ANBL00P2: expectant observation as primary therapy for neuroblastoma in young infants
Small adrenal masses found in infants under six months could safely be watched rather than operated on: nearly half shrank or disappeared and the rest were removed later without any child dying of neuroblastoma.
Overview
Children's Oncology Group prospective study of 87 infants under six months with small (under 3.1 cm solid or 5 cm cystic) adrenal masses managed by observation with serial ultrasound and urinary catecholamines, with surgery for growth or progression.
Eighty-one percent avoided surgery; among those observed, 45 percent had complete or partial spontaneous resolution, and three-year event-free and overall survival were 97.7 and 100 percent.
- Surgery avoided in 81 percent of infants.
- Three-year overall survival 100 percent.
Observation without biopsy is standard for small adrenal masses in young infants, sparing them surgery for tumours that often regress.
- Applies only to small localised masses in infants under six months with defined imaging criteria.