The Clinical Management and Outcomes of Cervical Neuroblastic Tumors

Abstract Background While patients with peripheral neuroblastoma (pelvic and thoracic) typically have better outcomes and less aggressive disease compared to patients with abdominal disease, little has been published with regard to the management and outcomes of patients with cervical neuroblastoma. Herein, we sought to determine the characteristics of cervical neuroblastic tumors and the effect of extent of resection on survival and outcomes. Methods We performed a retrospective review of 325 children with neuroblastic tumors at Children’s Hospital Los Angeles over a 15-year period (1/1990–2/2015). Data collected from the medical record included location of tumor, age at diagnosis, age at resection, extent of resection, chemotherapy course, INSS stage, INPC histological classification, and MYCN amplification, a poor prognostic marker. Outcome variables included postoperative complications and overall survival. Results Twelve patients (3.6%) were found to have cervical neuroblastic tumors (9 neuroblastomas, 1 ganglioneuroblastoma, and 2 ganglioneuromas). All had favorable histology, and none (0/12) had MYCN amplification. Of the neuroblastoma patients, 4 of 9 patients underwent resection while the other five underwent biopsy followed by chemotherapy or observation alone. Of the 12 total patients, 6 underwent gross total resection, 4 (67%) of which developed complications. At a median follow-up of 4.4 years, there were no recurrences or deaths. Conclusions Cervical neuroblastic tumors represent favorable lesions with good outcomes similar to other peripheral neuroblastic tumors. In our study, survival was excellent regardless of extent of tumor resection. Based on our data, we recommend a minimally aggressive surgical approach in managing children with cervical neuroblastic tumors.