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Locoregional recurrence
Source: Neuroblastoma Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: April 28, 2025 · Captured 2026-09-09.
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Treatment options for locoregional recurrent neuroblastoma initially classified as low risk include the following:
Surgery followed by observation or chemotherapy.
Chemotherapy that may be followed by surgery.
Local or regional recurrent cancer is resected if possible.
Patients with favorable biology and regional recurrence more than 3 months after completion of planned treatment are observed if resection of the recurrence is total or near total (≥90% resection). Those with favorable biology and a less-than-near-total resection are treated with chemotherapy.[16,17,19]
Infants younger than 1 year at the time of locoregional recurrence whose tumors have any unfavorable biological properties are observed if resection is total or near total. If the resection is less than near total, these infants are treated with chemotherapy. Chemotherapy may consist of moderate doses of carboplatin, cyclophosphamide, doxorubicin, and etoposide, or cyclophosphamide and topotecan. The cumulative dose of each agent is kept low to minimize long-term effects, as used in previous COG trials (COG-P9641 and COG-A3961).[16,17,19]
Evidence (surgery followed by observation or chemotherapy):
A COG study of low-risk patients with stages 1, 2A, 2B, and 4S neuroblastoma enrolled 915 patients, 800 of whom were asymptomatic and treated with surgery alone followed by observation. The other patients received chemotherapy with or without surgery.[17]
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A COG study of low-risk patients with stages 1, 2A, 2B, and 4S neuroblastoma enrolled 915 patients, 800 of whom were asymptomatic and treated with surgery alone followed by observation. The other patients received chemotherapy with or without surgery.[17]
About 10% of patients developed progressive or recurrent tumors.
A COG study of low-risk patients with stages 1, 2A, 2B, and 4S neuroblastoma enrolled 915 patients, 800 of whom were asymptomatic and treated with surgery alone followed by observation. The other patients received chemotherapy with or without surgery.[17]
Most recurrences were treated during the study with surgery alone or moderate chemotherapy with or without surgery.
A COG study of low-risk patients with stages 1, 2A, 2B, and 4S neuroblastoma enrolled 915 patients, 800 of whom were asymptomatic and treated with surgery alone followed by observation. The other patients received chemotherapy with or without surgery.[17]
Most patients' disease was salvaged, as demonstrated by the EFS (89%) and OS (97%) rates at 5 years.
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Preserved source evidence · Not medical advice