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Changes in image-defined risk factors with neoadjuvant chemotherapy in pediatric abdominal neuroblastoma

  • Kidneys, Ureters, Bladder, Retroperitoneum
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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To observe the changes in image-defined risk factors (IDRFs) with neoadjuvant chemotherapy in pediatric abdominal neuroblastoma and to investigate the correlations between IDRF changes and histopathological features. In addition, this study also investigated the correlations between residual IDRFs after neoadjuvant chemotherapy and intraoperative complications.

Methods

Forty-three patients with abdominal neuroblastoma who received neoadjuvant chemotherapy in our hospital from January 2015 to September 2021 were enrolled. Intraoperative records, histopathological features, and CT images at initial diagnosis and after neoadjuvant chemotherapy of all patients were retrospectively collected and analyzed.

Results

A total of 245 IDRFs were found at initial diagnosis, with a median of 6 [5, 7] IDRFs per patient. After neoadjuvant chemotherapy, IDRFs significantly decreased to 156 (p < 0.001), with a median of 4 [3, 5] IDRFs remaining per patient. The majority of IDRFs (6/8, 75.00%) were significantly improved after neoadjuvant chemotherapy (p < 0.05), while tumor invasion of renal pedicles (p > 0.05) and adjacent structures (p > 0.05) was the least responsive IDRF. IDRFs in different types of neuroblastoma decreased significantly after neoadjuvant chemotherapy (p < 0.05), while they were not significant in neuroblastoma with low and intermediate mitosis-karyorrhexis indices (p > 0.05). The number of residual IDRFs correlated positively with the volumes of intraoperative blood loss (r = 0.399, p = 0.008), but not with the presence of intraoperative complications (r = 0.111, p = 0.478).

Conclusions

IDRFs in different types of neuroblastoma can be significantly improved after neoadjuvant chemotherapy, while IDRFs in neuroblastoma with low and intermediate mitosis-karyorrhexis indices might not be easily improved. At the same time, the number of residual IDRFs after neoadjuvant chemotherapy might not correlate with the occurrence of intraoperative complications in abdominal neuroblastoma.

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Data availability

Available from the authors upon reasonable request.

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Funding

The project was funded by Project Supported by Scientific and Technological Research Program of Chongqing Municipal Education Commission (Grant No. KJQN202000440); Basic Research and Frontier Exploration Project (Yuzhong District, Chongqing, China) (Grant No. 20200155); and Science and Health Joint Medical Research Project (Science and Technology Commission and Health Bureau, Chongqing, China) (Grant No. 2020FYYX128).

Author information

Authors and Affiliations

  1. Department of Radiology, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, No. 136 Zhongshan Road 2, Yuzhong District, Chongqing, 400014, China

    Haoru Wang, **n Chen, Ke Zhang, Li Zhang, Hao Ding & Ling He

  2. Department of Pathology, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, No. 136 Zhongshan Road 2, Yuzhong District, Chongqing, 400014, China

    ** Zhu

  3. Department of Urology, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University, No. 136 Zhongshan Road 2, Yuzhong District, Chongqing, 400014, China

    Jiandong Lu

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Contributions

HW—Conceptualization. HW, XC, JZ, ZK, JL—Data curation. HW—Formal analysis. HW, LZ, HD—Investigation. HW, XC, LH—Methodology. XC, LH—Project administration. LH—Supervision. HW, XC—Validation. HW—Visualization. HW—Writing.

Corresponding author

Correspondence to Ling He.

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This retrospective study was approved by the ethics committee of our institution.

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Wang, H., Chen, X., Zhu, J. et al. Changes in image-defined risk factors with neoadjuvant chemotherapy in pediatric abdominal neuroblastoma. Abdom Radiol 47, 3520–3530 (2022). https://doi.org/10.1007/s00261-022-03596-0

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