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The Role of Surgery in Resectable, Nonresectable, and Metastatic Neuroblastoma

C. Everett Koop, MD, ScD
JAMA. 1968;205(3):157-158. doi:10.1001/jama.1968.03140290049013.
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The neuroblastoma is a unique tumor not only because of its apparent ability to change from a clinically and pathologically malignant tumor to one of a benign nature (ganglioneuroma) but also because of the remarkable gradient in histology exhibited by this tumor, the variable response according to the age of the patient, a prognosis definitely associated with the anatomical site of the tumor, and finally and perhaps most important to this discussion, what frequently appears to be a lack of correlation between the survival of the patient and the mode of surgical therapy.18-23

Because the prognosis is so much more favorable in children under the age of 1 year, surgery without adjuvant therapy is considered by many to be sufficient treatment. (Only 28% of our survivors were over 1 year of age at the time of diagnosis.)

The site of origin of the tumor has a definite effect upon


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