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. Author manuscript; available in PMC: 2013 Feb 1.
Published in final edited form as: Semin Pediatr Surg. 2012 Feb;21(1):2–14. doi: 10.1053/j.sempedsurg.2011.10.009

TABLE 2.

Objective Surgical Risk Factors for primary resection of localized neuroblastoma

  1. Neck:

    1. Tumor encasing major vessel(s) (e.g. carotid artery, vertebral artery, internal jugular vein)

    2. Tumor extending to base of skull

    3. Tumor compressing the trachea

    4. Tumor encasing the brachial plexus

  2. Thorax:

    1. Tumor encasing major vessel(s) (eg. subclavian vessels, aorta, superior vena cava)

    2. Tumor compressing the trachea or principal bronchi

    3. Lower mediastinal tumor, infiltrating the costo-vertebral junction between T9 and T12 (may involve the artery of Adamkiewicz perfusing the lower spinal cord)

  3. Abdomen:

    1. Tumor infiltrating the porta hepatis and/or the hepatoduodenal ligament

    2. Tumor encasing the origin of the celiac axis, and/or the superior mesenteric artery

    3. Tumor invading one or both renal pedicles

    4. Tumor encasing the aorta and/or vena cava

    5. Tumor encasing the iliac vessels

    6. Pelvic tumor crossing the sciatic notch

  4. Dumbbell tumors with symptoms of spinal cord compression: Any location

  5. Infiltration of adjacent organs/structures: Diaphragm, kidney, liver, duodeno-pancreatic block, and mesentery

(Adapted from Cecchetto G, Mosseri V, DeBernardi B. et al. Surgical risk factors in primary surgery for localized neuroblastoma: the LNESG1 study of the European International Society of Pediatric Oncology Neuroblastoma Group. J Clin Oncol 2005: 23:8483-9)