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目的总结延期手术治疗小儿恶性肿瘤的临床疗效，探讨其对器官保存和长期生存的积极作用。方法应用延期手术治疗５２例（神经母细胞瘤２９例、肾母细胞瘤１１例、横纹肌肉瘤１２例）晚期恶性肿瘤，总结手术切除率、器官肢体保存率、长期生存率、组织病理和ＤＮＡ及细胞时相变化，并与７９例一期手术病例对照分析。结果延期手术的肿瘤切除率（９２．１％）明显高于一期手术组（６５．８％），而累及脏器切除率（３．８％）较一期手术组（１７．７％）明显减少。延期手术的２年生存率８３．２％，５年生存率５０％，与一期手术组（５６．９％和３７．２％）有显著差异。组织病理提示术前化疗使肿瘤细胞坏死、固缩，增殖活性下降。结论延期手术是小儿晚期恶性肿瘤治疗的有效手段，具有提高肿瘤切除率、保存器官肢体和争取长期生存的积极作用。
Objective To summarize the clinical efficacy of delayed surgery for the treatment of pediatric malignancy and to explore its positive effects on organ preservation and long-term survival. Methods 52 cases (29 cases of neuroblastoma, 11 cases of nephroblastoma, and 12 cases of rhabdomyosarcoma) advanced malignant tumor were treated with delayed operation. The surgical resection rate, organ limb preservation rate, long-term survival rate, histopathology and DNA were summarized. The cellular phase changes and was compared with 79 cases of primary surgery. Results The rate of tumor resection for delayed operation (92.1%) was significantly higher than that of the first-stage operation group (65.8%), and the rate of organ involvement resection (3.8%) was higher than that of the first-stage operation group (17.7%). obviously decrease. The 2-year survival rate of delayed surgery was 83.2%, and the 5-year survival rate was 50%, which was significantly different from that of the first-stage surgery group (56.9% and 37.2%). Histopathology suggested that preoperative chemotherapy necrosis, pyknosis, and proliferative activity of tumor cells. Conclusion Delayed surgery is an effective method for the treatment of advanced malignant tumors in children. It has the positive effect of increasing the rate of tumor resection, organ limb preservation and long-term survival.