Abstract: Objective: To summarize our data of surgical treatment, chemotherapy and radiotherapy for 48 cases of children with stage Ⅳ neuroblastoma, who with complete followed-up , further to investigate the effect of surgical treatment in the combined management for children with Ⅳ neuroblastoma. Methods: Form June 1995 to June 2009, 48 cases with stage Ⅳ neuroblastoma in our hospital were enrolled in this study, including 31 boys and 17 girls , who were divided into medium and high risk groups ( 10 and 38 cases for each group ) according to their age of onset. The comprehensive protocol included delayed tumor resection , intensive chemotherapy mainly composed of multiple cytotoxic drugs and local radiotherapy and so on. Results: After a follow-up ( range 2 to 110 months )，the 38 patients who underwent complete tumor resection ,had the median survival of 27.5 months. And the median survival of 10 patients who underwent partial tumor resection was 23.5 months. No significant difference was noted between them(P＞0.05). And we found no significant difference in the CR rate ,relapse rate and survival condition between two groups (P＞0.05). Conclusions: stage Ⅳ neuroblastoma should be taken combined therapy, including surgery, radiotherapy and chemotherapy , complete primary tumor resection has no significant effect on the CR rate and relapse rate and survival condition , thus the prognosis of patients with stage Ⅳ neuroblastoma undergoing surgical treatment depends on the effect of chemotherapeutics which inhibits the metastasis.

Key words: Neuroblastoma, Children, Surgical resection