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There is limited understanding of the impact of individual IDRFs on resectability of the primary tumor or patient outcomes. A multicenter database of patients with high\u2010risk NB was interrogated to answer this question.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design\/methods<\/jats:title><jats:p>Patients with high\u2010risk NB (age &lt;20\u00a0years) were eligible if cross\u2010sectional imaging was performed at least twice prior to resection. IDRFs and primary tumor measurements were recorded for each imaging study. Extent of resection was determined from operative reports.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 211 of 229 patients with IDRFs at diagnosis, and 171 patients with IDRFs present pre\u2010surgery. A \u226590% resection was significantly more likely in the absence of tumor invading or encasing the porta hepatis, hepatoduodenal ligament, superior mesenteric artery (SMA), renal pedicles, abdominal aorta\/inferior vena cava (IVC), iliac vessels, and\/or diaphragm at diagnosis or an overlapping subset of IDRFs (except diaphragm) at pre\u2010surgery. There were no significant differences in event\u2010free survival (EFS) and overall survival (OS) when patients were stratified by the presence versus absence of any IDRF either at diagnosis or pre\u2010surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Two distinct but overlapping subsets of IDRFs present either at diagnosis or after induction chemotherapy significantly influence the probability of a complete resection in children with high\u2010risk NB. The presence of IDRFs was not associated with significant differences in OS or EFS in this cohort.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31218","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T05:04:59Z","timestamp":1722229499000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A subset of image\u2010defined risk factors predict completeness of resection in children with high\u2010risk neuroblastoma: An international multicenter study"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8716-3125","authenticated-orcid":false,"given":"Andres F.","family":"Espinoza","sequence":"first","affiliation":[{"name":"Department of Surgery Department of Pediatrics Texas Children's Hospital, Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5729-8819","authenticated-orcid":false,"given":"Rochelle","family":"Bagatell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Children's Hospital of Philadelphia, University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieran","family":"McHugh","sequence":"additional","affiliation":[{"name":"Radiology Department Great Ormond Street Hospital for Children  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arlene H.","family":"Naranjo","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Florida Colleges of Medicine and Public Health &amp; Health Professions Children's Oncology Group Statistics &amp; Data Center  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Collin","family":"Van Ryn","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Florida Colleges of Medicine and Public Health &amp; Health Professions Children's Oncology Group Statistics &amp; Data Center  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yesenia","family":"Rojas","sequence":"additional","affiliation":[{"name":"Department of Surgery Department of Pediatrics Texas Children's Hospital, Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Lyons","sequence":"additional","affiliation":[{"name":"Department of Radiology Texas Children's Hospital, Baylor College of Medicine  Houston Texas USA"},{"name":"Department of Pediatric Radiology British Columbia Children's Hospital  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8149-613X","authenticated-orcid":false,"given":"R. Paul","family":"Guillerman","sequence":"additional","affiliation":[{"name":"Department of Radiology Texas Children's Hospital, Baylor College of Medicine  Houston Texas USA"},{"name":"Department of Radiology and Medical Imaging Cincinnati Children's Hospital, University of Cincinnati  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaim","family":"Kirby","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1239-6316","authenticated-orcid":false,"given":"Penelope","family":"Brock","sequence":"additional","affiliation":[{"name":"Paediatric Oncology Great Ormand Street Hospital for Children  London United\u00a0Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Volchenboum","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3425-8451","authenticated-orcid":false,"given":"Thorsten","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology and Hematology University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"States","sequence":"additional","affiliation":[{"name":"Department of Radiology Children's Hospital of Philadelphia, University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Children's Hospital of Philadelphia, University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Krug","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Sarnacki","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Necker\u2010Enfants Malades Hospital \u2010 APHP and Universit\u00e9 de Paris Cit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Irtan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Necker\u2010Enfants Malades Hospital \u2010 APHP and Universit\u00e9 de Paris Cit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2794-5875","authenticated-orcid":false,"given":"Herve J.","family":"Brisse","sequence":"additional","affiliation":[{"name":"Imaging Department Institut Curie  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Valteau\u2010Couanet","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Oncology Gustave\u2010Roussy, Universit\u00e9 Paris\u2010Saclay  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietrich","family":"von Schweinitz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Munich University Hospital, Dr. von Hauner Children's Hospital  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit","family":"Kammer","sequence":"additional","affiliation":[{"name":"Department of Radiology LMU University Hospital LMU University of Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Granata","sequence":"additional","affiliation":[{"name":"Department of Radiology IRCCS Giannina. 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