{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:06:03Z","timestamp":1787065563645,"version":"build-2736575974"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"14","license":[{"start":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T00:00:00Z","timestamp":1689724800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T00:00:00Z","timestamp":1689724800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100012940","name":"Universit\u00e4tsklinikum T\u00fcbingen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012940","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cancer Res Clin Oncol"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Treatment of neuroblastoma metastases usually consists of chemotherapy and irradiation. However, in selected cases, surgical treatment is also indicated. In this study, we present three cases of patients with neuroblastoma metastases at rare sites that underwent surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed data of patients who underwent surgery for neuroblastoma at our department of Pediatric Surgery and Pediatric Urology at the University Children\u2019s Hospital in Tuebingen and selected those patients who had surgery explicitly for a metastasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between 2002 and 2020, 277 children underwent surgical treatment for neuroblastoma. Three cases with metastases at exceptional sites are presented here after therapy according to protocols. One patient had a penile metastasis and received surgery including a plastic reconstruction. The patient showed no signs of erectile or urinary dysfunction at follow-up. Another patient had a metastasis in the proximal ulna, which remained vital even after exhausted treatment after two relapses. Afterward there was no restriction of movement of the extremity. The third patient had, amongst others, metastases to the pancreatic body and to the liver. Both were surgically removed during primary tumor resection. This patient died after local tumor relapse. The other two patients showed no evidence of tumor relapse after a follow-up of 18 and 17\u00a0months, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although children with neuroblastoma often present with metastases, there is no recommendation for surgical treatment other than diagnostic biopsies. In case of persistence of metastasis or after exhaustion of high-risk therapy, surgical resection must be considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00432-023-05147-6","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T07:02:51Z","timestamp":1689750171000},"page":"12913-12921","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The role of surgery in the treatment of neuroblastoma metastases at rare sites"],"prefix":"10.1007","volume":"149","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6404-6919","authenticated-orcid":false,"given":"Simon","family":"Scherer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin F. B.","family":"Mayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Dietzel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Esser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven W.","family":"Warmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Lang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin U.","family":"Schuhmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Fuchs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,7,19]]},"reference":[{"key":"5147_CR1","unstructured":"Berthold F (2004) NB2004 Trial protocol for risk adapted treatment of children with neuroblastoma. Gesellschaft f\u00fcr P\u00e4diatrische Onkologie und H\u00e4matologie (GPOH). https:\/\/www.gpoh.de\/sites\/gpoh\/kinderkrebsinfo\/content\/e1676\/e9032\/e68518\/e206421\/download7674\/SeitenausNB_2004_1.00_klein_ger.pdf. Accessed 06 Jan 2023"},{"key":"5147_CR2","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1016\/j.ijrobp.2016.05.020","volume":"2","author":"DL Casey","year":"2016","unstructured":"Casey DL, Kushner BH, Cheung N-KV, Modak S, LaQuaglia MP, Wolden SL (2016) Local control with 21-Gy radiation therapy for high-risk neuroblastoma. Int J Radiat Oncol Biol Phys 2:393\u2013400","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"5147_CR3","doi-asserted-by":"publisher","first-page":"e27009","DOI":"10.1002\/pbc.27009","volume":"7","author":"DL Casey","year":"2018","unstructured":"Casey DL, Kushner BH, Cheung NV, Modak S, LaQuaglia MP, Wolden SL (2018) Dose-escalation is needed for gross disease in high-risk neuroblastoma. Pediatr Blood Cancer 7:e27009. https:\/\/doi.org\/10.1002\/pbc.27009","journal-title":"Pediatr Blood Cancer"},{"key":"5147_CR4","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1016\/j.ijrobp.2019.02.004","volume":"2","author":"DL Casey","year":"2019","unstructured":"Casey DL, Kushner BH, Cheung N-KV, Modak S, Basu EM, Roberts SS et al (2019) Reduced-dose radiation therapy to the primary site is effective for high-risk neuroblastoma: results from a prospective trial. Int J Radiat Oncol Biol Phys 2:409\u2013414","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"5147_CR5","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1097\/00043426-199905000-00005","volume":"3","author":"SG DuBois","year":"1999","unstructured":"DuBois SG, Kalika Y, Lukens JN, Brodeur GM, Seeger RC, Atkinson JB et al (1999) Metastatic sites in stage IV and IVS neuroblastoma correlate with age, tumor biology, and survival. J Pediatr Hematol Oncol 3:181\u2013189. https:\/\/doi.org\/10.1097\/00043426-199905000-00005","journal-title":"J Pediatr Hematol Oncol"},{"key":"5147_CR6","volume-title":"Seminars in pediatric surgery","author":"J Fuchs","year":"2012","unstructured":"Fuchs J, Seitz G, Handgretinger R, Sch\u00e4fer J, Warmann SW (2012) Surgical treatment of lung metastases in patients with embryonal pediatric solid tumors: an update. Seminars in pediatric surgery. Elsevier"},{"key":"5147_CR7","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/S0022-3476(83)80287-X","volume":"1","author":"FA Hayes","year":"1983","unstructured":"Hayes FA, Green A, Hustu HO, Kumar M (1983) Surgicopathologic staging of neuroblastoma: prognostic significance of regional lymph node metastases. J Pediatr 1:59\u201362. https:\/\/doi.org\/10.1016\/S0022-3476(83)80287-X","journal-title":"J Pediatr"},{"key":"5147_CR8","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.677023","author":"B He","year":"2021","unstructured":"He B, Mao J, Huang L (2021) Clinical characteristics and survival outcomes in neuroblastoma with bone metastasis based on SEER database analysis. Front Oncol. https:\/\/doi.org\/10.3389\/fonc.2021.677023","journal-title":"Front Oncol"},{"key":"5147_CR9","doi-asserted-by":"publisher","first-page":"3229","DOI":"10.1200\/jco.21.00278","volume":"29","author":"MS Irwin","year":"2021","unstructured":"Irwin MS, Naranjo A, Zhang FF, Cohn SL, London WB, Gastier-Foster JM et al (2021) Revised neuroblastoma risk classification system: a report from the children\u2019s oncology group. J Clin Oncol 29:3229\u20133241. https:\/\/doi.org\/10.1200\/jco.21.00278","journal-title":"J Clin Oncol"},{"key":"5147_CR10","doi-asserted-by":"publisher","first-page":"755","DOI":"10.2214\/ajr.176.3.1760755","volume":"3","author":"BF Kammen","year":"2001","unstructured":"Kammen BF, Matthay KK, Pacharn P, Gerbing R, Brasch RC, Gooding CA (2001) Pulmonary metastases at diagnosis of neuroblastoma in pediatric patients. Am J Roentgenol 3:755\u2013759. https:\/\/doi.org\/10.2214\/ajr.176.3.1760755","journal-title":"Am J Roentgenol"},{"key":"5147_CR11","doi-asserted-by":"publisher","first-page":"84","DOI":"10.3348\/kjr.2008.9.1.84","volume":"1","author":"EY Kim","year":"2008","unstructured":"Kim EY, Yoo S-Y, Kim JH, Sung KW (2008) Pancreatic metastasis in a child suffering with treated stage 4 neuroblastoma. Korean J Radiol 1:84\u201386. https:\/\/doi.org\/10.3348\/kjr.2008.9.1.84","journal-title":"Korean J Radiol"},{"key":"5147_CR12","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1016\/S1470-2045(13)70309-7","volume":"10","author":"SG Kreissman","year":"2013","unstructured":"Kreissman SG, Seeger RC, Matthay KK, London WB, Sposto R, Grupp SA et al (2013) Purged versus non-purged peripheral blood stem-cell transplantation for high-risk neuroblastoma (COG A3973): a randomised phase 3 trial. Lancet Oncol 10:999\u20131008. https:\/\/doi.org\/10.1016\/S1470-2045(13)70309-7","journal-title":"Lancet Oncol"},{"key":"5147_CR13","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1016\/j.jpedsurg.2009.12.024","volume":"3","author":"HR Kumar","year":"2010","unstructured":"Kumar HR, Sandoval JA, Lovell MA, Fenton LZ, Bealer JF (2010) Primary pancreatic neuroblastoma: an unusual tumor in infancy. J Pediatr Surg 3:642\u2013646. https:\/\/doi.org\/10.1016\/j.jpedsurg.2009.12.024","journal-title":"J Pediatr Surg"},{"key":"5147_CR14","doi-asserted-by":"publisher","DOI":"10.4081\/oncol.2012.e10","author":"L Mearini","year":"2012","unstructured":"Mearini L, Colella R, Zucchi A, Nunzi E, Porrozzi C, Porena M (2012) A review of penile metastasis. Oncol Rev. https:\/\/doi.org\/10.4081\/oncol.2012.e10","journal-title":"Oncol Rev"},{"key":"5147_CR15","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1016\/S0022-5347(01)66649-7","volume":"1","author":"ME Mitchell","year":"1996","unstructured":"Mitchell ME, Bagli DJ (1996) Complete penile disassembly for epispadias repair: the mitchell technique. J Urol 1:300\u2013304. https:\/\/doi.org\/10.1016\/S0022-5347(01)66649-7","journal-title":"J Urol"},{"key":"5147_CR16","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/j.ctrv.2010.02.006","volume":"4","author":"S Modak","year":"2010","unstructured":"Modak S, Cheung N-KV (2010) Neuroblastoma: therapeutic strategies for a clinical enigma. Cancer Treat Rev 4:307\u2013317. https:\/\/doi.org\/10.1016\/j.ctrv.2010.02.006","journal-title":"Cancer Treat Rev"},{"key":"5147_CR17","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1200\/jco.2008.16.6876","volume":"2","author":"T Monclair","year":"2009","unstructured":"Monclair T, Brodeur GM, Ambros PF, Brisse HJ, Cecchetto G, Holmes K et al (2009a) The International Neuroblastoma Risk Group (INRG) staging system: an INRG task force report. J Clin Oncol 2:298\u2013303. https:\/\/doi.org\/10.1200\/jco.2008.16.6876","journal-title":"J Clin Oncol"},{"key":"5147_CR18","doi-asserted-by":"publisher","first-page":"1536","DOI":"10.1002\/pbc.25460","volume":"9","author":"T Monclair","year":"2015","unstructured":"Monclair T, Mosseri V, Cecchetto G, De Bernardi B, Michon J, Holmes K (2015) Influence of image-defined risk factors on the outcome of patients with localised neuroblastoma. A report from the LNESG1 study of the European international society of paediatric oncology neuroblastoma group. Pediatr Blood Cancer 9:1536\u20131542. https:\/\/doi.org\/10.1002\/pbc.25460","journal-title":"Pediatr Blood Cancer"},{"key":"5147_CR19","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s13287-015-0002-,8","volume":"1","author":"V Pandian","year":"2015","unstructured":"Pandian V, Ramraj S, Khan FH, Azim T, Aravindan N (2015) Metastatic neuroblastoma cancer stem cells exhibit flexible plasticity and adaptive stemness signaling. Stem Cell Res Ther 1:2. https:\/\/doi.org\/10.1186\/s13287-015-0002-,8","journal-title":"Stem Cell Res Ther"},{"key":"5147_CR20","doi-asserted-by":"publisher","first-page":"3008","DOI":"10.1200\/JCO.2014.59.4648","volume":"27","author":"NR Pinto","year":"2015","unstructured":"Pinto NR, Applebaum MA, Volchenboum SL, Matthay KK, London WB, Ambros PF et al (2015) Advances in risk classification and treatment strategies for neuroblastoma. J Clin Oncol 27:3008","journal-title":"J Clin Oncol"},{"key":"5147_CR21","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1016\/j.ijrobp.2014.04.004","volume":"4","author":"AL Polishchuk","year":"2014","unstructured":"Polishchuk AL, Li R, Hill-Kayser C, Little A, Hawkins RA, Hamilton J et al (2014) Likelihood of bone recurrence in prior sites of metastasis in patients with high-risk neuroblastoma. Int J Radiat Oncol Biol Phys 4:839\u2013845. https:\/\/doi.org\/10.1016\/j.ijrobp.2014.04.004","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"5147_CR22","doi-asserted-by":"publisher","first-page":"W141","DOI":"10.2214\/AJR.12.9618","volume":"1","author":"DG Rosenbaum","year":"2013","unstructured":"Rosenbaum DG, Abramson SJ, DeLappe E, Teruya-Feldstein J, La Quaglia MP, Fox JJ et al (2013) Pancreatic involvement in neuroblastoma with radiologic-pathologic correlation: a single-institution experience. Am J Roentgenol 1:W141\u2013W146. https:\/\/doi.org\/10.2214\/AJR.12.9618","journal-title":"Am J Roentgenol"},{"key":"5147_CR23","doi-asserted-by":"publisher","DOI":"10.1016\/j.epsc.2021.101996","author":"S Sakai","year":"2021","unstructured":"Sakai S, Nomura K, Abe T, Hayashi K, Tsutsuno T, Mizushima H et al (2021) Neuroblastoma with ovarian and pancreatic metastasis. J Pediatr Surg Case Rep. https:\/\/doi.org\/10.1016\/j.epsc.2021.101996","journal-title":"J Pediatr Surg Case Rep"},{"key":"5147_CR24","first-page":"364","volume":"2","author":"H Shimada","year":"1999","unstructured":"Shimada H, Ambros IM, Dehner LP, Ji H, Joshi VV, Roald B et al (1999) The international neuroblastoma pathology classification (the Shimada system). Cancer Interdisciplinary Int J Am Cancer Soc 2:364\u2013372","journal-title":"Cancer Interdisciplinary Int J Am Cancer Soc"},{"key":"5147_CR25","unstructured":"Simon T (2019) S1-Leitlinie 025-008 Neuroblastom. Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). https:\/\/www.awmf.org\/uploads\/tx_szleitlinien\/025-008l_S1_Neuroblastom_2019-07_01.pdf. Accessed 06 Jan 2023."},{"key":"5147_CR26","first-page":"147","volume":"03","author":"T Simon","year":"2017","unstructured":"Simon T, Hero B, Schulte JH, Deubzer H, Hundsdoerfer P, von Schweinitz D et al (2017) 2017 GPOH guidelines for diagnosis and treatment of patients with neuroblastic tumors. Klin Padiatr 03:147\u2013167","journal-title":"Klin Padiatr"},{"key":"5147_CR27","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/j.canlet.2005.01.059","volume":"1","author":"Y Sohara","year":"2005","unstructured":"Sohara Y, Shimada H, DeClerck YA (2005) Mechanisms of bone invasion and metastasis in human neuroblastoma. Cancer Lett 1:203\u2013209. https:\/\/doi.org\/10.1016\/j.canlet.2005.01.059","journal-title":"Cancer Lett"},{"key":"5147_CR28","doi-asserted-by":"publisher","first-page":"6570","DOI":"10.1158\/0008-5472.Can-05-1448","volume":"13","author":"CM van Golen","year":"2006","unstructured":"van Golen CM, Schwab TS, Kim B, Soules ME, Su OhS, Fung K et al (2006) Insulin-like growth factor-I receptor expression regulates neuroblastoma metastasis to bone. Can Res 13:6570\u20136578. https:\/\/doi.org\/10.1158\/0008-5472.Can-05-1448","journal-title":"Can Res"},{"key":"5147_CR29","doi-asserted-by":"publisher","first-page":"2585","DOI":"10.1016\/j.jpedsurg.2019.08.031","volume":"12","author":"Z Wang","year":"2019","unstructured":"Wang Z, Sun H, Li K, Yao W, Dong K, Ma Y et al (2019) Prognostic factor analysis of stage 4S neuroblastoma in infant patients: a single center study. J Pediatr Surg 12:2585\u20132588. https:\/\/doi.org\/10.1016\/j.jpedsurg.2019.08.031","journal-title":"J Pediatr Surg"}],"container-title":["Journal of Cancer Research and Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00432-023-05147-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00432-023-05147-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00432-023-05147-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T04:09:10Z","timestamp":1697688550000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00432-023-05147-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,19]]},"references-count":29,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["5147"],"URL":"https:\/\/doi.org\/10.1007\/s00432-023-05147-6","relation":{},"ISSN":["0171-5216","1432-1335"],"issn-type":[{"value":"0171-5216","type":"print"},{"value":"1432-1335","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,19]]},"assertion":[{"value":"8 July 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 July 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 July 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no relevant financial or non-financial interests to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}