Tumor, SolidAKA-NBLNCT06798532
Interest of Preoperative Arteriography to Identify the Adamkiewicz Artery Before Surgery for Basi-thoracic Neuroblastic Tumors
An observational study of Tumor, Solid and Neuroblastic Tumors, run by Assistance Publique - Hôpitaux de Paris at 27 sites in France.
Trial summary
Neuroblastic tumors (NBTs) develop from neural crest cells that give rise to the sympathetic nervous system. They include neuroblastomas, ganglioneuroblastomas, and ganglioneuromas. They represent approximately 10% of solid tumors in children under 15 years of age. Read more about this study
- Who is it for?
- Ages Up to 18 years
- Conditions the study is for
- Tumor, Solid, Neuroblastic Tumors, Neuroblastoma
- What is being tested?
- Collection of data from the patient's medical file.
- How many people
- 150 participants
- Where
- 27 sitesFrance
- Study dates
- Oct 2025to Apr 2026
- Phase
- Observational
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Up to 18 years
- All sexes
- No healthy volunteers
- Child, Adult
Study population: Patients undergoing surgery for a neuroblastic tumor in a pediatric surgery department in France between 2005 and 2024 and meeting the inclusion criteria.
Who may be able to join
- Patients undergoing surgery for a neuroblastic tumor (neuroblastoma, ganglioneuroblastoma, ganglioneuroma)
- Basithoracic location between T8 and L1
- With or without intraspinal component
- Treated in a pediatric surgery department in France
- Between 2005 and 2024
- Adult patients or holders of parental authority of minor patients informed and not opposed to the use of data for the study
Who cannot join
- 1. Post-operative follow-up of less than 6 months
Trial locations and contacts
27 sites in 1 country. Contact the study team or a site near you to ask about taking part.
27 sites in 1 country
France27 sites
CHU d'Amiens
Amiens, 80000
Xavier MD Delforge, 0033322087560, delforge.xavier@chu-amiens.fr
CHU de Besançon
Besançon, 25000
Yann MD Chaussy, 0033381219403, ychaussy@chu-besancon.fr
CHU de Bordeaux
Bordeaux, 33000
Frederic MD Lavrand, 0033557821948, frederic.lavrand@chu-bordeaux.fr
CHU de Brest
Brest, 29200
Philine MD, PhD de Vries, 0033298223926, philine.devries@chu-brest.fr
CHU de Lyon
Bron, 69677
Frédéric MD Hameury, 0033427869217, frederic.hameury@chu-lyon.fr
CHU de Caen
Caen, 14000
Jean-Baptiste MD Marret, 0033231064489, marret-jb@chru-caen.fr
CHU de Dijon
Dijon, 21079
Emmanuel MD, PhD Sapin, 0033380293415, emmanuel.sapin@chu-dijon.fr
CHU de Grenoble
Grenoble, 38000
Christian MD, PhD Piolat, 0033476765900, cpiolat@chu-grenoble.fr
Hôpital Bicêtre
Le Kremlin-Bicêtre, 94270
Florent MD, PhD Guérin, 0033145213191, florent.guerin@aphp.fr
CHU de Lille
Lille, 59000
Dyuti MD Sharma, 0033320444343, dyuti.sharma@chru-lille.fr
CHU de Limoges
Limoges, 87000
Quentin MD Ballouhey, 0033555058684, quentin.ballouhey@chu-limoges.fr
CHU de Marseille
Marseille, 13005
Anne MD Dariel, 0033491386682, anne.dariel@ap-hm.fr
CHU de Montpellier
Montpellier, 34090
Nicolas MD, PhD Kalfa, 0033467338784, nicolaskalfa@gmail.com
CHU de Nancy
Nancy, 54100
Ludovic MD Mansuy, 0033383598542, lu.mansuy@chru-nancy.fr
CHU Nantes
Nantes, 44000
Marc-David MD, PhD Leclair, 0033240083585, marcdavid.leclair@chu-nantes.fr
CHU Nice
Nice, 06200
Jean-François MD Lecompte, 0033492030316, lecompte.j@lenval.com
Hôpital Trousseau
Paris, 75012
Sabine MD, PhD Irtan, 0033144736302, sabine.irtan@aphp.fr
Hôpital Necker enfants malades
Paris, 75015
Marianna MD Cornet, 0033679699489, marianna.cornet@aphp.fr
Hôpital Robert Debré
Paris, 75019
Pascale MD Chomette, 0033186468216, pascale.philippe-chomette@aphp.fr
CHU de Poitiers
Poitiers, 86000
Aurelien MD, PhD Binet, 0033549444444, aurelien.binet@univ-poitiers.fr
CHU de Reims
Reims, 51100
Antoine MD Liné, 0033326787578, aline@chu-reims.fr
CHU de Rennes
Rennes, 35203 CEDEX 2
Alexis MD, PhD Arnaud, 0033299265930, alexis.arnaud@chu-rennes.fr
CHU de Rouen
Rouen, 76000
Agnès MD, PhD Liard-Zmuda, 0033232888990, agnes.liard-zmuda@chu-rouen.fr
CHU de La Réunion
Saint-Denis, 97405
Jean-Luc MD Michel, 00262262905490, jean-luc.michel@chu-reunion.fr
CHU de Strasbourg
Strasbourg, 671091
Sarah MD Jannier, 0033388128097, sarah.jannier@chru-strasbourg.fr
CHU de Toulouse
Toulouse, 31059 cedex 9
Olivier MD, PhD Abbo, 0033534558516, abbo.o@chu-toulouse.fr
CHU de Tours
Tours, 37000
Hubert MD, PhD Lardy, 0033247473820, hubert.lardy@univ-tours.fr
About this study
Neuroblastic tumors (NBTs) develop from neural crest cells that give rise to the sympathetic nervous system. They include neuroblastomas, ganglioneuroblastomas, and ganglioneuromas. They represent approximately 10% of solid tumors in children under 15 years of age. In 15 to 20% of cases, NBTs are located in the thoracic region. These paravertebral tumors have an extracanal component and some also have an intraspinal component (dumbbell tumors) that can cause spinal cord compression. Surgery for these tumors also exposes the patient to neurological complications. In the thorax, the basi-thoracic location (T9-T12) may be particularly at risk due to the presence of the artery of Adamkiewicz (AKA), which supplies blood to the spinal cord; damage to this artery can result in spinal cord ischemia. To avoid this scenario, some teams recommend performing spinal cord arteriography to identify AKA. However, many centers do not perform arteriography and do not report more postoperative complications.
Currently, there is no consensus on the indications for performing preoperative spinal arteriography in patients undergoing surgery for basi-thoracic NBT.
This study evaluates the practice in France of preoperative arteriography to identify the AKA among patients undergoing surgery for basi-thoracic neuroblastic tumors and analyzes the incidence of postoperative neurological complications in these patients.
Read the detailed description
Neuroblastic tumors (NBTs) develop from neural crest cells that give rise to the sympathetic nervous system. They include neuroblastomas, ganglioneuroblastomas, and ganglioneuromas. They represent approximately 10% of solid tumors in children under 15 years of age. In 15 to 20% of cases, NBTs are located in the thoracic region. These paravertebral tumors have an extracanal component and some also have an intraspinal component (dumbbell tumors) that can cause spinal cord compression. Surgery for these tumors also exposes the patient to neurological complications. In the thorax, the basi-thoracic location (T9-T12) may be particularly at risk due to the presence of the artery of Adamkiewicz (AKA), which supplies blood to the spinal cord; damage to this artery can result in spinal cord ischemia. To avoid this scenario, some teams recommend performing spinal cord arteriography to identify AKA. However, many centers do not perform arteriography and do not report more postoperative complications.
Currently, there is no consensus on the indications for performing preoperative spinal arteriography in patients undergoing surgery for basi-thoracic NBT.
This study evaluates the practice in France of preoperative arteriography to identify the AKA among patients undergoing surgery for basi-thoracic neuroblastic tumors and analyzes the incidence of postoperative neurological complications in these patients.
It seems that in France, unlike other European sites, there is no systematic search for the artery of Adamkiewicz before surgery for neuroblastic tumors in most pediatric surgery departments. It does not seem that this is responsible for postoperative neurological complications but this assessment has never been performed.
The hypothesis of the study is that the neurological complications observed postoperatively are due to nerve root surgery or to spinal cord injury by direct trauma through the foramens, but not to spinal cord ischemia.
- Conditions
- Tumor, Solid, Neuroblastic Tumors, Neuroblastoma
- Being tested
- Collection of data from the patient's medical file.
- Keywords
- Neuroblastic tumors, Neuroblastomas, Ganglioneuroblastomas, Ganglioneuromas, Adamkiewicz Artery, Pediatric surgery
- Medical subject headings
- Neoplasms, Neuroblastoma, Ganglioneuroblastoma, Ganglioneuroma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Collection of data from the patient's medical file.Other
Collection of data from the patient's medical file.
| Study group | Role | What they receive |
|---|---|---|
| Pediatric patients | Patients undergoing surgery for a neuroblastic tumor (neuroblastoma, ganglioneuroblastoma) with basi-thoracic location between T8 and L1, with or without intraspinal component and treated in a pediatric surgery department in France between 2005 and 2024. Receives: Other: Collection of data from the patient's medical file. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Occurrence of neurological complications secondary to spinal cord ischemia
Assessment of postoperative neurological complications in patients undergoing surgery for basi-thoracic NBT, with or without preoperative spinal cord arteriography.
Measured: 2005 to 2024
Secondary outcomes (2)
Demographic characteristics of patients undergoing surgery for basithoracic neuroblastic tumor
Describe the demographic characteristics of patients undergoing surgery for basithoracic neuroblastic tumor.
Measured: 2005 to 2024
Outcome of patients undergoing surgery for basithoracic neuroblastic tumor
Describe the overall survival and recurrence-free survival.
Measured: 2005 to 2024
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Jan 2025
- Study startOct 2025 (estimated)
- Primary completionApr 2026 (estimated)
- Study completionApr 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (7)Papers the sponsor has linked to this study.
- Other trials for Tumor, SolidStudies of the same condition, open and under way.
- More trials run by Assistance Publique - Hôpitaux de ParisThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Case only
- Time perspective
- Retrospective
- Enrolment
- 150 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Assistance Publique - Hôpitaux de Paris
- Sponsor type
- University, hospital or other
- Collaborators
- URC-CIC Paris Descartes Necker Cochin
- Responsible party
- Sponsor
- Investigators
- Marianna MD Cornet, Principal investigator, Assistance Publique - Hôpitaux de ParisSabine MD, PhD Sarnacki, Principal investigator, Assistance Publique - Hôpitaux de Paris
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06798532
- Sponsor's protocol ID
- APHP241337
- Acronym
- AKA-NBL
- Status last verified
- Sep 2025
- First submitted
- 17 Jan 2025
- Last updated
- 12 Sep 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Lindeire S, Hauser JM. Anatomy, Back, Artery of Adamkiewicz. 2025 Mar 25. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK532971/
PubMed 30422566Nordin AB, Fallon SC, Jea A, Kim ES. The use of spinal angiography in the management of posterior mediastinal tumors: case series and review of the literature. J Pediatr Surg. 2013 Sep;48(9):1871-7. doi: 10.1016/j.jpedsurg.2013.04.029.
PubMed 24074660Schmidt A, Hempel JM, Ellerkamp V, Warmann SW, Ernemann U, Fuchs J. The Relevance of Preoperative Identification of the Adamkiewicz Artery in Posterior Mediastinal Pediatric Tumors. Ann Surg Oncol. 2022 Jan;29(1):493-499. doi: 10.1245/s10434-021-10381-8. Epub 2021 Jul 31.
PubMed 34331163Bosmia AN, Hogan E, Loukas M, Tubbs RS, Cohen-Gadol AA. Blood supply to the human spinal cord: part I. Anatomy and hemodynamics. Clin Anat. 2015 Jan;28(1):52-64. doi: 10.1002/ca.22281. Epub 2013 Jun 27.
PubMed 23813725De Bernardi B, Gambini C, Haupt R, Granata C, Rizzo A, Conte M, Tonini GP, Bianchi M, Giuliano M, Luksch R, Prete A, Viscardi E, Garaventa A, Sementa AR, Bruzzi P, Angelini P. Retrospective study of childhood ganglioneuroma. J Clin Oncol. 2008 Apr 1;26(10):1710-6. doi: 10.1200/JCO.2006.08.8799.
PubMed 18375900Furak J, Geczi T, Tiszlavicz L, Lazar G. Postoperative paraplegia after resection of a giant posterior mediastinal tumour. Importance of the blood supply in the upper spinal cord. Interact Cardiovasc Thorac Surg. 2011 May;12(5):855-6. doi: 10.1510/icvts.2010.257105. Epub 2011 Feb 8.
PubMed 21303870Boglino C, Martins AG, Ciprandi G, Sousinha M, Inserra A. Spinal cord vascular injuries following surgery of advanced thoracic neuroblastoma: an unusual catastrophic complication. Med Pediatr Oncol. 1999 May;32(5):349-52. doi: 10.1002/(sici)1096-911x(199905)32:53.0.co;2-p.
PubMed 10219336