nach oben

Erschienen in:

01.12.2023 | Original Article

Beyond image defined risk factors (IDRFs): a delphi survey highlighting definition of the surgical complexity index (SCI) in neuroblastoma

verfasst von: S. Avanzini, P. Dall’Igna, K. Bjornland, S. Braungart, K. Cross, P. Flores, H. O. S. Gabra, J. Gomez-Chacon, S. Irtan, P. Lobos, A. Loh, L. E. Matthyssens, M. Metzelder, S. Parodi, L. Pio, C. P. Van de Ven, J. Fuchs, P. D. Losty, S. Sarnacki

Erschienen in: Pediatric Surgery International | Ausgabe 1/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Preoperative evaluation of Image Defined Risk Factors (IDRFs) in neuroblastoma (NB) is crucial for determining suitability for upfront resection or tumor biopsy. IDRFs do not all carry the same weighting in predicting tumor complexity and surgical risk. In this study we aimed to assess and categorize a surgical complexity (Surgical Complexity Index, SCI) in NB resection.

Methods

A panel of 15 surgeons was involved in an electronic Delphi consensus survey to identify and score a set of shared items predictive and/or indicative of surgical complexity, including the number of preoperative IDRFs. A shared agreement included the achievement of at least 75% consensus focused on a single or two close risk categories.

Results

After 3 Delphi rounds, agreement was established on 25/27 items (92.6%). A severity score was established for each item ranging from 0 to 3 with an overall SCI range varying from a minimum score of zero to a maximum score of 29 points for any given patient.

Conclusions

A consensus on a SCI to stratify the risks related to neuroblastoma tumor resection was established by the panel experts. This index will now be deployed to critically assign a better severity score to IDRFs involved in NB surgery.

Brodeur GM, Look AT, Shimada H, Hamilton VM, Maris JM, Hann HW, Leclerc JM, Bernstein M, Brisson LC, Brossard J, Lemieux B, Tuchman M, Woods WG (2001) Biological aspects of neuroblastomas identified by mass screening in Quebec. Med Pediatr Oncol 36(1):157–159CrossRefPubMed

Monclair T, Brodeur GM, Ambros PF, Brisse HJ, Cecchetto G, Holmes K, Kaneko M, London WB, Matthay KK, Nuchtern JG, von Schweinitz D, Simon T, Cohn SL, Pearson AD (2009) INRG task force the international neuroblastoma risk group (INRG) staging system: an INRG task force report. J Clin Oncol 27(2):298–303CrossRefPubMedPubMedCentral

Brisse HJ, McCarville MB, Granata C, Krug KB, Wootton-Gorges SL, Kanegawa K, Giammarile F, Schmidt M, Shulkin BL, Matthay KK, Lewington VJ, Sarnacki S, Hero B, Kaneko M, London WB, Pearson AD, Cohn SL, Monclair T (2011) International neuroblastoma risk group project. Guidelines for imaging and staging of neuroblastic tumors: consensus report from the International neuroblastoma risk group project. Radiology 261(1):243–257CrossRefPubMed

Irtan S, Brisse HJ, Minard-Colin V, Schleiermacher G, Galmiche-Rolland L, Le Cossec C, Elie C, Canale S, Michon J, Valteau-Couanet D, Sarnacki S (2015) Image-defined risk factor assessment of neurogenic tumors after neoadjuvant chemotherapy is useful for predicting intra-operative risk factors and the completeness of resection. Pediatr Blood Cancer 62(9):1543–1549CrossRefPubMed

Phelps HM, Ndolo JM, Van Arendonk KJ, Chen H, Dietrich HL, Watson KD, Hilmes MA, Chung DH, Lovvorn HN 3rd (2019) Association between image-defined risk factors and neuroblastoma outcomes. J Pediatr Surg 54(6):1184–1191CrossRefPubMedPubMedCentral

Zhang AA, Pan C, Xu M, Wang XX, Ye QD, Gao YJ, Tang JY (2019) Association of image-defined risk factors, tumor resectability, and prognosis in children with localized neuroblastoma. World J Pediatr 15(6):572–579CrossRefPubMed

Temple WC, Vo KT, Matthay KK, Balliu B, Coleman C, Michlitsch J, Phelps A, Behr S, Zapala MA (2021) Association of image-defined risk factors with clinical features, histopathology, and outcomes in neuroblastoma. Cancer Med 10(7):2232–2241CrossRefPubMed

Simon T, Hero B, Benz-Bohm G, von Schweinitz D, Berthold F (2008) Review of image defined risk factors in localized neuroblastoma patients: results of the GPOH NB97 trial. Pediatr Blood Cancer 50(5):965–969CrossRefPubMed

Avanzini S, Pio L, Erminio G, Granata C, Holmes K, Gambart M, Buffa P, Castel V, Valteau Couanet D, Garaventa A, Pistorio A, Cecchetto G, Martucciello G, Mattioli G, Sarnacki S (2017) Image-defined risk factors in unresectable neuroblastoma: SIOPEN study on incidence, chemotherapy-induced variation, and impact on surgical outcomes. Pediatr Blood Cancer 64(11):e26605CrossRef

10.

Pohl A, Erichsen M, Stehr M, Hubertus J, Bergmann F, Kammer B, von Schweinitz D (2016) Image-defined risk factors correlate with surgical radicality and local recurrence in patients with neuroblastoma. Klin Padiatr 228(3):118–123CrossRefPubMed

11.

de Magalhaes ST. The European Union’s General Data Protection Regulation (GDPR). Available online https://www.semanticscholar.org/paper/The-European-Union%E2%80%99s-General-Data-Protection-(GDPR)-Magalhaes/6e9933ee4eb634ba691903ccbc83c9abd871747b last accessed on 23/10/2022

12.

Rayens MK, Hahn EJ (2000) Building consensus using the policy Delphi method. Policy Polit Nurs Pract 1(4):308–315CrossRef

13.

Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213CrossRefPubMedPubMedCentral

14.

Cecchetto G, Mosseri V, De Bernardi B, Helardot P, Monclair T, Costa E, Horcher E, Neuenschwander S, Tomà P, Rizzo A, Michon J, Holmes K (2005) Surgical risk factors in primary surgery for localized neuroblastoma: the LNESG1 study of the European International Society of Pediatric Oncology Neuroblastoma Group. J Clin Oncol 23(33):8483–8489CrossRefPubMed

15.

Matthyssens LE, Nuchtern JG, Van De Ven CP, Gabra HOS, Bjornland K, Irtan S, Stenman J, Pio L, Cross KM, Avanzini S, Inserra A, Chacon JG, Dall’igna P, Von Schweinitz D, Holmes K, Fuchs J, Squire R, Valteau-Couanet D, Park JR, Eggert A, Losty PD, La Quaglia MP, Sarnacki S (2022) A novel standard for systematic reporting of neuroblastoma surgery: the international neuroblastoma surgical report form (INSRF): a joint initiative by the pediatric oncological cooperative groups SIOPEN∗, COG∗∗, and GPOH∗∗∗. Surgical and medical Committees of SIOPEN, COG and GPOH COG and GPOH. Ann Surg 275(3):e575–e585CrossRefPubMed

16.

Yoneda A, Nishikawa M, Uehara S, Oue T, Usui N, Inoue M, Fukuzawa M, Okuyama H (2016) Can image-defined risk factors predict surgical complications in localized neuroblastoma? Eur J Pediatr Surg 26(1):117–122PubMed

17.

Günther P, Holland-Cunz S, Schupp CJ, Stockklausner C, Hinz U, Schenk JP (2011) Significance of image-defined risk factors for surgical complications in patients with abdominal neuroblastoma. Eur J Pediatr Surg 21(5):314–317CrossRefPubMed

18.

Iehara T, Yoneda A, Yokota I, Takahashi H, Teramukai S, Kamijyo T, Nakazawa A, Takimoto T, Kikuta A, Yagyu S, Ikeda H, Nakagawara A, Tajiri T, Japan Childhood Cancer Group Neuroblastoma Committee (JNBSG) (2019) Results of a prospective clinical trial JN-L-10 using image-defined risk factors to inform surgical decisions for children with low-risk neuroblastoma disease: a report from the Japan Children’s Cancer Group Neuroblastoma Committee. Pediatr Blood Cancer 66(11):e27914CrossRefPubMed

19.

Irtan S, Brisse HJ, Minard-Colin V, Schleiermacher G, Canale S, Sarnacki S (2015) Minimally invasive surgery of neuroblastic tumors in children: Indications depend on anatomical location and image-defined risk factors. Pediatr Blood Cancer 62(2):257–261CrossRefPubMed

20.

Tanaka Y, Kawashima H, Mori M, Fujiogi M, Suzuki K, Amano H, Morita K, Arakawa Y, Koh K, Oguma E, Iwanaka T, Uchida H (2016) Contraindications and image-defined risk factors in laparoscopic resection of abdominal neuroblastoma. Pediatr Surg Int 32(9):845–850CrossRefPubMed

21.

Shirota C, Tainaka T, Uchida H, Hinoki A, Chiba K, Tanaka Y (2017) Laparoscopic resection of neuroblastomas in low- to high-risk patients without image-defined risk factors is safe and feasible. BMC Pediatr 17(1):71CrossRefPubMedPubMedCentral

22.

Gabra HO, Irtan S, Cross K, Lobos P, Froeba-Pohl A, Pio L, Virgone C, Guillén Burrieza G, Gómez Chacón Villalba J, Riccipetitoni G, Guérin F, Nightingale M, Heloury Y, Faraj S, Leclair M, Scalabre A, Mattioli G, Warmann SW, Fuchs J, Basta N, Bjørnland K, Matthyssens LE, Losty PD, Sarnacki S (2022) Minimally invasive surgery for neuroblastic tumours: A SIOPEN multicentre study: Proposal for guidelines. Eur J Surg Oncol 48(1):283–291CrossRefPubMed

23.

Delforge X, De Cambourg P, Defachelles AS, Haffreingue A, Rod J, Kassite I, Chabani N, Lauriot-Dit-Prevost A, Gourmel A, Arnaud A, Duchesne C, Thebaud E, Leclair MD (2021) Unresectable thoracic neuroblastic tumors: changes in image-defined risk factors after chemotherapy and impact on surgical management. Pediatr Blood Cancer 68(12):e29260CrossRefPubMed

24.

Salim A, Raitio A, Pizer B, Mullassery D, Losty PD (2021) Neuroblastoma: the association of anatomical tumour site, molecular biology and patient outcomes. ANZ J Surg 91(5):1000–1004CrossRefPubMed

25.

Ryan AL, Akinkuotu A, Pierro A, Morgenstern DA, Irwin MS (2020) The role of surgery in high-risk neuroblastoma. J Pediatr Hematol Oncol 42(1):1–7CrossRefPubMed

26.

Mullassery D, Farrelly P, Losty PD (2014) Does aggressive surgical resection improve survival in advanced stage 3 and 4 neuroblastoma ? A systematic review and meta-analysis. Pediatr Hematol Oncol 31(8):703–716CrossRefPubMed

27.

Holmes K, Pötschger U, Pearson ADJ, Sarnacki S, Cecchetto G, Gomez-Chacon J, Squire R, Freud E, Bysiek A, Matthyssens LE, Metzelder M, Monclair T, Stenman J, Rygl M, Rasmussen L, Joseph JM, Irtan S, Avanzini S, Godzinski J, Björnland K, Elliott M, Luksch R, Castel V, Ash S, Balwierz W, Laureys G, Ruud E, Papadakis V, Malis J, Owens C, Schroeder H, Beck-Popovic M, Trahair T, International Society of Paediatric Oncology Europe Neuroblastoma Group (SIOPEN) (2020) Influence of surgical excision on the survival of patients with stage 4 high-risk neuroblastoma: a report from the HR-NBL1/SIOPEN Study. J Clin Oncol 38(25):2902–2915CrossRefPubMed

28.

Williamson PR, Altman DG, Bagley H, Barnes KL, Blazeby JM, Brookes ST, Clarke M, Gargon E, Gorst S, Harman N, Kirkham JJ, McNair A, Prinsen CAC, Schmitt J, Terwee CB, Young B (2017) The COMET handbook: version 1.0. Trials 18(Suppl 3):280CrossRefPubMedPubMedCentral

29.

Hsu C, Sandford BA (2007) The Delphi technique: making sense of consensus. Pract Assess Res Eval 12:10

30.

Hasson F, Keeney S, McKenna H (2000) Research guidelines for the Delphi survey technique. J Adv Nurs 32(4):1008–1015CrossRefPubMed

Titel: Beyond image defined risk factors (IDRFs): a delphi survey highlighting definition of the surgical complexity index (SCI) in neuroblastoma
verfasst von: S. Avanzini
P. Dall’Igna
K. Bjornland
S. Braungart
K. Cross
P. Flores
H. O. S. Gabra
J. Gomez-Chacon
S. Irtan
P. Lobos
A. Loh
L. E. Matthyssens
M. Metzelder
S. Parodi
L. Pio
C. P. Van de Ven
J. Fuchs
P. D. Losty
S. Sarnacki
Publikationsdatum: 01.12.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 1/2023
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-023-05477-z

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Beyond image defined risk factors (IDRFs): a delphi survey highlighting definition of the surgical complexity index (SCI) in neuroblastoma