Beyond image defined risk factors (IDRFs): a delphi survey highlighting definition of the surgical complexity index (SCI) in neuroblastoma

Expert surgeons developed a Surgical Complexity Index (SCI) to better stratify operative risk in neuroblastoma resection beyond traditional Image Defined Risk Factors. Through a three-round Delphi consensus, 25 weighted items were identified with scores ranging 0-29 points to guide preoperative decision-making between upfront resection versus biopsy.