Abstract
Neuroblastoma is a heterogeneous cancer; tumors can spontaneously regress or mature or display an aggressive, malignant phenotype. Clinical factors, including age and stage at diagnosis, and biologic factors, including amplification of the MYCN proto-oncogene and tumor histopathology, predictive of outcome, have been identified. This has allowed for the risk-based adjustment of therapy intensity, lessening intensity for children with low-risk disease to avoid long-term therapy toxicity and increasing intensity for those with high-risk disease to increase the likelihood of cure. This risk of disease relapse should be considered when determining the extent and aggressiveness to which surgical removal of a primary tumor and locoregional disease, if present, should be attempted, given that there is a high incidence of complications associated with neuroblastoma resection, many of which are significant. This is due, in large part, to the fact that neuroblastoma often infiltrates organs and surrounds critical vessels and nerves. More recently, image-defined risk factors have been identified that are associated with a greater risk of complications and a lower rate of complete tumor resection. Understanding these image-defined risk factors can help surgeons in their preoperative planning and discussions with families about potential complications associated with neuroblastoma surgery. These complications associated with the surgical management of children with neuroblastoma are discussed in this chapter.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Bhakta N, Liu Q, Ness KK, Baassiri M, Eissa H, Yeo F, Chemaitilly W, Ehrhardt MJ, Bass J, Bishop MW, et al. The cumulative burden of surviving childhood cancer: an initial report from the St Jude Lifetime Cohort Study (SJLIFE). Lancet. 2017;390(10112):2569–82.
Kuroda T, Saeki M, Honna T, Kumagai M, Masaki H. Late complications after surgery in patients with neuroblastoma. J Pediatr Surg. 2006;41(12):2037–40.
Ziegler MM. Pediatric surgical oncology. Curr Opin Pediatr. 1990;2(3):579–84.
von Allmen D, Davidoff AM, London WB, Ryn CV, Haas-Kogan DA, Kreissman SG, Khanna G, Rosen N, Park JR, Quaglia MPL. Impact of extent of resection on local control and survival in patients from the COG A3973 study with high-risk neuroblastoma. J Clin Oncol. 2017;35(2):208–16.
Canete A, Jovani C, Lopez A, Costa E, Segarra V, Fernandez JM, Verdeguer A, Velazquez J, Castel V. Surgical treatment for neuroblastoma: complications during 15 years’ experience. J Pediatr Surg. 1998;33(10):1526–30.
Azizkhan RG, Shaw A, Chandler JG. Surgical complications of neuroblastoma resection. Surgery. 1985;97(5):514–7.
Losty P, Quinn F, Breatnach F, O’Meara A, Fitzgerald RJ. Neuroblastoma—a surgical perspective. Eur J Surg Oncol. 1993;19(1):33–6.
Kiely EM. Radical surgery for abdominal neuroblastoma. Semin Surg Oncol. 1993;9(6):489–92.
Rich BS, McEvoy MP, Kelly NE, Oh E, Abramson SJ, Price AP, Cheung NK, La Quaglia MP. Resectability and operative morbidity after chemotherapy in neuroblastoma patients with encasement of major visceral arteries. J Pediatr Surg. 2011;46(1):103–7.
Cantos MF, Gerstle JT, Irwin MS, Pappo A, Farley S, Cheang T, Kim PC. Surgical challenges associated with intensive treatment protocols for high-risk neuroblastoma. J Pediatr Surg. 2006;41(5):960–5.
Davidoff AM. Neuroblastoma. Semin Pediatr Surg. 2012;21(1):2–14.
Schmidt ML, Lukens JN, Seeger RC, Brodeur GM, Shimada H, Gerbing RB, Stram DO, Perez C, Haase GM, Matthay KK. Biologic factors determine prognosis in infants with stage IV neuroblastoma: a prospective Children’s Cancer Group study. J Clin Oncol. 2000;18(6):1260–8.
Cecchetto G, Mosseri V, De Bernardi B, Helardot P, Monclair T, Costa E, Horcher E, Neuenschwander S, Toma P, Rizzo A, et al. Surgical risk factors in primary surgery for localized neuroblastoma: the LNESG1 study of the European International Society of Pediatric Oncology Neuroblastoma Group. J Clin Oncol. 2005;23(33):8483–9.
Jackson JR, Tran HC, Stein JE, Shimada H, Patel AM, Marachelian A, Kim ES. The clinical management and outcomes of cervical neuroblastic tumors. J Surg Res. 2016;204(1):109–13.
Qureshi SS, Kembhavi S, Ramadwar M, Chinnaswamy G, Laskar S, Talole S, Desai S, Khanna N, Vora T, Kurkure P. Outcome and morbidity of surgical resection of primary cervical and cervicothoracic neuroblastoma in children: a comparative analysis. Pediatr Surg Int. 2014;30(3):267–73.
Paran TS, Corbally MT, Gross-Rom E, Rutigliano DN, Kayton ML, La Quaglia MP. Experience with aortic grafting during excision of large abdominal neuroblastomas in children. J Pediatr Surg. 2008;43(2):335–40.
Katzenstein HM, Kent PM, London WB, Cohn SL. Treatment and outcome of 83 children with intraspinal neuroblastoma: the Pediatric Oncology Group experience. J Clin Oncol. 2001;19(4):1047–55.
Nordin 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;48(9):1871–7.
Kiely EM. The surgical challenge of neuroblastoma. J Pediatr Surg. 1994;29(2):128–33.
Lim II, Goldman DA, Farber BA, Murphy JM, Abramson SJ, Basu E, Roberts S, LaQuaglia MP, Price AP. Image-defined risk factors for nephrectomy in patients undergoing neuroblastoma resection. J Pediatr Surg. 2016;51(6):975–80.
Fusaro F, Cecchetto G, Boglino C, Inserra A, Zanon GF, Giusti F, Dall’Igna P. Measures to prevent renal impairment after resection of retroperitoneal neuroblastoma. Pediatr Surg Int. 2002;18(5–6):388–91.
Dickson PV, Sims TL, Streck CJ, McCarville MB, Santana VM, McGregor LM, Furman WL, Davidoff AM. Avoiding misdiagnosing neuroblastoma as Wilms tumor. J Pediatr Surg. 2008;43(6):1159–63.
Qureshi SS, Rent EG, Bhagat M, Dsouza P, Kembhavi S, Vora T, Prasad M, Chinnaswamy G, Ramadwar M, Laskar S, et al. Chyle leak following surgery for abdominal neuroblastoma. J Pediatr Surg. 2016;51(9):1557–60.
Liu Y, Pan C, Tang JY, Chen J, Zhou M, Ye QD. What is the result: chylous leakage following extensive radical surgery of neuroblastoma. World J Pediatr. 2012;8(2):151–5.
Rees H, Markley MA, Kiely EM, Pierro A, Pritchard J. Diarrhea after resection of advanced abdominal neuroblastoma: a common management problem. Surgery. 1998;123(5):568–72.
Ein SH, Ferguson JM. Intussusception—the forgotten postoperative obstruction. Arch Dis Child. 1982;57(10):788–90.
Holcomb GW 3rd, Ross AJ 3rd, O’Neill JA Jr. Postoperative intussusception: increasing frequency or increasing awareness? South Med J. 1991;84(11):1334–9.
Pumberger W, Pomberger G, Wiesbauer P. Postoperative intussusception: an overlooked complication in pediatric surgical oncology. Med Pediatr Oncol. 2002;38(3):208–10.
Kaste SC, Wilimas J, Rao BN. Postoperative small-bowel intussusception in children with cancer. Pediatr Radiol. 1995;25(1):21–3.
VanHouwelingen LT, Seims AD, Ortega-Laureano L, Coleman JL, McCarville MB, Davidoff AM, Fernandez-Pineda I. Use of ultrasound in diagnosing postoperative small-bowel intussusception in pediatric surgical oncology patients: a single-center retrospective review. Pediatr Radiol. 2017;48(2):204–9.
Yang G, Wang X, Jiang W, Ma J, Zhao J, Liu W. Postoperative intussusceptions in children and infants: a systematic review. Pediatr Surg Int. 2013;29(12):1273–9.
Madenci AL, Fisher S, Diller LR, Goldsby RE, Leisenring WM, Oeffinger KC, Robison LL, Sklar CA, Stovall M, Weathers RE, et al. Intestinal obstruction in survivors of childhood cancer: a report from the childhood cancer survivor study. J Clin Oncol. 2015;33(26):2893–900.
Barrena S, Miguel M, de la Torre CA, Ramirez M, Diaz M, Martinez L, Perez-Grueso FS, Lassaletta L, Tovar JA. Late surgery for spinal deformities in children previously treated for neural tumors. Eur J Pediatr Surg. 2011;21(1):54–7.
Paulino AC, Fowler BZ. Risk factors for scoliosis in children with neuroblastoma. Int J Radiat Oncol Biol Phys. 2005;61(3):865–9.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Davidoff, A.M. (2020). Complications of the Surgical Management of Children with Neuroblastoma. In: Sarnacki, S., Pio, L. (eds) Neuroblastoma. Springer, Cham. https://doi.org/10.1007/978-3-030-18396-7_21
Download citation
DOI: https://doi.org/10.1007/978-3-030-18396-7_21
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-18395-0
Online ISBN: 978-3-030-18396-7
eBook Packages: MedicineMedicine (R0)