Background. The purpose of our study was to evaluate the incidence and clinical characteristics of febrile episodes during neutropenia following chem

Purpose: Although tumor resection is the mainstay of treatment for localized neuroblastoma, there are no established guidelines indicating which patients should be operated on immediately and which should undergo surgery after tumor reduction with chemotherapy. In an effort to develop such guidelines, the LNESG1 study defined surgical risk factors (SRFs) based on the imaging characteristics. Patients and Methods: A total of 905 patients with suspected localized neuroblastoma were registered by 10 European countries between January 1995 and October 1999; 811 of 905 patients were eligible for this analysis. Results: Information on SRFs was obtained for 719 of 811 patients; 367 without and 352 with SRFs. Of these 719 patients, 201 patients (four without and 197 with SRFs) underwent biopsy only. An attempt at tumor excision was made in 518 patients: 363 of 367 patients without and 155 of 352 patients with SRFs (98.9% v 44.0%). Complete excision was achieved in 271 of 363 patients without and in 72 of 155 patients with SRF (74.6% v 46.4%), near-complete excision was achieved in 81 and 61 patients (22.3% v 39.3%), and incomplete excision was achieved in 11 and 22 patients (3.0% v 14.2%), respectively. There were two surgery-related deaths. Nonfatal surgery-related complications occurred in 45 of 518 patients (8.7%) and were less frequent in patients without SRFs (5.0% v 17.4%). Associated surgical procedures were also less frequent in patients without SRFs (1.6% v 9.7%). Conclusion: The adoption of SRFs as predictors of adverse surgical outcome was validated because their presence was associated with lower complete resection rate and greater risk of surgery-related complications. Additional studies aiming to better define the surgical approach to localized neuroblastoma are warranted.

Lymphomas account for 10%-15% of all childhood cancers and include a number of different pathologic subtypes, which arise from the constituent cells of the immune system or from their precursors. All organ systems may be involved at some stage of the disease, including the central nervous system, head and neck, thorax, abdomen, gonads, and bone. However, at onset, nodal and splenic involvement are more common in Hodgkin disease, whereas extranodal involvement is more frequent in non-Hodgkin lymphomas. Diagnostic imaging modalities have a fundamental role in the staging of lymphomas and, owing to major advances during the past two decades, make surgical staging unnecessary in most cases. Conventional, sonographic, and cross-sectional imaging techniques are excellent tools for evaluating the extent and sites of disease in childhood lymphomas. Familiarity with the spectrum of imaging findings in lymphomas is essential for radiologists to enable them to provide guidance for the treating physicians.