Rationale and Objectives
This research examines the prevalence and occurrence of intraoperative vascular injuries
in abdominal or pelvic neuroblastomas. It also investigates the correlations between
preoperative radiographic vascular involvement on computed tomography (CT) and intraoperative
vascular injuries in abdominal or pelvic neuroblastomas.
Materials and Methods
This study enrolled 297 patients with abdominal or pelvic neuroblastomas. The relationships
between neuroblastomas and adjacent arteries on preoperative CT were categorized as
no contact, contact (less than 50% of vessel circumference involved), partial encasement
(less than 100% of vessel circumference involved), and total encasement (100% of vessel
circumference involved). Similarly, the relationships between neuroblastomas and adjacent
veins on preoperative CT were categorized as no compression, flattened with a visible
lumen, and flattened with an invisible lumen. Furthermore, the correlations between
preoperative radiographic vascular involvement of neuroblastomas and intraoperative
vascular injuries were analyzed.
Results
A total of 61 patients had intraoperative vascular injuries, among which 76 vessels
suffered injuries. Venous injuries (66/76, 86.84%) were more common than arterial
injuries (10/76, 13.16%). Moreover, venous injuries frequently occurred in the inferior
vena cava (32/66, 48.48%), renal veins (19/66, 28.79%), and iliac veins (8/66, 12.12%).
All the injured arteries exhibited a total encasement on preoperative CT, and no injury
occurred when the arteries were contacted or partially encased. In total, 87.88% (58/66)
of injured veins were flattened with a visible lumen on preoperative CT, whereas only
12.12% (8/66) of the injured veins were flattened with an invisible lumen.
Conclusion
Intraoperative injuries to veins occur more frequently than that to arteries in abdominal
or pelvic neuroblastomas. Importantly, intraoperative injuries to veins may occur
even if the veins are flattened with a visible lumen.
Key words
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References
- Neuroblastoma heterogeneity, plasticity, and emerging therapies.Curr Oncol Rep. 2022; 24: 1053-1062https://doi.org/10.1007/s11912-022-01270-8
- Imaging findings of patients with metastatic neuroblastoma to the brain.Acad Radiol. 2014; 21: 329-337https://doi.org/10.1016/j.acra.2013.10.016
- Revisions of the international criteria for neuroblastoma diagnosis, staging, and response to treatment.J Clin Oncol. 1993; 11: 1466-1477https://doi.org/10.1200/JCO.1993.11.8.1466
- The International Neuroblastoma risk group (INRG) staging system: an INRG Task Force report.J Clin Oncol. 2009; 27: 298-303https://doi.org/10.1200/JCO.2008.16.6876
- Overview and recent advances in the treatment of neuroblastoma.Expert Rev Anticancer Ther. 2017; 17: 369-386https://doi.org/10.1080/14737140.2017.1285230
- Results of a prospective clinical trial JN-L-10 using image-defined risk factors to inform surgical decisions for children with low-risk neuroblastoma disease: a report from the Japan children's Cancer group neuroblastoma committee.Pediatr Blood Cancer. 2019; 66: e27914https://doi.org/10.1002/pbc.27914
- A phase II JN-I-10 efficacy study of IDRF-based surgical decisions and stepwise treatment intensification for patients with intermediate-risk neuroblastoma: a study protocol.BMC Pediatr. 2020; 20: 212https://doi.org/10.1186/s12887-020-02061-5
- Revised neuroblastoma risk classification system: a report from the children's oncology group.J Clin Oncol. 2021; 39: 3229-3241https://doi.org/10.1200/JCO.21.00278
- Vascular encasement as element of risk stratification in abdominal neuroblastoma.Surg Oncol. 2011; 20: 231-235https://doi.org/10.1016/j.suronc.2010.01.003
- Guidelines for imaging and staging of neuroblastic tumors: consensus report from the International Neuroblastoma risk group project.Radiology. 2011; 261: 243-257https://doi.org/10.1148/radiol.11101352
- A review of neuroblastoma image-defined risk factors on magnetic resonance imaging.Pediatr Radiol. 2018; 48: 1337-1347https://doi.org/10.1007/s00247-018-4117-9
- Validity of image-defined risk factors in localized neuroblastoma: a report from two centers in Western Japan.J Pediatr Surg. 2015; 50: 2102-2106https://doi.org/10.1016/j.jpedsurg.2015.08.039
- Can image-defined risk factors predict surgical complications in localized neuroblastoma?.Eur J Pediatr Surg. 2016; 26: 117-122https://doi.org/10.1055/s-0035-1566100
- A technique for excision of abdominal and pelvic neuroblastomas.Ann R Coll Surg Engl. 2007; 89: 342-348https://doi.org/10.1308/003588407X179071
- Surgical approaches to neuroblastoma: review of the operative techniques.Children (Basel). 2021; 8: 446https://doi.org/10.3390/children8060446
- Vessel adherent growth represents a major challenge in the surgical resection of neuroblastoma and Is associated with adverse outcome.J Pediatr Surg. 2019; 54: 2336-2342https://doi.org/10.1016/j.jpedsurg.2019.07.012
- Unresectable thoracic neuroblastic tumors: changes in image-defined risk factors after chemotherapy and impact on surgical management.Pediatr Blood Cancer. 2021; 68: e29260https://doi.org/10.1002/pbc.29260
- Impact of neoadjuvant chemotherapy on image-defined risk factors in high-risk neuroblastoma.Ann Surg Oncol. 2022; 29: 661-670
- Preoperative computed tomography scanning for abdominal neuroblastomas is superior to magnetic resonance imaging for safe surgical planning.Pediatr Blood Cancer. 2019; 66: e27955https://doi.org/10.1002/pbc.27955
- Changes in image-defined risk factors with neoadjuvant chemotherapy in pediatric abdominal neuroblastoma.Abdom Radiol (NY). 2022; 47: 3520-3530https://doi.org/10.1007/s00261-022-03596-0
- Anatomy, Blood Vessels. 2021;
- Imaging evaluation of the inferior vena cava.Radiographics. 2015; 35: 578-592https://doi.org/10.1148/rg.352140136
- Intra-abdominal inferior Vena cava injuries: operative strategies and outcomes.Am Surg. 2021; 87: 1316-1326https://doi.org/10.1177/0003134820973395
- Contraindications and image-defined risk factors in laparoscopic resection of abdominal neuroblastoma.Pediatr Surg Int. 2016; 32: 845-850https://doi.org/10.1007/s00383-016-3932-z
- Laparoscopic resection of neuroblastomas in low- to high-risk patients without image-defined risk factors is safe and feasible.BMC Pediatr. 2017; 17: 71https://doi.org/10.1186/s12887-017-0826-8
- Complete surgical resection improves outcome in INRG high-risk patients with localized neuroblastoma older than 18 months.BMC Cancer. 2017; 17: 520https://doi.org/10.1186/s12885-017-3493-0
Article info
Publication history
Published online: October 09, 2022
Accepted:
September 12,
2022
Received in revised form:
August 31,
2022
Received:
August 5,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.