Recently we performed multi-modal therapy including chemotherapy with bone marrow transplantation (BMT), surgery, and local irradiation in the treatment of advanced neuroblastoma. As a result, all Stage III patients survived, and 4 out of 8 Stage IV patients who underwent our original systemic gross complete resection achieved long-term survival, 4y 8m, 5y 8m, 5y 6m and 5y 5m, respectively. Long-term survival patients were treated by local irradiation, brain surgery and intensive induction chemotherapy before primary site operation, and when resolution of distant metastases was obtained, the primary site was resected completely, followed by postoperative supralethal chemotherapy with BMT. The purpose of this report is to elucidate the role of surgery in advanced neuroblastoma based on our clinical results.
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