Neuroblastoma
Also covered as: high-risk neuroblastoma · stage 4 neuroblastoma · metastatic disease · congenital diaphragmatic hernia · Wilms tumor · hepatoblastoma · stage 3 neuroblastoma · bony metastasis
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Answers come only from this collection's statement ledger and cite the exact moment · not medical advice
Content of this collection
Foundations
2 items
Neuroblastoma
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Dr. Daniel von Allmen, surgeon-in-chief at Cincinnati Children’s, joins Dr. Rae Hanke to review the essentials of neuroblastoma in this videocast.
video · May 2020
Topics in 10: Neuroblastoma
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Drs Daniel von Allmen, Todd Ponsky and Rae Hanke come together to provide you the essentials on the diagnosis and management of Neuroblastoma. Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist U
podcast · 10:25 · Dec 2020
Diagnosis & Workup
2 items
Update Course Rewind: Staging and Management of Neuroblastoma 2022
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We are back with another Update Course Rewind video! This time we are presenting you updates in "Staging and Management of Neuroblastoma" with Dr. Paul Jeziorczak from APSA Professional Development Committee.
Host: Ellen Encisco
video · Jun 2023
The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report
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Tom Monclair, Garrett M Brodeur, Peter F Ambros, Hervé J Brisse, Giovanni Cecchetto, Keith Holmes, Michio Kaneko, Wendy B London, Katherine K Matthay, Jed G Nuchtern, Dietrich von Schweinitz, Thorsten Simon, Susan L Cohn, Andrew D J Pearson
video · 0:59 · Mar 2026
Medical Management
1 item
Coagulopathy and Analgesia
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This podcast is an interactive discussion about the management of coagulopathy, analgesia, sedation, and delirium in critically ill pediatric patients between Dr. Adam Vogel and Dr. Alexander Gibbons. Intro and outro tracks are adapted from
podcast · 45:33 · Dec 2020
Surgical Management
1 item
Update Course Rewind: Highlighting Collaboration from Surgery & Interventional Radiology in the OR 2024
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In this Update Course Rewind, Drs. Dan von Allmen, John Racadio, and Timothy Lautz, alongside IR technologist Amanda Wallingford, discuss how strong collaboration between surgery and interventional radiology is transforming patient care at
video · 10:20 · Mar 2025
Evidence & Research
12 items
Neuroblastoma: Update Course 2016
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At the 4th Annual Stay Current in Pediatric Surgery Update Course in 2016,Dr. Daniel Von Allmen, director of the division of general and thoracic surgery, Cincinnati Children's Hospital, begins the second half of this symposium with a discu
video · 25:42 · Sep 2018
Neuroblastoma: Update Course 2014
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Dr. Daniel Von Allmen, director of the division of general and thoracic surgery, cincinnati children's hospital, begins the second half of this symposium with a discussion of neuroblastoma. Case presentations are shared as well as panel dis
video · 25:59 · Nov 2018
Update Course 2021: TOP PUBLICATIONS IN NON - PED SURG JOURNALS
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Dr. Jose Campos and his team, Sociedad Chilena Cirugia Pediatrica curate the best pediatric surgical articles in non-core pediatric surgery journals and in this session, they describe their 5 favorites from the past year. The conversation i
video · 22:13 · May 2022
Update Course 2022 - APSA PDC UPDATES - Mary Edwards, Paul Jeziorczak, Craig Lillehei, and Charles Snyder,
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In this session, members of the APSA Professional Development Committee (PDC) discussed the latest top articles and practice updates. We were joined by Drs. Mary Edwards, Paul Jeziorczak, Craig Lillehei, and Charles Snyder.
Topics discus
video · 64:30 · Sep 2022
Image-guided core-needle or surgical biopsy for neuroblastoma diagnosis in children
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New article you should know by Cecilia Gigena
"Image-guided core-needle or surgical biopsy for neuroblastoma diagnosis in children: A systematic review and meta-analysis from the International Society of Pediatric Surgical Oncology (IPSO
video · 0:54 · Feb 2024
Biopsia quirúrgica o con aguja guiada por imágenes para el diagnóstico de neuroblastoma en niños
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Nuevo artículo que tenes que conocer por Cecilia Gigena
"Biopsia quirúrgica o con aguja central guiada por imágenes para el diagnóstico de neuroblastoma en niños: Una revisión sistemática y metanálisis de la Sociedad Internacional de Onc
video · 0:53 · Feb 2024
Heat 2 Winner: Matthew Urichuk, PhD - Best of the Best in Pediatric Surgery 2024
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Watch the voting from the first heat!
Presentations from heat two:
Bailey Roberts, MD: Extracellular vesicles from metastatic osteosarcoma contribute to creation of a pre-metastatic nich.
Dominique Simons, MSc: Multimodal 3-D vi
video · 1:52 · Feb 2024
Dr. Yujie Ma - Best of the Best in Pediatric Surgery 2025
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Watch PAPS' Dr. Yujie Ma's presentation on “CAMK2G Promotes Neuronal Differentiation and Inhibits Migration in Neuroblastoma” at the 2025 Best of the Best in Pediatric Surgery event!
Moderators: Drs. Todd Ponsky, Dan von Allmen, and Meer
video · 8:08 · Mar 2025
Dr. Sabine Irtan - Best of the Best in Pediatric Surgery 2025
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Watch IPSO's Dr. Sabine Irtan’s presentation on “Only MIBG positive post-surgery residues impact on outcomes in patients with stage 4 neuroblastoma: Results from the HR-NBL1/SIOPEN trial” at the 2025 Best of the Best in Pediatric Surgery ev
video · 6:52 · Mar 2025
Quick Literature Updates Ep 19
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We’re back with nineteenth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most int
video · 4:27 · May 2025
Social Determinants of Health Influence on Survival in Wilms Tumor, Neuroblastoma, and Hepatoblastoma
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Colleen P Nofi, Bailey K Roberts, Erin G Brown, Barrie S Rich, Meera Kotagal, & Richard D Glick Background: The influence of social determinants of health (SDOH) on childhood cancer outcomes is complex and understudied. This study aimed to
video · 1:06 · Jan 2026
Enhanced Recovery After Surgery (ERAS) Improves Length of Stay and Decreases Complications After Resection of Abdominal Neuroblastoma
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Sara A Mansfield, Meera Kotagal, Stephen J Hartman, Andrew J Murphy, Brady Hogan, Darren Ha, Doralina L Anghelescu, Marc Mecoli, Nicholas G Cost, Andrew M Davidoff, Kyle O RoveBackground: Enhanced recovery after surgery (ERAS) pathways are
video · 1:02 · Feb 2026
Case-Based Learning
1 item
Neuroblastoma
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Drs Erika Newman, Dan von Allmen and Tony Sandler join Dr. Todd Ponsky in a discussion covering the latest in neuroblastoma. Contributing editor: Rachel (Rae) Hanke, MD
Case 1: Mother who presents with 26 week fetus
with a pr
podcast · 56:19 · Dec 2020
In-Depth Reviews
4 items
Hepatoblastoma
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This is an interactive discussion between Todd Ponsky, MD and Max Langham, MD on the management of hepatoblastomas. Dr. Max Langham is a Professor of Surgery and Pediatrics and the Vice Chairman of the Department of Surgery at the Universi
podcast · 54:16 · Dec 2020
Wilms Tumor: Audio Chapter
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An interactive discussion about Wilms tumor between Todd Ponsky, MD, Avraham Schlager, and Peter Ehrlich, MD.Dr. Peter Ehrlich is a professor of pediatrics surgery at the University of Michigan C.S. Mott Children’s Hospital who is also a vi
podcast · 64:03 · Jan 2021
Hepatoblastoma with Dr. Greg Tiao
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Hepatoblastoma is the most common malignant liver tumor in the pediatric population. But treatment strategies have changed dramatically over the past 25 years. That’s why today, were going to review the basics-with an expert.
00:27:38-0027:
video · Mar 2022
Neuroblastoma with Dr. Meera Kotagal
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In this podcast, we cover the basics of neuroblastoma including presentation, differentiation, diagnosis and management with Dr. Meera Kotagal.
Host: Em Gootee
video · 14:02 · Sep 2024
Emerging & Future Directions
1 item
Dominique Simons, MSc - Best of the Best in Pediatric Surgery 2024
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Watch IPSO's Dominique Simons, MSc presentation on “Multimodal 3-D visualization of pediatric neuroblastoma: Aiding surgical planning beyond anatomical information” at the 2024 Best of the Best in Pediatric Surgery event!
Moderators: Tod
video · 7:55 · Feb 2024
Long-Term Care
2 items
Long-Term Follow-Up of Surgical Outcomes for Patients With Wilms Tumor and Neuroblastoma
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Jo Cooke-Barber, Federico Scorletti, Beth Rymeski, Debra Eshelman-Kent, Rajaram Nagarajan, Karen Burns, Todd Jenkins, Roshni DasguptaBackground: There are minimal data on long-term surgical outcomes of patients who have undergone resection
video · 1:04 · Feb 2026
Pancreas, Muscle, and Subcutaneous Fat Atrophy in Patients Undergoing Radiation for Neuroblastoma
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Pradipta Debnath, Marissa Ray, Luke Pater, Alexandra O Glenn, Stephen Hartman, Elanchezhian Somasundaram, Todd Jenkins, Juan P Gurria, Katherine Somers, Andrew T Trout, Meera KotagalBackground/objectives: Radiation therapy (RT) is part of s
video · 1:10 · Apr 2026
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Every statement below comes from the recorded discussions, with its speaker and moment.
Hepatoblastoma
Hepatoblastoma presents from the first year of life through perhaps 10 years of age, although there are a few that have been diagnosed older than that
epidemiologicalMax Langham2:19 ↗
If alpha fetoprotein is quite high and very elevated, the presumptive diagnosis in a 1 year old would be hepatoblastoma
clinicalMax Langham2:06 ↗
If it's a rhabdoid tumor, chemotherapy is not important and the lesion needs to be resected
clinicalMax Langham2:43 ↗
Most people favor needle biopsy of the liver rather than an open biopsy or a laparoscopic biopsy
guidelineMax Langham3:40 ↗
The biopsy should go through the normal part of the liver that will be resected with a specimen, approaching from the side of the tumor to avoid seeding
clinicalMax Langham3:51 ↗
Hepatoblastoma will seed and it can create big issues for future resection and cure if you cross the left lobe when the left lobe doesn't have tumor
clinicalMax Langham4:06 ↗
There is a predisposition of premature infants to getting hepatoblastomas, usually in the first year or two of life rather than in the nursery
epidemiologicalMax Langham7:40 ↗
For the biology arm of the children's oncology group, they want 10 core biopsies
guidelineMax Langham8:52 ↗
The complication rate and in fact some mortality seems higher with open biopsies than it does with the needle technique
clinicalMax Langham9:16 ↗
The overarching goal of treatment for hepatoblastoma is to get the kids to a safe resection
guidelineMax Langham10:27 ↗
A PRETEXT 1 lesion has three contiguous sectors of the liver that are free, only possible with lesions in left lateral segment, left lateral sector, or right posterior sector
clinicalMax Langham12:50 ↗
PRETEXT 2 is 2 adjoining sectors free, which can happen three ways: right sided lesion with left hemi liver free, left sided lesion with right hemi liver free, or right posterior and left lateral lesions with right anterior and left medial free
clinicalMax Langham13:17 ↗
PRETEXT 3 means only one sector is free of disease
clinicalMax Langham13:45 ↗
In PRETEXT 4, all sectors are involved with no sectors of the liver free of disease
clinicalMax Langham14:00 ↗
Upfront resection is OK if it's a conventional hemihepatectomy or less, with clearly 1 centimeter of normal liver between the middle hepatic vein and the tumor, and no annotation factors
guidelineMax Langham14:48 ↗
If it is pure fetal histology after upfront resection, that baby's done with no need for any chemotherapy at all, and survival in that instance is 100%
clinicalMax Langham15:37 ↗
Pulmonary metastases make up the vast majority of the metastases in hepatoblastoma, and even small liver tumors can metastasize
clinicalMax Langham17:12 ↗
If there are no involvement of the vena cava, confluence of hepatic veins, or portal vein, and the surgeon judges it's resectable at diagnosis, a PRETEXT 1 lesion should be resected with an anatomic resection
guidelineMax Langham17:45 ↗
A child that is 8 years of age or older with hepatoblastoma is going to be a significantly higher risk patient
clinicalMax Langham29:06 ↗
Metastases always get you to high risk status
clinicalMax Langham29:41 ↗
Involvement of vessels will get you to intermediate or high risk
clinicalMax Langham29:53 ↗
If the patient has a hepatoblastoma but the alpha fetoprotein is less than 100, that patient's going to be a high risk patient
clinicalMax Langham30:18 ↗
Most of the bang that you're going to get with shrinkage of the tumor is going to happen in the first two rounds of chemotherapy
clinicalMax Langham26:31 ↗
After 2 rounds of chemotherapy, the surgeon ought to make a commitment whether this is a kid that can be resected or needs referral to transplant
guidelineMax Langham26:41 ↗
Multifocal tumors should be referred straight away to a transplant center
guidelineMax Langham27:35 ↗
In AHE 0731, patients with mixed fetal-embryonal histology after upfront resection with negative margins were treated with just two courses of cisplatin-based chemotherapy with excellent results
clinicalMax Langham24:37 ↗
A child with metastatic lesion in the lung is going to get a total of 6 courses of chemotherapy, and you would like to have them resected no later than the end of the 4th cycle
guidelineMax Langham35:08 ↗
Before doing anything of consequence with the liver, make sure you can vascularly isolate the liver by dissecting the suprahepatic and infrahepatic vena cava
clinicalMax Langham36:56 ↗
The disasters that have happened during liver resection are because of big time bleeding or because of air embolism
clinicalMax Langham37:52 ↗
You want to use a hypovolemic type of anesthesia, preserving transfusions till later in the case and keeping the CVP low, because a high CVP makes the liver swell and bleed more
clinicalMax Langham38:52 ↗