren"
        },
        {
            "affiliation": "Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.",
            "firstname": "Shen",
            "initials": "S",
            "lastname": "Yang"
        },
        {
            "affiliation": "Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.",
            "firstname": "Saishuo",
            "initials": "S",
            "lastname": "Chang"
        },
        {
            "affiliation": "Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.",
            "firstname": "Wei",
            "initials": "W",
            "lastname": "Yang"
        },
        {
            "affiliation": "Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.",
            "firstname": "Haiyan",
            "initials": "H",
            "lastname": "Cheng"
        },
        {
            "affiliation": "Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.",
            "firstname": "Xiaofeng",
            "initials": "X",
            "lastname": "Chang"
        },
        {
            "affiliation": "Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.",
            "firstname": "Zhiyun",
            "initials": "Z",
            "lastname": "Zhu"
        },
        {
            "affiliation": "Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.",
            "firstname": "Tong",
            "initials": "T",
            "lastname": "Yu"
        },
        {
            "affiliation": "Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.",
            "firstname": "Jun",
            "initials": "J",
            "lastname": "Feng"
        },
        {
            "affiliation": "Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.",
            "firstname": "Jianyu",
            "initials": "J",
            "lastname": "Han"
        },
        {
            "affiliation": "Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.",
            "firstname": "Jianing",
            "initials": "J",
            "lastname": "Mou"
        },
        {
            "affiliation": "Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China. Electronic address: qinhong999999@163.com.",
            "firstname": "Hong",
            "initials": "H",
            "lastname": "Qin"
        },
        {
            "affiliation": "Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China; MOE Key Laboratory of Major Diseases in Children, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China. Electronic address: wanghuanmin@bch.com.cn.",
            "firstname": "Huanmin",
            "initials": "H",
            "lastname": "Wang"
        }
    ],
    "conclusions": "In high-risk retroperitoneal neuroblastoma patients, nephrectomy does not enhance CILP, EFS, or OS. The guiding surgical tenet involves preserving the kidney while striving for gross total resection of the primary neoplasm, barring instances of severe deterioration of the affected renal function.",
    "copyrights": "\u00a9 2023 Published by Elsevier Ltd.",
    "doi": "10.1016/j.ejso.2023.107303",
    "journal": "European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology",
    "keywords": [
        "Children",
        "Kidney-sparing",
        "Nephrectomy",
        "Neuroblastoma",
        "Prognosis"
    ],
    "methods": null,
    "publication_date": "2023-12-06",
    "pubmed_id": "38056023",
    "results": "The study encompassed 225 patients, presenting a median age of 37 months. Concomitant nephrectomy and tumor excision were performed in 11 (4.9%) patients, while 214 (95.1%) patients successfully preserved their kidneys during surgery. Among the patients who retained their kidneys, 8 (3.5%) experienced renal atrophy postoperatively. Predominant rationales for simultaneous nephrectomy included tumor invasion into the renal hilum (n\u00a0=\u00a09), markedly diminished function of the affected kidney (n\u00a0=\u00a02), and ureteral infiltration (n\u00a0=\u00a01). Subsequent to a median follow-up duration of 43 months, the outcomes demonstrated no considerable divergence in overall survival (OS) and event-free survival (EFS) between the nephrectomy and renal-preserving cohorts among high-risk (HR) neuroblastoma patients. Among the eight HR children who underwent nephrectomy, four experienced local recurrence. The nephrectomy cohort exhibited a significantly elevated cumulative incidence of local progression (CILP) relative to the renal-preserving group.",
    "title": "Renal preservation in high-risk retroperitoneal neuroblastoma: Impact on survival and local progression.",
    "xml": "<Element 'PubmedArticle' at 0x7885042c7f10>"
}