Yang Li,Xu Sheng,Yang Binyi,et al.Diagnosis and treatment of adrenal-region tumors in children:an analysis of 72 cases[J].Journal of Clinical Pediatric Surgery,,():859-862.[doi:10.3760/cma.j.cn101785-202411029]
Diagnosis and treatment of adrenal-region tumors in children:an analysis of 72 cases
- Keywords:
- Adrenal Gland Neoplasms; Diagnosis; Therapy; Prognosis; Surgical Procedures; Operative; Child
- Abstract:
- Objective To investigate the clinical features,diagnosis,treatment,and prognosis of adrenal-region tumors in children.Methods This was a retrospective case series study.Seventy-two children with adrenal-region tumors who underwent surgical treatment in Qingdao Women and Children’s Hospital and the Department of Pediatric Surgery of the Affiliated Hospital of Qingdao University from July 2009 to May 2022 were included.Data on clinical features,diagnosis,treatment,and prognosis were collected.The children were grouped according to a tumor diameter cut-off of 6 cm and surgical approach.For children who underwent surgery for malignant adrenal-region tumors,survival time was calculated using the Kaplan-Meier method,and univariate analysis of prognostic factors was performed using the Log-rank test.Results Among the 72 children,19 had tumors of adrenal origin and 53 had tumors of peri-adrenal origin,including 23 cases of neuroblastoma,13 cases of ganglioneuroblastoma,10 cases of ganglioneuroma (one case was diagnosed as neuroblastoma by puncture before neoadjuvant chemotherapy and was pathologically confirmed to have transformed into ganglioneuroma after surgery),5 cases of mature cystic teratoma,and 2 cases of ectopic bronchogenic cyst.Complete tumor resection was achieved in all children,with no perioperative death.When grouped by tumor diameter using 6 cm as the cut-off,there were no statistically significant differences between the <6 cm group and the ≥6 cm group in the proportion of laparoscopic surgery,operative time,or postoperative hospital stay (P>0.05).When grouped by surgical approach,there were also no statistically significant differences in operative time or postoperative hospital stay between the laparoscopic and open surgery groups (P>0.05),but the proportion of malignant cases differed significantly between the two groups (39.1% vs.83.0%,P<0.01).Postoperative follow-up was completed in 54 children (75%),with a mean follow-up duration of 24.4 months.Postoperative recurrence occurred in 1 child,metastasis occurred in 12 children,and 3 children died.Univariate survival analysis showed that surgical approach was not associated with survival in children with malignant adrenal-region tumors (100% in the laparoscopic group vs.89.7% in the open surgery group,P=0.34).Conclusion Adrenal-region tumors in children have insidious onset,mostly lack specific clinical manifestations,and have diverse pathological origins.Imaging examination is the main diagnostic basis,and surgical resection after adequate preoperative evaluation and preparation is the most effective treatment.Multidisciplinary diagnosis and treatment are important means to improve survival in affected children.
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Memo
收稿日期:2024-11-13。
基金项目:山东省医药卫生科技发展计划项目（202202080942）
通讯作者:鹿洪亭,Email:luhongting@163.com