Surgery in Treating Children With Neuroblastoma

DISEASE CHARACTERISTICS:

• Histologically proven low-risk neuroblastoma (excluding ganglioneuroma)

  • International Neuroblastoma Staging System (INSS) stage 1 in all patients
  • INSS stage 2A or 2B in patients less than 365 days of age
  • INSS stage 2A or 2B tumor with nonamplified MYCN with any Shimada histology in patients ages 1 to 20 years
  • INSS stage 2A or 2B tumor with amplified MYCN with Shimada favorable histology in patients ages 1 to 20 years
  • INSS stage 4S tumors with nonamplified MYCN, Shimada favorable histology, and a DNA index not equal to 1 in patients less than 365 days of age

• Immediate chemotherapy allowed prior to biopsy for patients with intradural extension and/or emergent paresis if biopsy performed within 96 hours

  • Must have no abnormal organ function unless due to neuroblastoma
• Concurrent registration on companion biology study (protocol COG-ANBL00B1) or its successor

PATIENT CHARACTERISTICS:

Age:

• Under 21

Performance status:

• Not specified

Life expectancy:

• Not specified

Hematopoietic:

• Not specified

Hepatic:

• Bilirubin less than 1.5 times normal
• SGOT or SGPT less than 2.5 times normal

Renal:

• Creatinine less than 1.5 times normal

Cardiovascular:

• Shortening fraction greater than 27% by echocardiogram OR
• Ejection fraction greater than 47% by radionuclide angiogram

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• No prior immunotherapy

Chemotherapy:

• See Disease Characteristics

Endocrine therapy:

• No prior hormonal therapy

Radiotherapy:

• No prior radiotherapy

Surgery:

• Prior surgery allowed

Other:

• No other prior therapy