# High-risk Neuroblastoma — GCMD Library living collection Everything in the library about high-risk neuroblastoma — built automatically from dossiers that name it. Updated: n/a · 4 episodes · 80 cited statements ## Episodes ### Surgical Management - [Neuroblastoma: Update Course 2016](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434) — video · 25:42 · [machine version](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434.md) - [Neuroblastoma: Update Course 2014](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651) — video · 25:59 · [machine version](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651.md) ### Complications - [Pancreas, Muscle, and Subcutaneous Fat Atrophy in Patients Undergoing Radiation for Neuroblastoma](https://library.globalcastmd.com/watch/pancreas-muscle-and-subcutaneous-fat-atrophy-in-patients-undergoing-radiation-for-neuroblastoma-11866) — video · 1:10 · [machine version](https://library.globalcastmd.com/watch/pancreas-muscle-and-subcutaneous-fat-atrophy-in-patients-undergoing-radiation-for-neuroblastoma-11866.md) ### Evidence & Research - [Dr. Yujie Ma - Best of the Best in Pediatric Surgery 2025](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036) — video · 8:08 · [machine version](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036.md) ## Chapters - [0:00](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=0) Case presentation and initial surgical approach (Ep 1) - [3:29](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=209) Surgical technique and timing of resection (Ep 1) - [8:17](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=497) Evidence for aggressive resection in stage 3 versus stage 4 disease (Ep 1) - [12:40](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=760) German study results: no benefit from aggressive resection (Ep 1) - [17:49](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1069) European SIOPEN study: survival benefit demonstrated (Ep 1) - [20:29](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1229) COG 3973 study results and chemotherapy response correlation (Ep 1) - [22:05](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1325) Technical considerations: referral patterns, nephrectomy, and recurrent disease (Ep 1) - [0:00](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=0) Case presentation and initial surgical approach discussion (Ep 2) - [3:46](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=226) Surgical technique and timing of resection (Ep 2) - [6:47](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=407) Discordance between surgical assessment and radiographic findings (Ep 2) - [8:25](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=505) Approach to metastatic disease and surgical morbidity (Ep 2) - [13:25](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=805) German study results: no survival benefit from aggressive resection (Ep 2) - [18:11](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1091) European study results: survival benefit demonstrated (Ep 2) - [20:34](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1234) COG 3973 study results and interpretation (Ep 2) - [22:21](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1341) Technical expertise requirements and organ preservation (Ep 2) - [0:00](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=0) Introduction (Ep 3) - [0:30](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=30) Background and Mechanism (Ep 3) - [2:54](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=174) Clinical Relevance and Functional Studies (Ep 3) - [4:42](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=282) Conclusions (Ep 3) - [5:24](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=324) Discussion with Dr. Erin Brown (Ep 3) - [0:00](https://library.globalcastmd.com/watch/pancreas-muscle-and-subcutaneous-fat-atrophy-in-patients-undergoing-radiation-for-neuroblastoma-11866?t=0) Introduction and Study Context (Ep 4) - [0:13](https://library.globalcastmd.com/watch/pancreas-muscle-and-subcutaneous-fat-atrophy-in-patients-undergoing-radiation-for-neuroblastoma-11866?t=13) Study Design and Pancreatic Findings (Ep 4) - [0:43](https://library.globalcastmd.com/watch/pancreas-muscle-and-subcutaneous-fat-atrophy-in-patients-undergoing-radiation-for-neuroblastoma-11866?t=43) Body Composition Changes and Clinical Implications (Ep 4) ## Statements Every statement is attributed, typed, and timestamped; the link is the citation. - "Radiation improves survival in high-risk neuroblastoma" — Sophia Schermerhorn (clinical) [Ep 4 · 0:00](https://library.globalcastmd.com/watch/pancreas-muscle-and-subcutaneous-fat-atrophy-in-patients-undergoing-radiation-for-neuroblastoma-11866?t=0) - "This is a retrospective study of 50 children with high-risk neuroblastoma undergoing abdominal radiation therapy" — Sophia Schermerhorn (clinical) [Ep 4 · 0:13](https://library.globalcastmd.com/watch/pancreas-muscle-and-subcutaneous-fat-atrophy-in-patients-undergoing-radiation-for-neuroblastoma-11866?t=13) - "The authors use CT and MRI body segmentation to measure pancreatic volume, subcutaneous fat, and muscle area before and after treatment" — Sophia Schermerhorn (clinical) [Ep 4 · 0:19](https://library.globalcastmd.com/watch/pancreas-muscle-and-subcutaneous-fat-atrophy-in-patients-undergoing-radiation-for-neuroblastoma-11866?t=19) - "There was a significant decrease in pancreatic volume after radiation" — Sophia Schermerhorn (clinical) [Ep 4 · 0:27](https://library.globalcastmd.com/watch/pancreas-muscle-and-subcutaneous-fat-atrophy-in-patients-undergoing-radiation-for-neuroblastoma-11866?t=27) - "Very few patients developed clinically apparent pancreatic insufficiency" — Sophia Schermerhorn (clinical) [Ep 4 · 0:31](https://library.globalcastmd.com/watch/pancreas-muscle-and-subcutaneous-fat-atrophy-in-patients-undergoing-radiation-for-neuroblastoma-11866?t=31) - "Pancreatic insufficiency wasn't systematically screened for in this study" — Sophia Schermerhorn (clinical) [Ep 4 · 0:31](https://library.globalcastmd.com/watch/pancreas-muscle-and-subcutaneous-fat-atrophy-in-patients-undergoing-radiation-for-neuroblastoma-11866?t=31) - "Follow-up may not be long enough to detect pancreatic effects, especially given the young average age of these patients" — Sophia Schermerhorn (opinion) [Ep 4 · 0:31](https://library.globalcastmd.com/watch/pancreas-muscle-and-subcutaneous-fat-atrophy-in-patients-undergoing-radiation-for-neuroblastoma-11866?t=31) - "Pancreatic dysfunction could be an under-recognized late effect" — Sophia Schermerhorn (opinion) [Ep 4 · 0:43](https://library.globalcastmd.com/watch/pancreas-muscle-and-subcutaneous-fat-atrophy-in-patients-undergoing-radiation-for-neuroblastoma-11866?t=43) - "Patients had a significant drop in weight percentile with smaller decreases in fat and muscle" — Sophia Schermerhorn (clinical) [Ep 4 · 0:48](https://library.globalcastmd.com/watch/pancreas-muscle-and-subcutaneous-fat-atrophy-in-patients-undergoing-radiation-for-neuroblastoma-11866?t=48) - "Body composition changes likely reflect the overall impact of cancer therapy overall rather than radiation alone" — Sophia Schermerhorn (opinion) [Ep 4 · 0:48](https://library.globalcastmd.com/watch/pancreas-muscle-and-subcutaneous-fat-atrophy-in-patients-undergoing-radiation-for-neuroblastoma-11866?t=48) - "These findings highlight the importance of nutritional screening during cancer treatments" — Sophia Schermerhorn (opinion) [Ep 4 · 0:48](https://library.globalcastmd.com/watch/pancreas-muscle-and-subcutaneous-fat-atrophy-in-patients-undergoing-radiation-for-neuroblastoma-11866?t=48) - "As survival improves, understanding and screening for long-term effects is becoming just as important as curing the cancer itself" — Sophia Schermerhorn (opinion) [Ep 4 · 1:03](https://library.globalcastmd.com/watch/pancreas-muscle-and-subcutaneous-fat-atrophy-in-patients-undergoing-radiation-for-neuroblastoma-11866?t=63) - "Survival rate for high-risk neuroblastoma patients is in the 38 to 40% range" — Daniel von Allmen (epidemiological) [Ep 2 · 0:42](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=42) - "Surgeon-reported degree of resection showed only 66% concordance with radiologist assessment of postoperative imaging in tandem transplant pilot study" — Daniel von Allmen (clinical) [Ep 2 · 6:52](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=412) - "Repeat study in recent COG high-risk trial showed same 66% concordance rate between surgeon op notes and postoperative imaging, with surgeons underestimating and radiologists overcalling resection completeness" — Daniel von Allmen (clinical) [Ep 2 · 7:33](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=453) - "Memorial Sloan Kettering data suggests biggest volume response of neuroblastoma tumor occurs with first two cycles of chemotherapy, with very little response after that" — Daniel von Allmen (host_summary) [Ep 2 · 10:00](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=600) - "More chemotherapy or other agents like MIBG may make tumor more fibrotic and make subadventitial dissection more difficult" — Daniel von Allmen (opinion) [Ep 2 · 10:17](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=617) - "Complication rate for aggressive neuroblastoma resection is approximately 30% morbidity with mortality less than 1%" — Daniel von Allmen (epidemiological) [Ep 2 · 13:07](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=787) - "Riley Hospital study showed only survivors with stage 4 neuroblastoma were those who had primary tumor resection" (clinical) [Ep 2 · 14:07](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=847) - "Sloan Kettering study suggests stage 4 neuroblastoma patients do better with primary tumor resection" (host_summary) [Ep 2 · 14:27](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=867) - "Kylie's study showed no difference in survival based on completeness of neuroblastoma resection" (host_summary) [Ep 2 · 14:33](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=873) - "European studies show no difference in survival based on completeness of neuroblastoma resection" (host_summary) [Ep 2 · 14:35](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=875) - "Most recent COG study shows probably no difference in survival based on completeness of neuroblastoma resection" (host_summary) [Ep 2 · 14:35](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=875) - "High-risk neuroblastoma patients receive 9 different drugs, bone marrow transplantation, and some receive total body radiation" (clinical) [Ep 2 · 14:55](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=895) - "High-risk neuroblastoma treatment includes tandem peripheral blood stem cell transplants, with second transplant given as soon as patient recovers from first, followed by immunotherapy and Retin-A" — Daniel von Allmen (clinical) [Ep 2 · 15:10](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=910) - "High-risk neuroblastoma survival increased from 10% to 30-40% with treatment intensification" (epidemiological) [Ep 2 · 16:01](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=961) - "Georgia study showed 46% survival in high-risk neuroblastoma with transplantation plus immunotherapy plus differentiating agents" (host_summary) [Ep 2 · 16:22](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=982) - "Many deaths in intensified high-risk neuroblastoma treatment were due to the treatment itself rather than cancer" (host_summary) [Ep 2 · 16:22](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=982) - "German study of 278 stage 4 high-risk neuroblastoma patients achieved complete resection in almost half and >90% resection in another quarter (75% total with >90% resection)" — Daniel von Allmen (host_summary) [Ep 2 · 16:48](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1008) - "German study showed overall survival 45%, event-free survival 33%, and local progression-free survival 58% in stage 4 neuroblastoma" — Daniel von Allmen (host_summary) [Ep 2 · 17:13](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1033) - "German study showed no difference in overall survival, event-free survival, or local progression-free survival based on completeness of resection in stage 4 neuroblastoma" — Daniel von Allmen (host_summary) [Ep 2 · 17:32](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1052) - "German study concluded aggressive surgery is not justified in stage 4 neuroblastoma, that limited operations decrease complications, and there is limited impact on patient outcome" — Daniel von Allmen (host_summary) [Ep 2 · 17:51](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1071) - "European study included 1,324 high-risk neuroblastoma patients (stages 2, 3, and 4) and achieved 76% with >95% resection" — Daniel von Allmen (host_summary) [Ep 2 · 18:14](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1094) - "European neuroblastoma study showed 0.5% mortality and 10% morbidity (30% including lesser complications)" — Daniel von Allmen (host_summary) [Ep 2 · 19:02](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1142) - "European study showed significant improvement in event-free survival and overall survival with aggressive resection in high-risk neuroblastoma - first study to show overall survival benefit" — Daniel von Allmen (host_summary) [Ep 2 · 19:17](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1157) - "European study concluded >95% resection results in improvement in event-free survival in high-risk neuroblastoma" — Daniel von Allmen (host_summary) [Ep 2 · 20:17](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1217) - "COG 3973 study of approximately 230 high-risk neuroblastoma patients showed significant improvement in local relapse-free survival and event-free survival but not overall survival" — Daniel von Allmen (host_summary) [Ep 2 · 21:24](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1284) - "COG 3973 study's inability to demonstrate overall survival benefit may be type 2 error due to smaller sample size (230 vs 1,300 patients in European study)" — Daniel von Allmen (opinion) [Ep 2 · 21:56](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1316) - "Aggressive neuroblastoma resections using subadventitial dissection should not be performed by occasional pediatric oncological surgeons doing one case per year or every other year" (opinion) [Ep 2 · 22:21](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1341) - "European neuroblastoma procedures are performed in more than 200 hospitals yet still demonstrated survival improvements" — Daniel von Allmen (host_summary) [Ep 2 · 23:33](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1413) - "Older data shows worse survival in neuroblastoma when kidney is removed, likely because single kidney limits chemotherapy dosing" — Daniel von Allmen (host_summary) [Ep 2 · 24:03](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1443) - "Immunotherapy is effective in neuroblastoma in the setting of minimal residual disease" — Daniel von Allmen (clinical) [Ep 2 · 25:38](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1538) - "Neuroblastoma is the most common extracranial solid tumor of childhood arising from aberrant differentiation of sympatho adrenal cells in neuro crest" — Yujie Ma (epidemiological) [Ep 3 · 0:45](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=45) - "Retinoic acid is used to induce differentiation in treatment of high risk neuroblastoma" — Yujie Ma (guideline) [Ep 3 · 0:56](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=56) - "Retinoic acid efficacy varied in patients due to the highly heterogeneity of this disease" — Yujie Ma (clinical) [Ep 3 · 1:03](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=63) - "PCP4 was identified as one of the differentiation markers of neuroblastoma tumor cells in a previous Cancer Cell publication" — Yujie Ma (clinical) [Ep 3 · 1:19](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=79) - "PCP4 modulates the rate of calcium binding to calmodulin, which is a critical step in activating calmodulin dependent kinase" — Yujie Ma (clinical) [Ep 3 · 1:38](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=98) - "The binding of PCP4 with calmodulin was verified in neuroblastoma by co-immunoprecipitation" — Yujie Ma (clinical) [Ep 3 · 1:49](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=109) - "CAMK2G was identified as a target kinase of calmodulin using mass spectrometry" — Yujie Ma (clinical) [Ep 3 · 1:49](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=109) - "CAMK2G is a member of the serine threonine protein kinase family" — Yujie Ma (clinical) [Ep 3 · 2:06](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=126) - "CAMK2G plays an important role in neuronal development and synaptic plasticity" — Yujie Ma (clinical) [Ep 3 · 2:10](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=130) - "When CAMK2G is activated by calmodulin, it gets autophosphorylated at the site of threonine 287" — Yujie Ma (clinical) [Ep 3 · 2:24](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=144) - "PCP4 overexpression upregulated the threonine 287 phosphorylation of CAMK2G in neuroblastoma cells" — Yujie Ma (clinical) [Ep 3 · 2:33](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=153) - "Low CAMK2G mRNA expression was associated with worse overall and event-free survival" — Yujie Ma (clinical) [Ep 3 · 3:02](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=182) - "Low CAMK2G expression was associated with advanced INSS stages and unfavorable histology" — Yujie Ma (clinical) [Ep 3 · 3:02](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=182) - "Low CAMK2G expression was associated with MYCN amplified status, high risk, and tumor progression" — Yujie Ma (clinical) [Ep 3 · 3:14](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=194) - "CAMK2G knockdown in SKNSH cells resulted in inhibited neuron outgrowths even under the induction of retinoic acid" — Yujie Ma (clinical) [Ep 3 · 3:30](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=210) - "Expression of neuronal differentiation markers were down regulated following CAMK2G knockdown" — Yujie Ma (clinical) [Ep 3 · 3:44](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=224) - "CAMK2G knockdown promoted migration and invasion of neuroblastoma cells as shown by transwell assays" — Yujie Ma (clinical) [Ep 3 · 4:13](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=253) - "CAMK2G expression is associated with favorable clinical features" — Yujie Ma (clinical) [Ep 3 · 4:42](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=282) - "CAMK2G plays an essential role in promoting neuronal differentiation and inhibiting migration in neuroblastoma" — Yujie Ma (clinical) [Ep 3 · 4:51](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=291) - "CAMK2G is expressed low in SKNSH cells" — Yujie Ma (clinical) [Ep 3 · 6:20](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=380) - "CAMK2G is highly expressed in BE2 and SKNS cell lines, which are MYCN amplified cell lines" — Yujie Ma (clinical) [Ep 3 · 6:33](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=393) - "CAMK2G function is not strong enough to overcome the oncogenic function of MYCN" — Yujie Ma (clinical) [Ep 3 · 7:11](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=431) - "CAMK2G did not regulate neuronal differentiation in MYCN amplified cell lines" — Yujie Ma (clinical) [Ep 3 · 7:11](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=431) - "The CAMK2G mechanism is not universal for all neuroblastoma cell lines and patients" — Yujie Ma (opinion) [Ep 3 · 7:40](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=460) - "The CAMK2G mechanism can only be explained in MYCN non-amplified cell lines and the corresponding patients" — Yujie Ma (opinion) [Ep 3 · 7:45](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=465) - "High-risk neuroblastoma patients continue to have survival rates in the 38-40% range despite aggressive therapy" — Dan (epidemiological) [Ep 1 · 0:25](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=25) - "Surgeons overestimated their degree of resection compared to postoperative imaging in 2/3 of cases (66% concordance rate) in the tandem transplant pilot study" — Dan (clinical) [Ep 1 · 6:35](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=395) - "In a repeat study with COG high-risk patients, surgeons underestimated resection extent while radiologists overcalled it, again showing only 66% concordance, suggesting no correlation between surgeon assessment and imaging" — Dan (clinical) [Ep 1 · 7:22](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=442) - "The biggest volume response of neuroblastoma tumor occurs with the first two cycles of chemotherapy, with very little response after that (Memorial Sloan Kettering data)" — Dan (clinical) [Ep 1 · 9:43](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=583) - "More chemotherapy or other treatments like MIBG make the tumor more fibrotic and make subadventitial dissection more difficult" — Dan (opinion) [Ep 1 · 10:00](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=600) - "There is good evidence that aggressive resection improves survival in stage 3 neuroblastoma patients, supported by pre-COG merger studies" (clinical) [Ep 1 · 11:53](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=713) - "Surgical complication rate for aggressive neuroblastoma resection is approximately 30% morbidity with mortality less than 1%" — Dan (epidemiological) [Ep 1 · 12:50](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=770) - "The Riley study showed the only survivors with stage 4 neuroblastoma were those who had primary tumor resection" (clinical) [Ep 1 · 13:50](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=830) - "The Sloan Kettering study suggests stage 4 patients do better with primary tumor resection" (clinical) [Ep 1 · 14:10](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=850) - "Kiely's study showed no difference in survival based on extent of resection" (clinical) [Ep 1 · 14:16](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=856) - "European studies show no difference in survival based on extent of resection in stage 4 disease" (clinical) [Ep 1 · 14:19](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=859) - "High-risk neuroblastoma patients receive 9 different drugs, bone marrow transplantation, and some receive total body radiation, with outrageous morbidity from medical treatment" (clinical) [Ep 1 · 14:31](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=871) - "High-risk neuroblastoma treatment includes tandem peripheral blood stem cell transplants (two sequential transplants), followed by immunotherapy and Retin-A" — Dan (clinical) [Ep 1 · 14:53](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=893) - "High-risk neuroblastoma survival improved from 10% to 30-40% with treatment intensification" (epidemiological) [Ep 1 · 15:44](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=944) - "The Georgia study showed 46% survival with transplantation plus immunotherapy plus differentiating agents, but many deaths were due to intensified treatment rather than cancer" (epidemiological) [Ep 1 · 16:05](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=965) - "German study of 278 stage 4 high-risk neuroblastoma patients achieved complete resection in almost half and >90% resection in another quarter (75% total achieving >90% resection)" — Dan (epidemiological) [Ep 1 · 16:30](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=990) - "German study outcomes: overall survival 45%, event-free survival 33%, local progression-free survival 58%" — Dan (epidemiological) [Ep 1 · 16:57](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1017) - "German study showed no difference in overall survival, event-free survival, or local progression-free survival based on completeness of resection" — Dan (clinical) [Ep 1 · 17:15](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1035) - "German study concluded aggressive surgery is not justified in stage 4 disease, limited operations decrease complications, and there is limited impact on patient outcome" — Dan (host_summary) [Ep 1 · 17:34](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1054) - "European SIOPEN study included 1,324 high-risk neuroblastoma patients (stages 3 and 4) and achieved >95% resection in 76% of patients" — Dan (epidemiological) [Ep 1 · 17:57](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1077) - "SIOPEN study surgical mortality was 0.5% with 10% morbidity (30% if including lesser complications)" — Dan (epidemiological) [Ep 1 · 18:45](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1125) - "SIOPEN study showed significant improvement in event-free survival and overall survival with >95% resection - the first study to show overall survival benefit" — Dan (clinical) [Ep 1 · 19:01](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1141) - "SIOPEN study concluded >95% resection results in improvement in event-free survival in high-risk neuroblastoma" — Dan (clinical) [Ep 1 · 19:55](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1195) - "COG 3973 study (230 patients) showed statistically significant improvement in local relapse-free survival and event-free survival with aggressive resection" — Dan (clinical) [Ep 1 · 21:07](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1267) - "COG 3973 study was not able to demonstrate improvement in overall survival, possibly due to type 2 error from smaller sample size (230 vs 1,300 in European study)" — Dan (clinical) [Ep 1 · 21:35](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1295) - "Aggressive neuroblastoma resections using the Kiely subadventitial approach should not be performed by occasional pediatric oncological surgeons doing one case per year or every other year" (opinion) [Ep 1 · 22:05](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1325) - "European neuroblastoma procedures are performed in more than 200 hospitals, yet still demonstrated survival improvements despite this distribution" — Dan (epidemiological) [Ep 1 · 23:16](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1396) - "Older data shows that if the kidney is removed during neuroblastoma resection, survival is worse; renal preservation leads to better outcomes" — Dan (clinical) [Ep 1 · 23:53](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1433) - "Renal preservation is important because patients with only one kidney cannot receive as much chemotherapy, which impacts overall survival" — Dan (clinical) [Ep 1 · 24:12](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1452) - "Aggressive surgical approach to local neuroblastoma recurrence is justified as long as it is not progressive metastatic disease, though prognosis is worse" — Dan (opinion) [Ep 1 · 24:36](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1476) - "New therapies like targeted MIBG therapy may justify surgical removal of bulk disease in recurrent neuroblastoma" — Dan (opinion) [Ep 1 · 25:05](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1505) - "Immunotherapy is effective in the setting of minimal residual disease, so achieving 95% resection may improve the impact of medical therapy on metastatic disease" — Dan (opinion) [Ep 1 · 25:21](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1521) ## Changelog - Sep 8: 1 item added automatically - Sep 7: Published again automatically — condition is back above threshold - Sep 7: 1 item no longer name high-risk neuroblastoma - Sep 7: Unpublished automatically — folded or below threshold - Sep 7: Audit reverted — short clips unhidden - Sep 7: 1 item added automatically - Sep 7: 3 items added automatically --- Educational content from recorded physician discussions — not medical advice. 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