Is “watchful waiting” superior to surgery in children with neurofibromatosis type 1 presenting with extracranial and extramedullary tumor mass at diagnosis?
Identifieur interne : 000248 ( Istex/Corpus ); précédent : 000247; suivant : 000249Is “watchful waiting” superior to surgery in children with neurofibromatosis type 1 presenting with extracranial and extramedullary tumor mass at diagnosis?
Auteurs : Wojciech Wozniak ; Marek W. KarwackiSource :
- Child's Nervous System [ 0256-7040 ] ; 2008-12-01.
English descriptors
Abstract
Abstract: Aim: The aim of this study was to compare aggressive surgery to “watchful waiting” in neurofibromatosis type 1 (NF-1) patients with benign peripheral nerve sheath tumors exceeding 150 cm3. Materials and methods: Observational study based on imaging studies and results of surgery was utilized. Results: Twenty-seven out of 114 NF-1 patients (mean age of 12.8 years) registered throughout the last 10 years were studied. The mean tumor volume was 237 cm3. Among them, 18 (66%) underwent surgery. In 15 (84%), regrowth of a tumor was observed. Reoperation was necessary in five (27%). Two out of these five children (2/18, 11%) required a third operation. Stable process has been shown in the remaining nine children (34%) since diagnosis and in most operated children (10/18; 56%), besides the regrowth of the tumor. Conclusions: “Watchful waiting” could be superior to aggressive surgery in selected patients without “oncological awareness” confirmed by imaging techniques (mostly magnetic resonance imaging). NF-1 children with gross tumor mass require lifetime imaging monitoring and complex medical evaluation.
Url:
DOI: 10.1007/s00381-008-0668-7
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ISTEX:B2ABE1D8A8C22852CB09EF2408D00FE1973B8862Le document en format XML
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Karwacki</name><affiliation><mods:affiliation>NF Outpatient Clinic, Clinical Department of Oncological Surgery for Children and Youth, National Research Institute of Mother and Child, Kasprzaka 17a, 01-211, Warsaw, Poland</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: marekwk@astercity.net</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:B2ABE1D8A8C22852CB09EF2408D00FE1973B8862</idno><date when="2008" year="2008">2008</date><idno type="doi">10.1007/s00381-008-0668-7</idno><idno type="url">https://api.istex.fr/ark:/67375/VQC-MRXHSKTM-L/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">000248</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000248</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Is “watchful waiting” superior to surgery in children with neurofibromatosis type 1 presenting with extracranial and extramedullary tumor mass at diagnosis?</title><author><name sortKey="Wozniak, Wojciech" sort="Wozniak, Wojciech" uniqKey="Wozniak W" first="Wojciech" last="Wozniak">Wojciech Wozniak</name><affiliation><mods:affiliation>NF Outpatient Clinic, Clinical Department of Oncological Surgery for Children and Youth, National Research Institute of Mother and Child, Kasprzaka 17a, 01-211, Warsaw, Poland</mods:affiliation></affiliation></author><author><name sortKey="Karwacki, Marek W" sort="Karwacki, Marek W" uniqKey="Karwacki M" first="Marek W." last="Karwacki">Marek W. Karwacki</name><affiliation><mods:affiliation>NF Outpatient Clinic, Clinical Department of Oncological Surgery for Children and Youth, National Research Institute of Mother and Child, Kasprzaka 17a, 01-211, Warsaw, Poland</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: marekwk@astercity.net</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Child's Nervous System</title><title level="j" type="abbrev">Childs Nerv Syst</title><idno type="ISSN">0256-7040</idno><idno type="eISSN">1433-0350</idno><imprint><publisher>Springer-Verlag</publisher><pubPlace>Berlin/Heidelberg</pubPlace><date type="published" when="2008-12-01">2008-12-01</date><biblScope unit="volume">24</biblScope><biblScope unit="issue">12</biblScope><biblScope unit="page" from="1431">1431</biblScope><biblScope unit="page" to="1436">1436</biblScope></imprint><idno type="ISSN">0256-7040</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0256-7040</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Gross tumor mass</term><term>Neurofibromatosis type 1</term><term>Peripheral nerve sheath tumors</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: Aim: The aim of this study was to compare aggressive surgery to “watchful waiting” in neurofibromatosis type 1 (NF-1) patients with benign peripheral nerve sheath tumors exceeding 150 cm3. Materials and methods: Observational study based on imaging studies and results of surgery was utilized. Results: Twenty-seven out of 114 NF-1 patients (mean age of 12.8 years) registered throughout the last 10 years were studied. The mean tumor volume was 237 cm3. Among them, 18 (66%) underwent surgery. In 15 (84%), regrowth of a tumor was observed. Reoperation was necessary in five (27%). Two out of these five children (2/18, 11%) required a third operation. Stable process has been shown in the remaining nine children (34%) since diagnosis and in most operated children (10/18; 56%), besides the regrowth of the tumor. Conclusions: “Watchful waiting” could be superior to aggressive surgery in selected patients without “oncological awareness” confirmed by imaging techniques (mostly magnetic resonance imaging). NF-1 children with gross tumor mass require lifetime imaging monitoring and complex medical evaluation.</div></front></TEI><istex><corpusName>springer-journals</corpusName><author><json:item><name>Wojciech Wozniak</name><affiliations><json:string>NF Outpatient Clinic, Clinical Department of Oncological Surgery for Children and Youth, National Research Institute of Mother and Child, Kasprzaka 17a, 01-211, Warsaw, Poland</json:string></affiliations></json:item><json:item><name>Marek W. Karwacki</name><affiliations><json:string>NF Outpatient Clinic, Clinical Department of Oncological Surgery for Children and Youth, National Research Institute of Mother and Child, Kasprzaka 17a, 01-211, Warsaw, Poland</json:string><json:string>E-mail: marekwk@astercity.net</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Neurofibromatosis type 1</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Peripheral nerve sheath tumors</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Gross tumor mass</value></json:item></subject><articleId><json:string>668</json:string><json:string>s00381-008-0668-7</json:string></articleId><arkIstex>ark:/67375/VQC-MRXHSKTM-L</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>OriginalPaper</json:string></originalGenre><abstract>Abstract: Aim: The aim of this study was to compare aggressive surgery to “watchful waiting” in neurofibromatosis type 1 (NF-1) patients with benign peripheral nerve sheath tumors exceeding 150 cm3. Materials and methods: Observational study based on imaging studies and results of surgery was utilized. Results: Twenty-seven out of 114 NF-1 patients (mean age of 12.8 years) registered throughout the last 10 years were studied. The mean tumor volume was 237 cm3. Among them, 18 (66%) underwent surgery. In 15 (84%), regrowth of a tumor was observed. Reoperation was necessary in five (27%). Two out of these five children (2/18, 11%) required a third operation. Stable process has been shown in the remaining nine children (34%) since diagnosis and in most operated children (10/18; 56%), besides the regrowth of the tumor. Conclusions: “Watchful waiting” could be superior to aggressive surgery in selected patients without “oncological awareness” confirmed by imaging techniques (mostly magnetic resonance imaging). 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type="inbook"><analytic><title level="a" type="main" xml:lang="en">Is “watchful waiting” superior to surgery in children with neurofibromatosis type 1 presenting with extracranial and extramedullary tumor mass at diagnosis?</title><author xml:id="author-0000"><persName><forename type="first">Wojciech</forename><surname>Wozniak</surname></persName><affiliation>NF Outpatient Clinic, Clinical Department of Oncological Surgery for Children and Youth, National Research Institute of Mother and Child, Kasprzaka 17a, 01-211, Warsaw, Poland</affiliation></author><author xml:id="author-0001" corresp="yes"><persName><forename type="first">Marek</forename><surname>Karwacki</surname></persName><email>marekwk@astercity.net</email><affiliation>NF Outpatient Clinic, Clinical Department of Oncological Surgery for Children and Youth, National Research Institute of Mother and Child, Kasprzaka 17a, 01-211, Warsaw, Poland</affiliation></author><idno 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Materials and methods: Observational study based on imaging studies and results of surgery was utilized. Results: Twenty-seven out of 114 NF-1 patients (mean age of 12.8 years) registered throughout the last 10 years were studied. The mean tumor volume was 237 cm3. Among them, 18 (66%) underwent surgery. In 15 (84%), regrowth of a tumor was observed. Reoperation was necessary in five (27%). Two out of these five children (2/18, 11%) required a third operation. Stable process has been shown in the remaining nine children (34%) since diagnosis and in most operated children (10/18; 56%), besides the regrowth of the tumor. Conclusions: “Watchful waiting” could be superior to aggressive surgery in selected patients without “oncological awareness” confirmed by imaging techniques (mostly magnetic resonance imaging). NF-1 children with gross tumor mass require lifetime imaging monitoring and complex medical evaluation.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Neurofibromatosis type 1</term></item><item><term>Peripheral nerve sheath tumors</term></item><item><term>Gross tumor mass</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>Medicine & Public Health</head><item><term>Neurosciences</term></item><item><term>Neurosurgery</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2007-12-23">Created</change><change when="2008-12-01">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/VQC-MRXHSKTM-L/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus springer-journals not found" 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TocLevels="0"><ArticleID>668</ArticleID><ArticleDOI>10.1007/s00381-008-0668-7</ArticleDOI><ArticleSequenceNumber>10</ArticleSequenceNumber><ArticleTitle Language="En">Is “watchful waiting” superior to surgery in children with neurofibromatosis type 1 presenting with extracranial and extramedullary tumor mass at diagnosis?</ArticleTitle><ArticleCategory>Original Paper</ArticleCategory><ArticleFirstPage>1431</ArticleFirstPage><ArticleLastPage>1436</ArticleLastPage><ArticleHistory><RegistrationDate><Year>2008</Year><Month>5</Month><Day>21</Day></RegistrationDate><Received><Year>2007</Year><Month>12</Month><Day>23</Day></Received><Revised><Year>2008</Year><Month>4</Month><Day>28</Day></Revised><OnlineDate><Year>2008</Year><Month>7</Month><Day>1</Day></OnlineDate></ArticleHistory><ArticleCopyright><CopyrightHolderName>Springer-Verlag</CopyrightHolderName><CopyrightYear>2008</CopyrightYear></ArticleCopyright><ArticleGrants Type="Regular"><MetadataGrant Grant="OpenAccess"></MetadataGrant><AbstractGrant Grant="OpenAccess"></AbstractGrant><BodyPDFGrant Grant="Restricted"></BodyPDFGrant><BodyHTMLGrant Grant="Restricted"></BodyHTMLGrant><BibliographyGrant Grant="Restricted"></BibliographyGrant><ESMGrant Grant="Restricted"></ESMGrant></ArticleGrants></ArticleInfo><ArticleHeader><AuthorGroup><Author AffiliationIDS="Aff1"><AuthorName DisplayOrder="Western"><GivenName>Wojciech</GivenName><FamilyName>Wozniak</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff1" CorrespondingAffiliationID="Aff1"><AuthorName DisplayOrder="Western"><GivenName>Marek</GivenName><GivenName>W.</GivenName><FamilyName>Karwacki</FamilyName></AuthorName><Contact><Phone>+48-22-77205</Phone><Fax>+48-22-6329851</Fax><Email>marekwk@astercity.net</Email></Contact></Author><Affiliation ID="Aff1"><OrgDivision>NF Outpatient Clinic, Clinical Department of Oncological Surgery for Children and Youth</OrgDivision><OrgName>National Research Institute of Mother and Child</OrgName><OrgAddress><Street>Kasprzaka 17a</Street><Postcode>01-211</Postcode><City>Warsaw</City><Country Code="PL">Poland</Country></OrgAddress></Affiliation></AuthorGroup><Abstract ID="Abs1" Language="En"><Heading>Abstract</Heading><AbstractSection ID="ASec1"><Heading>Aim</Heading><Para>The aim of this study was to compare aggressive surgery to “watchful waiting” in neurofibromatosis type 1 (NF-1) patients with benign peripheral nerve sheath tumors exceeding 150 cm<Superscript>3</Superscript>.</Para></AbstractSection><AbstractSection ID="ASec2"><Heading>Materials and methods</Heading><Para>Observational study based on imaging studies and results of surgery was utilized.</Para></AbstractSection><AbstractSection ID="ASec3"><Heading>Results</Heading><Para>Twenty-seven out of 114 NF-1 patients (mean age of 12.8 years) registered throughout the last 10 years were studied. The mean tumor volume was 237 cm<Superscript>3</Superscript>. Among them, 18 (66%) underwent surgery. In 15 (84%), regrowth of a tumor was observed. Reoperation was necessary in five (27%). Two out of these five children (2/18, 11%) required a third operation. Stable process has been shown in the remaining nine children (34%) since diagnosis and in most operated children (10/18; 56%), besides the regrowth of the tumor.</Para></AbstractSection><AbstractSection ID="ASec4"><Heading>Conclusions</Heading><Para>“Watchful waiting” could be superior to aggressive surgery in selected patients without “oncological awareness” confirmed by imaging techniques (mostly magnetic resonance imaging). NF-1 children with gross tumor mass require lifetime imaging monitoring and complex medical evaluation.</Para></AbstractSection></Abstract><KeywordGroup Language="En"><Heading>Keywords</Heading><Keyword>Neurofibromatosis type 1</Keyword><Keyword>Peripheral nerve sheath tumors</Keyword><Keyword>Gross tumor mass</Keyword></KeywordGroup></ArticleHeader><NoBody></NoBody></Article></Issue></Volume></Journal></Publisher></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Is “watchful waiting” superior to surgery in children with neurofibromatosis type 1 presenting with extracranial and extramedullary tumor mass at diagnosis?</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Is “watchful waiting” superior to surgery in children with neurofibromatosis type 1 presenting with extracranial and extramedullary tumor mass at diagnosis?</title></titleInfo><name type="personal"><namePart type="given">Wojciech</namePart><namePart type="family">Wozniak</namePart><affiliation>NF Outpatient Clinic, Clinical Department of Oncological Surgery for Children and Youth, National Research Institute of Mother and Child, Kasprzaka 17a, 01-211, Warsaw, Poland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal" displayLabel="corresp"><namePart type="given">Marek</namePart><namePart type="given">W.</namePart><namePart type="family">Karwacki</namePart><affiliation>NF Outpatient Clinic, Clinical Department of Oncological Surgery for Children and Youth, National Research Institute of Mother and Child, Kasprzaka 17a, 01-211, Warsaw, Poland</affiliation><affiliation>E-mail: marekwk@astercity.net</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="OriginalPaper" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>Springer-Verlag</publisher><place><placeTerm type="text">Berlin/Heidelberg</placeTerm></place><dateCreated encoding="w3cdtf">2007-12-23</dateCreated><dateIssued encoding="w3cdtf">2008-12-01</dateIssued><copyrightDate encoding="w3cdtf">2008</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><abstract lang="en">Abstract: Aim: The aim of this study was to compare aggressive surgery to “watchful waiting” in neurofibromatosis type 1 (NF-1) patients with benign peripheral nerve sheath tumors exceeding 150 cm3. Materials and methods: Observational study based on imaging studies and results of surgery was utilized. Results: Twenty-seven out of 114 NF-1 patients (mean age of 12.8 years) registered throughout the last 10 years were studied. The mean tumor volume was 237 cm3. Among them, 18 (66%) underwent surgery. In 15 (84%), regrowth of a tumor was observed. Reoperation was necessary in five (27%). Two out of these five children (2/18, 11%) required a third operation. Stable process has been shown in the remaining nine children (34%) since diagnosis and in most operated children (10/18; 56%), besides the regrowth of the tumor. Conclusions: “Watchful waiting” could be superior to aggressive surgery in selected patients without “oncological awareness” confirmed by imaging techniques (mostly magnetic resonance imaging). NF-1 children with gross tumor mass require lifetime imaging monitoring and complex medical evaluation.</abstract><note>Original Paper</note><subject lang="en"><genre>Keywords</genre><topic>Neurofibromatosis type 1</topic><topic>Peripheral nerve sheath tumors</topic><topic>Gross tumor mass</topic></subject><relatedItem type="host"><titleInfo><title>Child's Nervous System</title></titleInfo><titleInfo type="abbreviated"><title>Childs Nerv Syst</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><originInfo><publisher>Springer</publisher><dateIssued encoding="w3cdtf">2008-11-11</dateIssued><copyrightDate encoding="w3cdtf">2008</copyrightDate></originInfo><subject><genre>Medicine & Public Health</genre><topic>Neurosciences</topic><topic>Neurosurgery</topic></subject><identifier type="ISSN">0256-7040</identifier><identifier type="eISSN">1433-0350</identifier><identifier type="JournalID">381</identifier><identifier type="IssueArticleCount">22</identifier><identifier type="VolumeIssueCount">12</identifier><part><date>2008</date><detail type="volume"><number>24</number><caption>vol.</caption></detail><detail type="issue"><number>12</number><caption>no.</caption></detail><extent unit="pages"><start>1431</start><end>1436</end></extent></part><recordInfo><recordOrigin>Springer-Verlag, 2008</recordOrigin></recordInfo></relatedItem><identifier type="istex">B2ABE1D8A8C22852CB09EF2408D00FE1973B8862</identifier><identifier type="ark">ark:/67375/VQC-MRXHSKTM-L</identifier><identifier type="DOI">10.1007/s00381-008-0668-7</identifier><identifier type="ArticleID">668</identifier><identifier type="ArticleID">s00381-008-0668-7</identifier><accessCondition type="use and reproduction" contentType="copyright">Springer-Verlag, 2008</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-3XSW68JL-F">springer</recordContentSource><recordOrigin>Springer-Verlag, 2008</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/ark:/67375/VQC-MRXHSKTM-L/record.json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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