{"entity":{"id":"paper-p9641-low-risk-neuroblastoma-strother-jco-2012","kind":"paper","name":"COG P9641: surgery alone or with restricted chemotherapy for low-risk neuroblastoma","aka":[],"tldr":"In the largest low-risk neuroblastoma trial, surgery alone cured almost all children with stage 1 and most with stage 2 disease, with chemotherapy reserved for symptoms or unfavourable features, confirming that many children need no drug treatment.","summary":"Children's Oncology Group phase 3 study of 915 children with low-risk neuroblastoma (stage 1, asymptomatic stage 2 and 4S with favourable biology) treated with surgery alone, with chemotherapy only for symptomatic, unresectable or progressive disease.\n\nFive-year event-free survival was 89 percent and overall survival 97 percent; outcomes were excellent for stage 1 and for stage 2 with favourable biology, and lower in stage 2 with unfavourable histology or diploidy in children over 18 months.","asOf":"2026-09-17","links":[{"label":"J Clin Oncol 2012","url":"https://doi.org/10.1200/JCO.2011.37.9990"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/22529259/"}],"tags":[],"related":[],"cancers":["neuroblastoma-low-risk"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["jco"],"dependsOn":[],"notes":[],"journal":"Journal of Clinical Oncology","year":2012,"doi":"10.1200/JCO.2011.37.9990","pmid":"22529259","authors":"Strother DR, London WB, Schmidt ML, et al.","paperType":"observational","findings":["Five-year overall survival 97 percent; event-free survival 89 percent.","Stage 1: event-free survival 93 percent with surgery alone."],"whatItMeans":"Surgery alone, or observation, is standard for low-risk neuroblastoma, with chemotherapy limited to those with symptoms or unfavourable biology.","caveats":["Non-randomised risk-adapted design."],"changedPractice":true,"participants":915},"route":"/key-papers/paper-p9641-low-risk-neuroblastoma-strother-jco-2012/","neighbours":{"cancer":[{"id":"neuroblastoma-low-risk","kind":"cancer","name":"Low-risk neuroblastoma (INRG very low and low risk, including stage MS)","route":"/cancers/neuroblastoma-low-risk/"}],"journal":[{"id":"jco","kind":"journal","name":"Journal of Clinical Oncology","route":"/journals/jco/"}]}}