HISTOPATHOLOGIC FINDINGS OF ADVANCED NEUROBLASTOMA AFTER INTENSIVE INDUCTION CHEMOTHERAPY

Background: Histopathologic findings of advanced neuroblastoma after i ntensive induction chemotherapy have not been studied well. Methods: I n the present study, all of the surgical specimens from 19 patients wh o had advanced abdominal neuroblastoma a nd were pretreated intensivel y with the protocol of the Study Group of Japan were reviewed. The aut hors found that dissection of the contralateral lymph nodes is mandato ry in advanced neuroblastoma when the goal is the complete dissection of the abdominal disease. Effects of chemotherapy were graded histolog ically according to the ratio of viable residual neuroblastoma tissue to total areas of the tumor, including neuroblastoma, ganglioneuroblas toma, ganglioneuroma, hemorrhage, necrosis and fibrosis, in five ranks from (+++) to (-). Conclusions: The newly introduced, highly cytotoxi c regimen of the Japanese protocol, designated ''A(3),'' appears to be more effective histologically than the conventional regimen, designat ed ''A(1)'' or ''new A(1).'' Effects designated (+++) or (++) were pre requisites for survival in stage IV disease, but some stage III patien ts with the (+) effect survived. Copyright (C) 1997 by W.B. Saunders C ompany.