Neuroblastoma Surgery in Children

Procedure, Treatment Process, Recovery, and Survival Rates

Neuroblastoma surgery is a critical component of treatment for children diagnosed with neuroblastoma, one of the most common solid tumors in early childhood. This cancer develops from immature nerve cells, typically forming in the adrenal glands or along the sympathetic nervous system.

Surgery aims to remove as much of the tumor as safely possible while protecting nearby organs and vital structures. In many cases, surgical treatment is combined with chemotherapy, radiation therapy, immunotherapy, or stem cell transplantation to improve outcomes.

Advances in pediatric oncology surgery have significantly improved survival rates and long-term outcomes for children with neuroblastoma.

What Is Neuroblastoma?

Neuroblastoma is a cancer that develops from immature nerve cells called neuroblasts. It most often occurs in infants and young children, usually under the age of five.

The tumor commonly develops in:

• The adrenal glands above the kidneys

• The abdomen

• The chest

• The spine

• The pelvis

According to the American Cancer Society, neuroblastoma accounts for about 6–8% of all childhood cancers but represents a significant portion of pediatric cancer deaths due to its aggressive nature in high-risk cases.

When Is Neuroblastoma Surgery Needed?

Surgery is often an essential step in neuroblastoma treatment.

Doctors may recommend surgical removal of the tumor when:

• The tumor is localized or partially removable

• Chemotherapy has reduced the tumor size

• Surgery can significantly decrease tumor burden

• The tumor is causing symptoms or pressure on nearby organs

Treatment decisions are made by a multidisciplinary pediatric oncology team, including pediatric surgeons, oncologists, radiologists, and pathologists.

Neuroblastoma Surgery Procedure

The surgical approach depends on the tumor's size, location, and whether it has spread.

1. Preoperative evaluation

Before surgery, doctors perform extensive diagnostic tests such as:

• MRI scans

• CT scans

• MIBG scans

• Blood and urine tests

• Bone marrow evaluation

These tests help determine the stage of the disease and the safest surgical plan.

2. Chemotherapy before surgery

In many cases, children receive chemotherapy before surgery to shrink the tumor. This makes the tumor easier and safer to remove.

This stage is known as neoadjuvant therapy.

3. Tumor removal surgery

During the operation, pediatric surgeons attempt to remove as much of the tumor as possible.

The procedure may involve:

• Open abdominal or thoracic surgery

• Careful separation of the tumor from nearby blood vessels

• Removal of surrounding lymph nodes if necessary

Because neuroblastoma tumors often grow near major blood vessels, surgeons must carefully balance maximal tumor removal with preservation of vital structures.

4. Pathological examination

After surgery, the tumor tissue is analyzed in a laboratory to determine:

• Tumor biology

• Genetic markers

• Treatment response

This information helps doctors decide whether additional therapies are required.

Recovery After Neuroblastoma Surgery

Recovery time varies depending on the complexity of the surgery and the child’s overall health.

Hospital stay

Children typically stay in the hospital for 5 to 10 days after surgery.

Postoperative care

Recovery includes:

• Pain management

• Monitoring for complications

• Nutritional support

• Gradual return to normal activity

Most children can resume daily activities within several weeks, although additional cancer treatments may continue.

Risks and Possible Complications

Although neuroblastoma surgery is often necessary, it is a complex procedure due to the tumor’s proximity to critical structures.

Possible risks include:

• Bleeding

• Infection

• Injury to nearby organs or nerves

• Incomplete tumor removal

• Postoperative complications

However, surgery performed at specialized pediatric oncology centers significantly reduces these risks.

Studies published in The Journal of Clinical Oncology show that combining surgery with chemotherapy and immunotherapy has greatly improved survival in high-risk neuroblastoma patients.

Neuroblastoma Survival Rates

Survival rates depend on several factors:

• Age of the child

• Tumor stage

• Genetic features of the tumor

• Response to treatment

Children with low-risk neuroblastoma often have survival rates above 90%.

For high-risk neuroblastoma, modern multimodal treatments including surgery, chemotherapy, stem cell transplant, and immunotherapy have significantly improved outcomes over the past two decades.

Life After Neuroblastoma Treatment

Many children successfully treated for neuroblastoma go on to live healthy and active lives.

Long-term follow-up focuses on:

• Monitoring for cancer recurrence

• Managing possible treatment side effects

• Supporting growth and development

• Psychological and emotional support

Regular medical follow-ups are essential to ensure the child’s long-term health.

Procedures in Pediatric Hematology & Oncology

Bone marrow transplant (BMT), stem cell transplantation, pediatric tumor resection surgery, neuroblastoma surgery, Wilms tumor surgery, pediatric brain tumor surgery, pediatric solid tumor surgery, lymph node biopsy, central venous catheter (port) placement, splenectomy, liver tumor surgery in children, soft tissue sarcoma surgery.