Perioperative management of hypertensive neuroblastoma: A study from the Italian Group of Pediatric Surgical Oncologists (GICOP)

Fortunato Siracusa, Paolo D'Angelo, Lucia Miglionico, Stefano Avanzini, Alessandro Inserra, Luca Pio, Elisa Tirtei, Claudio Granata, Alessandra Narciso, Jurgen Schleef, Elisa Severi, Nino Tedesco, Giuseppe Martucciello, Pierluigi Lelli Chiesa, Pierluigi Lelli Chiesa, Anna Maria Fagnani, Francesco Vaccarella, Umberto Caccioppoli, Fortunato Siracusa, Giovanna RiccipetitoniBruno Noccioli, Francesco Camoglio, Annarita Gigliotti, Angela Rita Sementa, Jurgen Schleef, Giovanni Cecchetto, Claudio Carlini, Simone Cesaro, Massimo Conte, Girolamo Mattioli, Ernesto Leva

    Risultato della ricerca: Articlepeer review

    2 Citazioni (Scopus)

    Abstract

    Background: Hypertension (HT) is rarely reported in patients affected by Neuroblastoma (NB), and management guidelines are lacking. Clinical features and perioperativemedical treatment insuchpatientswere reviewed to1) ascertain whether a shared treatment strategy exists among centers and 2) if possible, propose some recommendations for the perioperative management of HT in NB patients.Methods: A retrospectivemulticenter surveywas conducted on patients affected by NBwho presented HT symptoms.Results: From 2006 to 2014, 1126 children were registered in the Italian Registry of Neuroblastoma (RINB). Of these, 21 with HT (1.8%) were included in our analysis. Pre- and intraoperative HT management was somewhat dissimilar among the participating centers, apart from a certain consistency in the intraoperative use of the alpha-1 blocker urapidil. Six of the 21 patients (28%) needed persistent antihypertensive treatment at a median follow-up of 36 months (range 4–-96 months) despite tumor removal. Involvement of the renal pedicle was the only risk factor constantly associated to HT persistency following surgery. A correlation between the presence of HT and the secretion of specific catecholamines and/or compression of the renal vascular pedicle could not be demonstrated.Conclusion: Based on this retrospective review of NB patients with HT, no definite therapeutic protocol can be recommended owing to heterogeneity of adopted treatments in different centers. A proposal of perioperative HT management in NB patients is however presented. Level of evidence: IV.
    Lingua originaleEnglish
    Numero di pagine4
    RivistaJournal of Pediatric Surgery
    Volume52
    Stato di pubblicazionePublished - 2017

    All Science Journal Classification (ASJC) codes

    • Surgery
    • Pediatrics, Perinatology, and Child Health

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