{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T12:19:27Z","timestamp":1775218767992,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2015,3,23]],"date-time":"2015-03-23T00:00:00Z","timestamp":1427068800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The value of gross total resection (GTR) for children with high\u2010risk neuroblastoma (NB) is controversial. We hypothesized that patients undergoing GTR would demonstrate improved overall survival (OS) compared those having &lt;GTR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using a single institutional database, we reviewed the medical records of all children with high\u2010risk NB undergoing hematopoietic stem cell transplantation (HSCT) as part of multimodality therapy from 1990 to 2012. Children had received surgical care at multiple institutions (n\u2009=\u200914) prior to HSCT and were divided into two groups based on extent of surgical resection: GTR (no visible or palpable disease at end of operation) and &lt;GTR (no surgery, biopsy only, or subtotal resection). Kaplan\u2013Meier curves and Cox hazards models evaluated differences in overall survival (OS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred four children underwent HSCT, and 87 (83.6%) had adequate data for analysis. Thirty eight percent had GTR while 62% had &lt;GTR prior to HSCT. There was no significant difference in OS in patients undergoing GTR compared to &lt;GTR (Log rank test: <jats:italic>P<\/jats:italic>\u2009=\u20090.49). Post\u2010hoc analysis demonstrated a survival advantage for patients undergoing &gt;90% resection compared to &lt;90% resection (<jats:italic>P<\/jats:italic>\u2009=\u20090.008). Multivariable Cox models confirmed these findings with improved survival in children undergoing &gt;90% vs. &lt;90% resection but no difference in GTR vs. &lt;GTR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Gross total resection prior to HSCT in high\u2010risk NB patients is not associated with improved OS compared to &lt;GTR; however, these results suggest that &gt;90% resection is associated with improved OS compared to less than 90% resection. Pediatr Blood Cancer 2015;62:1529\u20131535. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.25504","type":"journal-article","created":{"date-parts":[[2015,3,24]],"date-time":"2015-03-24T21:02:31Z","timestamp":1427230951000},"page":"1529-1535","source":"Crossref","is-referenced-by-count":48,"title":["Value of surgical resection in children with high\u2010risk neuroblastoma"],"prefix":"10.1002","volume":"62","author":[{"given":"Brian R.","family":"Englum","sequence":"first","affiliation":[{"name":"Department of Surgery Duke University School of Medicine Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristy L.","family":"Rialon","sequence":"additional","affiliation":[{"name":"Department of Surgery Duke University School of Medicine Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul J.","family":"Speicher","sequence":"additional","affiliation":[{"name":"Department of Surgery Duke University School of Medicine Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Gulack","sequence":"additional","affiliation":[{"name":"Department of Surgery Duke University School of Medicine Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy A.","family":"Driscoll","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Duke University School of Medicine Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan G.","family":"Kreissman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Duke University School of Medicine Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry E.","family":"Rice","sequence":"additional","affiliation":[{"name":"Department of Surgery Duke University School of Medicine Durham North Carolina"},{"name":"Department of Pediatrics Duke University School of Medicine Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,3,23]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"GoodmanM GurneyJ SmithM OlshanA. 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