{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:00:42Z","timestamp":1791820842679,"version":"4.3.4"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2014,3,12]],"date-time":"2014-03-12T00:00:00Z","timestamp":1394582400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Fondazione Italiana per la Lotta al Neuroblastoma, Geneva"},{"name":"OPEN Association, Napoli, Italy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Symptoms of epidural compression (SEC) in children with neuroblastoma (particularly infants) may be misinterpreted, leading to delay in diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>Clinical, imaging and follow\u2010up data of 34 infants with neuroblastoma and SEC diagnosed between 2000 and 2011 at Italian AIEOP centers were retrieved and reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median age at initial SEC was 104 days (IQR 47\u2013234). Main symptoms included motor deficit (85.3%), pain (38.2%), bladder and bowel dysfunctions (20.6% each). In the symptom\u2010diagnosis interval (S\u2010DI) (median, 12 days; IQR 7\u201334), the frequency of grade 3 motor deficit increased from 11.8% to 44.1% and that of bladder dysfunction from 20.6% to 32.4%. S\u2010DI was significantly longer (<jats:italic>P<\/jats:italic>\u2009=\u20090.011) for patients developing grade 3 motor deficit. First treatment of SEC was neurosurgery in 14 patients, and chemotherapy in 20. SEC regressed in 11 patients (32.3%), improved in 9 (26.5%), and remained stable in 14 (41.2%), without treatment\u2010related differences. Median follow\u2010up was 82 months. At last visit, 11 patients (32.3%) were sequelae\u2010free while 23 (67.7%) had sequelae, including motor deficit (55.9%), bladder (50.0%) and bowel dysfunctions (28.4%), and spinal abnormalities (38.2%). Sequelae were rated severe in 50% of patients. Severe sequelae scores were more frequent in patients presenting with spinal canal invasion &gt;66% (<jats:italic>P<\/jats:italic>\u2009=\u20090.039) and grade 3 motor deficit (<jats:italic>P<\/jats:italic>\u2009=\u20090.084).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both neurosurgery and chemotherapy provide unsatisfactory results once paraplegia has been established. Sequelae developed in the majority of study patients and were severe in a half of them. Greater awareness by parents and physicians regarding SEC is warranted. Pediatr Blood Cancer 2014; 61:1369\u20131375. \u00a9 2014 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.25028","type":"journal-article","created":{"date-parts":[[2014,3,12]],"date-time":"2014-03-12T09:10:54Z","timestamp":1394615454000},"page":"1369-1375","source":"Crossref","is-referenced-by-count":30,"title":["Neuroblastoma with symptomatic epidural compression in the infant: The AIEOP experience"],"prefix":"10.1002","volume":"61","author":[{"given":"Bruno","family":"De Bernardi","sequence":"first","affiliation":[{"name":"Department of Hematology\u2010Oncology Istituto Giannina Gaslini Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Quaglietta","sequence":"additional","affiliation":[{"name":"Department of Oncology AORN Santobono\u2010Pausilipon Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Haupt","sequence":"additional","affiliation":[{"name":"Epidemiology and Biostatistics Section Istituto Giannina Gaslini Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurora","family":"Castellano","sequence":"additional","affiliation":[{"name":"Department of Hematology\u2010Oncology Ospedale Pediatrico Bambino Ges\u00f9 Roma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Tirtei","sequence":"additional","affiliation":[{"name":"Department of Onco\u2010Hematology Ospedale Pediatrico Regina Margherita Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Luksch","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Fondazione IRCCS Istituto Nazionale dei Tumori Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Mastrangelo","sequence":"additional","affiliation":[{"name":"Division of Pediatric Oncology Universit\u00e0 Cattolica di Roma\u2010Ospedale A. 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