Trial reportAnnals of surgery2012
A prospective study of expectant observation as primary therapy for neuroblastoma in young infants: a Children's Oncology Group study.
Trial report in Annals of surgery, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
76 citing papers in PubMed, 1 synthesis or guideline pooled it, 193 citations in OpenAlex.
- SIOP-PODC adapted risk stratification and treatment guidelines: Recommendations for neuroblastoma in low- and middle-income settings.Pediatric blood & cancer · 2015Guideline
- Treatment and survival of childhood neuroblastoma: Evidence from a population-based study in the United States.Pediatric hematology and oncology · 2017Trial
- Advances and disparities in survival of childhood and adolescent cancers.Journal of the National Cancer Institute · 2026Observational
- Development and Initial Validation of High-Fidelity 3D Hybrid Simulators for Training in Complex Pediatric Oncologic Surgery.Cancers · 2026Article
- Impact of primary tumor resection on survival in high-risk neuroblastoma: a long-term single-center study.Pediatric surgery international · 2026Article
- Clinical characteristics and survival outcomes of surgically managed prenatally diagnosed neuroblastoma: a single-center, real-world study.BMC pediatrics · 2025Article
- The baselineBMC medical imaging · 2025Article
- 'Wolf in Sheep's Clothing': Third Trimester Diagnosis of Rare Adrenal Malignancy Masquerading as Common Renal Anomaly.Australasian journal of ultrasound in medicine · 2025Article
- Essential Knowledge and Skills for the Practice of Pediatric Surgical Oncology: A Modified Delphi Consensus Study by the APSA Cancer Committee.Annals of surgical oncology · 2025Article
- Long-Term Outcome of Young Infants With Suspected Neuroblastoma following Observation as Primary Therapy: A Report From the Children's Oncology Group.Pediatric blood & cancer · 2025Observational
- Clinical value ofQuantitative imaging in medicine and surgery · 2025Article
- Integrated bulk and single-cell RNA sequencing reveals a cuproptosis-related LncRNA prognostic signature in neuroblastoma.BMC cancer · 2025Article
- Horner syndrome in a pediatric patient.Pediatric investigation · 2025Article
- Anaplastic Lymphoma Kinase Inhibition Therapy for Hereditary Neuroblastoma.JCO precision oncology · 2025Article
- PHD-2/HIF-1α axis mediates doxorubicin-induced angiogenesis in SH-SY5Y neuroblastoma microenvironment: a potential survival mechanism.Scientific reports · 2025Article
- Therapeutic Innovation in Pediatric Neuroblastoma: Age and Stage-Specific Strategies from Prenatal to Early Childhood-A Review Article.Iranian journal of child neurology · 2025Review
- Impact of the relationship between renal pedicles and tumors on surgical outcomes for non-high-risk abdominal neuroblastoma.Pediatric surgery international · 2024Article
- Defining neuroblastoma: From origin to precision medicine.Neuro-oncology · 2024Review
- Review
- Minimally invasive approach of paediatric neuroblastoma with thoracic vascular encasement.Journal of minimal access surgery · 2024Article
16 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo demonstrate that expectant observation of young infants with small adrenal masses would result in excellent event-free and overall survival.
backgroundNeuroblastoma is the most common malignant tumor in infants, and in young infants, 90% of neuroblastomas are located in the adrenal gland. Although surgical resection is standard therapy, multiple observations suggest that expectant observation could be a safe alternative for infants younger than 6 months who have small adrenal masses.
methodsA prospective study of infants younger than 6 months with small adrenal masses and no evidence of spreading beyond the primary tumor was performed at participating Children's Oncology Group institutions. Parents could choose observation or immediate surgical resection. Serial abdominal sonograms and urinary vanillylmandelic acid and homovanillic acid measurements were performed during a 90-week interval. Infants experiencing a 50% increase in the volume of the mass, urine catecholamine values, or an increase in the homovanillic acid to vanillylmandelic acid ratio greater than 2, were referred for surgical resection.
resultsEighty-seven eligible patients were enrolled: 83 elected observation and 4 chose immediate surgery. Sixteen observational patients ultimately had surgery; 8 had International Neuroblastoma Staging System stage 1 neuroblastoma, 2 had higher staged neuroblastoma (2B and 4S), 2 had low-grade adrenocortical neoplasm, 2 had adrenal hemorrhage, and 2 had extralobar pulmonary sequestration. The 2 patients with adrenocortical tumors were resected because of a more than 50% increase in tumor volume. The 3-year event-free survival for a neuroblastoma event was 97.7 ± 2.2% within the entire cohort of patients (n = 87). The 3-year overall survival was 100%, with a median follow-up of 3.2 years. Eighty-one percent of patients on the observation arm were spared resection.
conclusionsExpectant observation of infants younger than 6 months with small adrenal masses led to excellent event-free survival and overall survival while avoiding surgical intervention in a large majority of the patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.