TY - JOUR
T1 - Suprarenal Masses in Very Young Infants
T2 - Is It Safe to Watch and Wait? Report of a SIOPEN Observational Study Results
AU - Papadakis, Vassilios
AU - Segura, Vanessa
AU - Conte, Massimo
AU - Plantaz, Dominique
AU - Di Cataldo, Andrea
AU - Schleiermacher, Gudrun
AU - Wheeler, Kate
AU - Bermúdez, Jose D.
AU - Ash, Shifra
AU - Brichard, Bénédicte
AU - Ladenstein, Ruth
AU - Combaret, Valérie
AU - Sarnacki, Sabine
AU - Fagnani, Anna Maria
AU - Granata, Claudio
AU - Cañete, Adela
N1 - Publisher Copyright:
© 2022 by the authors.
PY - 2022/8
Y1 - 2022/8
N2 - Background: To assess whether expectant observation of infants ≤ 90 days old with small suprarenal masses (sSRMs) could avoid unnecessary surgery without impacting outcome. Methods: Infants ≤ 90 days with a ≤ 5 cm mass, without midline extension or lymph node or distant spread were registered (ClinicalTrials.org:NCT01728155). Once staging was completed, they were followed with ultrasound, MRI and urinary catecholamines. Surgical resection was only planned if there was a ≥40% mass volume increase or for a mass persisting after 48 weeks of the planned observation. Results: Over a 5-year period, 128 infants were registered. No infant had detectable MYCN amplification in the peripheral blood. Surgery was performed in 39 (30.5%) patients, in 18 during and in 21 after the planned 48-week observation, and 74% were confirmed to be neuroblastomas. Non-life-threatening surgical complications occurred in two cases. The 3-year overall survival and event-free survival were 100% and 87.1%, respectively. The 16 events observed were volume increase (N = 11) and progression to neuroblastoma stage MS (N = 5). Patients with solid masses or MIBG-positive masses had lower EFS. Conclusions: Expectant observation for infants with sSRMs with clinical follow-up and timely imaging (including MRI scan) is safe and effective, allowing surgery to be avoided in the majority of them.
AB - Background: To assess whether expectant observation of infants ≤ 90 days old with small suprarenal masses (sSRMs) could avoid unnecessary surgery without impacting outcome. Methods: Infants ≤ 90 days with a ≤ 5 cm mass, without midline extension or lymph node or distant spread were registered (ClinicalTrials.org:NCT01728155). Once staging was completed, they were followed with ultrasound, MRI and urinary catecholamines. Surgical resection was only planned if there was a ≥40% mass volume increase or for a mass persisting after 48 weeks of the planned observation. Results: Over a 5-year period, 128 infants were registered. No infant had detectable MYCN amplification in the peripheral blood. Surgery was performed in 39 (30.5%) patients, in 18 during and in 21 after the planned 48-week observation, and 74% were confirmed to be neuroblastomas. Non-life-threatening surgical complications occurred in two cases. The 3-year overall survival and event-free survival were 100% and 87.1%, respectively. The 16 events observed were volume increase (N = 11) and progression to neuroblastoma stage MS (N = 5). Patients with solid masses or MIBG-positive masses had lower EFS. Conclusions: Expectant observation for infants with sSRMs with clinical follow-up and timely imaging (including MRI scan) is safe and effective, allowing surgery to be avoided in the majority of them.
KW - infant
KW - neonate
KW - neuroblastoma
KW - observation
KW - suprarenal masses
KW - surgery
UR - http://www.scopus.com/inward/record.url?scp=85137368160&partnerID=8YFLogxK
U2 - 10.3390/cancers14164007
DO - 10.3390/cancers14164007
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C2 - 36011005
AN - SCOPUS:85137368160
SN - 2072-6694
VL - 14
JO - Cancers
JF - Cancers
IS - 16
M1 - 4007
ER -
