Long-term outcome of patients with intraspinal neuroblastoma

Background. Chemotherapy, radiotherapy, and surgical decompression with lam inectomy are effective therapeutic options in the treatment of cord compres sion from neuroblastoma (NB). We report the long-term outcome of patients w ith intraspinal NB treated with or without laminectomy at two large pediatr ic oncology centers. Procedure. We reviewed the medical records and radiogr aphs of 26 children with intraspinal NB treated at Children's Memorial Hosp ital in Chicago, Illinois, between 1985 and 1994 or at St. Jude Children's Research Hospital in Memphis, Tennessee, between 1967 and 1992. Results. Tw enty-four of the 26 patients are alive and disease-free (follow-up of 2-29 years; median, 10 years 2 months). Fifteen of the 23 patients with neurolog ic impairment underwent initial laminectomy. Nine of these 15 patients reco vered neurologic function, including 3 patients who presented with parapleg ia. Eleven of the 15 patients who underwent laminectomy have developed mild to severe spinal deformities. Eight patients with neurologic symptoms cons equent to cord compression were treated with initial chemotherapy and/or su rgery, but did not undergo laminectomy. Three patients with mild to moderat e deficits recovered neurologic function. Four of 11 patients with intraspi nal NB who did not undergo laminectomy have mild to severe scoliosis. Concl usions. A low incidence of neurologic recovery was seen in patients with lo ng-standing severe cord compression regardless of treatment modality. For p atients with partial neurologic deficits, recovery was seen in most patient s following chemotherapy or surgical decompression with laminectomy. A high er incidence of spinal deformities was seen in the patients treated with in itial laminectomy. Med. Pediatr. Oncol. 32:353-359, 1999. (C) 1999 Wiley-Li ss, Inc.