J.Jpn. Surg. Soc.. 83(9): 921-926, 1982
Report on the annual meeting
EVALUATION OF SURGICAL TREATMENT FOR THE ADVANCED NEUROBLASTOMA (STAGE III $ IV) WITH SPECIAL REFERENCE TO ANGIO-GRAPHIC FINDINGS AND PROLIFERATION KINTICS OF RESIDUAL TUMOR
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The First Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan Shuhei Ogita, Yukikatsu Goto, Kyozo Hashimoto, Masaaki Nanri, Toshiaki Tsuto, Naomi Iwai, Bunzo Nishioka, Yoshihiro Fujita, Susumu Majima |
Five patients of them were performed a primary resection of the tumor soon after the diagnosis was made (Group A), six patients, who showed clinically a complete or partial responce to preoperative chemotherapy, were received “delayed primary” or “second-look” resection of the tumor (Group B) and the other 10 patients were not received a resection but a diagnostic laparotomy (Group C). All of them were treated by postoperative chemotherapy and/or radiation therapy.
Sixty percent of the patients of Group B survived for more than 2 years after the diagnosis. On the other hand, no patients of Group C survived for 20 months and others of Group A and C died within a year. Furthermore, in 4 patients of Group A, it was recognized that the residual tumor began to grow rapidly after the resection,in spite of a persistent postoperative chemotherapy.
These results indicate that a resection of the primary tumor was not always favorable for survival unless the postoperative chemotherapy was effective to the residual tumor.
Abdominal aortography was performed in 20 of these patients, and was thought to be useful to evaluate the resectability of the tumor, preoperatively. Serial angiographic findings such as, displacement of aorta, narrowing of the aorta, parasitic blood supply and A-V fistula, were especially useful to dicide the time of the “second look” operation.
In order to elucidate the rapid proliferation of the residual tumor, experimental studies were performed, using C-1300NB/AJ mice and Sarcoma-180/ddY mice, tumor-host systems. Both tumor cells (1 x 105) were inoculated subcutaneously at the left hind leg and the right lateral chest of the respective mice. Two different kinds of tumor bearing mice were respectively divided into two groups (A and B group). Mice of Group A were received the amputation of the tumor bearing leg and these of Group B were not. Growth rate and proliferation kenetics of the tumor which were inoculated at the chest, were respectively compared between Group A and B by means of 3H-TdR autoradiography and feulgen-DNA cytofluorometric study. Results of these experiments indicate that the residual tumor become to grow rapidly by insufficient removal of the primary tumor because non-cycling cells (G0 phase) in the residual tumor are converted into dividing components.
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