# Neuroblastoma — GCMD Library living collection

Also covered as: high-risk neuroblastoma · stage 4 neuroblastoma · metastatic disease · congenital diaphragmatic hernia · Wilms tumor · hepatoblastoma · stage 3 neuroblastoma · bony metastasis

Experts: Dr. Todd Ponsky, Dr. Daniel von Allmen, Dr. Sophia Schermerhorn, Dr. Cecilia Gigena

Updated: n/a · 26 episodes · 546 cited statements

## Episodes
### Foundations
- [Neuroblastoma](https://library.globalcastmd.com/watch/neuroblastoma-2534) — video · [machine version](https://library.globalcastmd.com/watch/neuroblastoma-2534.md)
- [Topics in 10: Neuroblastoma](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659) — podcast · 10:25 · [machine version](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659.md)

### Diagnosis & Workup
- [Update Course Rewind: Staging and Management of Neuroblastoma 2022](https://library.globalcastmd.com/watch/update-course-rewind-staging-and-management-of-neuroblastoma-2022-6710) — video · [machine version](https://library.globalcastmd.com/watch/update-course-rewind-staging-and-management-of-neuroblastoma-2022-6710.md)
- [The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report](https://library.globalcastmd.com/watch/the-international-neuroblastoma-risk-group-staging-system-an-inrg-task-force-report-11727) — video · 0:59 · [machine version](https://library.globalcastmd.com/watch/the-international-neuroblastoma-risk-group-staging-system-an-inrg-task-force-report-11727.md)

### Medical Management
- [Coagulopathy and Analgesia](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793) — podcast · 45:33 · [machine version](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793.md)

### Surgical Management
- [Update Course Rewind: Highlighting Collaboration from Surgery & Interventional Radiology in the OR 2024](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109) — video · 10:20 · [machine version](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109.md)

### Evidence & Research
- [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)
- [Update Course 2021: TOP PUBLICATIONS IN NON - PED SURG JOURNALS](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404) — video · 22:13 · [machine version](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404.md)
- [Update Course 2022 - APSA PDC UPDATES - Mary Edwards, Paul Jeziorczak, Craig Lillehei, and Charles Snyder,](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820) — video · 64:30 · [machine version](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820.md)
- [Image-guided core-needle or surgical biopsy for neuroblastoma diagnosis in children](https://library.globalcastmd.com/watch/image-guided-core-needle-or-surgical-biopsy-for-neuroblastoma-diagnosis-in-children-7988) — video · 0:54 · [machine version](https://library.globalcastmd.com/watch/image-guided-core-needle-or-surgical-biopsy-for-neuroblastoma-diagnosis-in-children-7988.md)
- [Biopsia quirúrgica o con aguja guiada por imágenes para el diagnóstico de neuroblastoma en niños](https://library.globalcastmd.com/watch/biopsia-quir-rgica-o-con-aguja-guiada-por-im-genes-para-el-diagn-stico-de-neuroblastoma-en-ni-os-7990) — video · 0:53 · [machine version](https://library.globalcastmd.com/watch/biopsia-quir-rgica-o-con-aguja-guiada-por-im-genes-para-el-diagn-stico-de-neuroblastoma-en-ni-os-7990.md)
- [Heat 2 Winner: Matthew Urichuk, PhD - Best of the Best in Pediatric Surgery 2024](https://library.globalcastmd.com/watch/heat-2-winner-matthew-urichuk-phd-best-of-the-best-in-pediatric-surgery-2024-8013) — video · 1:52 · [machine version](https://library.globalcastmd.com/watch/heat-2-winner-matthew-urichuk-phd-best-of-the-best-in-pediatric-surgery-2024-8013.md)
- [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)
- [Dr. Sabine Irtan - Best of the Best in Pediatric Surgery 2025](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044) — video · 6:52 · [machine version](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044.md)
- [Quick Literature Updates Ep 19](https://library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465) — video · 4:27 · [machine version](https://library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465.md)
- [Social Determinants of Health Influence on Survival in Wilms Tumor, Neuroblastoma, and Hepatoblastoma](https://library.globalcastmd.com/watch/social-determinants-of-health-influence-on-survival-in-wilms-tumor-neuroblastoma-and-hepatoblastoma-11371) — video · 1:06 · [machine version](https://library.globalcastmd.com/watch/social-determinants-of-health-influence-on-survival-in-wilms-tumor-neuroblastoma-and-hepatoblastoma-11371.md)
- [Enhanced Recovery After Surgery (ERAS) Improves Length of Stay and Decreases Complications After Resection of Abdominal Neuroblastoma](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522) — video · 1:02 · [machine version](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522.md)

### Case-Based Learning
- [Neuroblastoma](https://library.globalcastmd.com/watch/neuroblastoma-1620) — podcast · 56:19 · [machine version](https://library.globalcastmd.com/watch/neuroblastoma-1620.md)

### In-Depth Reviews
- [Hepatoblastoma](https://library.globalcastmd.com/watch/hepatoblastoma-291) — podcast · 54:16 · [machine version](https://library.globalcastmd.com/watch/hepatoblastoma-291.md)
- [Wilms Tumor: Audio Chapter](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487) — podcast · 64:03 · [machine version](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487.md)
- [Hepatoblastoma with Dr. Greg Tiao](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256) — video · [machine version](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256.md)
- [Neuroblastoma with Dr. Meera Kotagal](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212) — video · 14:02 · [machine version](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212.md)

### Emerging & Future Directions
- [Dominique Simons, MSc - Best of the Best in Pediatric Surgery 2024](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009) — video · 7:55 · [machine version](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009.md)

### Long-Term Care
- [Long-Term Follow-Up of Surgical Outcomes for Patients With Wilms Tumor and Neuroblastoma](https://library.globalcastmd.com/watch/long-term-follow-up-of-surgical-outcomes-for-patients-with-wilms-tumor-and-neuroblastoma-11581) — video · 1:04 · [machine version](https://library.globalcastmd.com/watch/long-term-follow-up-of-surgical-outcomes-for-patients-with-wilms-tumor-and-neuroblastoma-11581.md)
- [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)

## Chapters
- [0:00](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=0) Introduction and Initial Presentation (Ep 7)
- [6:50](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=410) PRETEXT System and Risk Stratification (Ep 7)
- [19:30](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=1170) Histologic Subtypes and Treatment Protocols (Ep 7)
- [28:50](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=1730) High-Risk Features and Metastatic Disease (Ep 7)
- [36:20](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=2180) Surgical Technique and Intraoperative Management (Ep 7)
- [44:40](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=2680) Extreme Resections, Transplantation, and Relapse Management (Ep 7)
- [0:00](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=0) ERAS Protocol for Neuroblastoma Resection (Ep 23)
- [0:00](https://library.globalcastmd.com/watch/long-term-follow-up-of-surgical-outcomes-for-patients-with-wilms-tumor-and-neuroblastoma-11581?t=0) Long-Term Surgical Outcomes in Wilms Tumor and Neuroblastoma Survivors (Ep 24)
- [0:00](https://library.globalcastmd.com/watch/the-international-neuroblastoma-risk-group-staging-system-an-inrg-task-force-report-11727?t=0) Image-Defined Risk Factors in Neuroblastoma (Ep 25)
- [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 26)
- [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 26)
- [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 26)
- [0:00](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=0) Introduction and Neuroblastoma Overview (Ep 17)
- [1:43](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=103) Case 1: Diagnosis and Staging Systems (Ep 17)
- [4:53](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=293) Case 1: Risk Stratification and Surgical Management (Ep 17)
- [8:32](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=512) Case 2: Mediastinal Neuroblastoma and Biopsy Techniques (Ep 17)
- [11:38](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=698) Case 3: Observation Strategy for Infant Neuroblastoma (Ep 17)
- [0:00](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=0) Introduction (Ep 18)
- [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 18)
- [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 18)
- [4:42](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=282) Conclusions (Ep 18)
- [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 18)
- [0:00](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=0) Introduction and Study Rationale (Ep 19)
- [1:21](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=81) Study Design and Patient Characteristics (Ep 19)
- [2:58](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=178) Survival Outcomes and External Validation (Ep 19)
- [4:59](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=299) Discussion: Surgeon vs. Radiologist Assessment (Ep 19)
- [0:00](https://library.globalcastmd.com/watch/social-determinants-of-health-influence-on-survival-in-wilms-tumor-neuroblastoma-and-hepatoblastoma-11371?t=0) Social Determinants and Pediatric Oncology Survival (Ep 22)
- [0:00](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=0) Case presentation and surgical approach (Ep 1)
- [3:29](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=209) Surgical technique and timing (Ep 1)
- [8:17](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=497) Metastatic disease management (Ep 1)
- [12:40](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=760) Evidence review: conflicting data (Ep 1)
- [20:42](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1242) Technical considerations and future directions (Ep 1)
- [0:00](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=0) Case presentation and initial surgical approach (Ep 2)
- [3:46](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=226) Surgical technique and timing (Ep 2)
- [8:35](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=515) Evidence for resection completeness in stage 3 (Ep 2)
- [12:56](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=776) Metastatic disease management (Ep 2)
- [16:40](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1000) Review of recent outcome data (Ep 2)
- [22:12](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1332) Technical considerations and recurrent disease (Ep 2)
- [0:00](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=0) Introduction and Background (Ep 10)
- [1:53](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=113) Case 1: Malrotation Diagnosis (Ep 10)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "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" — Max Langham (epidemiological) [Ep 7 · 2:19](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=139)
- "If alpha fetoprotein is quite high and very elevated, the presumptive diagnosis in a 1 year old would be hepatoblastoma" — Max Langham (clinical) [Ep 7 · 2:06](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=126)
- "If it's a rhabdoid tumor, chemotherapy is not important and the lesion needs to be resected" — Max Langham (clinical) [Ep 7 · 2:43](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=163)
- "Most people favor needle biopsy of the liver rather than an open biopsy or a laparoscopic biopsy" — Max Langham (guideline) [Ep 7 · 3:40](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=220)
- "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" — Max Langham (clinical) [Ep 7 · 3:51](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=231)
- "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" — Max Langham (clinical) [Ep 7 · 4:06](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=246)
- "There is a predisposition of premature infants to getting hepatoblastomas, usually in the first year or two of life rather than in the nursery" — Max Langham (epidemiological) [Ep 7 · 7:40](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=460)
- "For the biology arm of the children's oncology group, they want 10 core biopsies" — Max Langham (guideline) [Ep 7 · 8:52](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=532)
- "The complication rate and in fact some mortality seems higher with open biopsies than it does with the needle technique" — Max Langham (clinical) [Ep 7 · 9:16](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=556)
- "The overarching goal of treatment for hepatoblastoma is to get the kids to a safe resection" — Max Langham (guideline) [Ep 7 · 10:27](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=627)
- "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" — Max Langham (clinical) [Ep 7 · 12:50](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=770)
- "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" — Max Langham (clinical) [Ep 7 · 13:17](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=797)
- "PRETEXT 3 means only one sector is free of disease" — Max Langham (clinical) [Ep 7 · 13:45](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=825)
- "In PRETEXT 4, all sectors are involved with no sectors of the liver free of disease" — Max Langham (clinical) [Ep 7 · 14:00](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=840)
- "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" — Max Langham (guideline) [Ep 7 · 14:48](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=888)
- "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%" — Max Langham (clinical) [Ep 7 · 15:37](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=937)
- "Pulmonary metastases make up the vast majority of the metastases in hepatoblastoma, and even small liver tumors can metastasize" — Max Langham (clinical) [Ep 7 · 17:12](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=1032)
- "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" — Max Langham (guideline) [Ep 7 · 17:45](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=1065)
- "A child that is 8 years of age or older with hepatoblastoma is going to be a significantly higher risk patient" — Max Langham (clinical) [Ep 7 · 29:06](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=1746)
- "Metastases always get you to high risk status" — Max Langham (clinical) [Ep 7 · 29:41](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=1781)
- "Involvement of vessels will get you to intermediate or high risk" — Max Langham (clinical) [Ep 7 · 29:53](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=1793)
- "If the patient has a hepatoblastoma but the alpha fetoprotein is less than 100, that patient's going to be a high risk patient" — Max Langham (clinical) [Ep 7 · 30:18](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=1818)
- "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" — Max Langham (clinical) [Ep 7 · 26:31](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=1591)
- "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" — Max Langham (guideline) [Ep 7 · 26:41](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=1601)
- "Multifocal tumors should be referred straight away to a transplant center" — Max Langham (guideline) [Ep 7 · 27:35](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=1655)
- "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" — Max Langham (clinical) [Ep 7 · 24:37](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=1477)
- "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" — Max Langham (guideline) [Ep 7 · 35:08](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=2108)
- "Before doing anything of consequence with the liver, make sure you can vascularly isolate the liver by dissecting the suprahepatic and infrahepatic vena cava" — Max Langham (clinical) [Ep 7 · 36:56](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=2216)
- "The disasters that have happened during liver resection are because of big time bleeding or because of air embolism" — Max Langham (clinical) [Ep 7 · 37:52](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=2272)
- "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" — Max Langham (clinical) [Ep 7 · 38:52](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=2332)
- "You want to take inflow before you get outflow, so you don't want to interrupt the hepatic veins before you control the inflow because the liver will swell" — Max Langham (clinical) [Ep 7 · 39:37](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=2377)
- "Liver transplant has great 3 and 5 year disease-free survival but comes at the expense of requiring lifelong immunosuppression with potential for rejection and secondary malignancies" — Max Langham (clinical) [Ep 7 · 42:20](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=2540)
- "Extreme resections with vascular reconstruction can provide equivalent oncologic results to transplant without immunosuppression, but have higher complication rates including vascular thrombosis and portal hypertension" — Max Langham (opinion) [Ep 7 · 43:07](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=2587)
- "Having a grossly positive margin, getting into an operation and leaving gross residual disease behind is not acceptable" — Max Langham (guideline) [Ep 7 · 44:47](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=2687)
- "If they have a negative margin resection and they relapse locally in the liver, refer them for transplantation as salvage transplantation is probably better than re-resection" — Max Langham (guideline) [Ep 7 · 45:36](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=2736)
- "Hepatoblastoma is not thought to be radiation sensitive" — Max Langham (clinical) [Ep 7 · 46:32](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=2792)
- "After resection following 4 rounds of chemotherapy with clear margins, patients usually have 2 courses of consolidation chemotherapy and then long term follow up for at least 5 years" — Max Langham (guideline) [Ep 7 · 46:53](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=2813)
- "Most recurrences will happen within the first 3 years of therapy" — Max Langham (epidemiological) [Ep 7 · 47:02](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=2822)
- "In a recent SIOPEL study, nearly half of PRETEXT 4 lesions were resected with conventional resections and did not need liver transplants" — Max Langham (clinical) [Ep 7 · 48:30](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=2910)
- "In the US for PRETEXT 4 in AHE 0731, about 90% of those patients were transplanted" — Max Langham (epidemiological) [Ep 7 · 48:44](https://library.globalcastmd.com/watch/hepatoblastoma-291?t=2924)
- "A multi-center prospective study evaluated a structured ERAS pathway for children undergoing abdominal neuroblastoma resection" — Sophia Schermerhorn (clinical) [Ep 23 · 0:03](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=3)
- "The ERAS protocol included 20 evidence-based elements spanning the entire perioperative process" — Sophia Schermerhorn (clinical) [Ep 23 · 0:13](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=13)
- "ERAS protocol elements included preoperative counseling, hydrate loading, standardized multimodal analgesia, early feeding, and early mobilization" — Sophia Schermerhorn (clinical) [Ep 23 · 0:13](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=13)
- "Length of stay decreased from about 7 days to 3.7 days" — Sophia Schermerhorn (clinical) [Ep 23 · 0:28](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=28)
- "Post-operative opioid use dropped by over half" — Sophia Schermerhorn (clinical) [Ep 23 · 0:32](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=32)
- "Patients resumed regular diets and ambulated about 3 days earlier" — Sophia Schermerhorn (clinical) [Ep 23 · 0:32](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=32)
- "The proportion of patients experiencing any postoperative complication decreased by over 50%" — Sophia Schermerhorn (clinical) [Ep 23 · 0:39](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=39)
- "Patients were cleared to resume adjuvant chemotherapy earlier at around 8 days as opposed to 10 days" — Sophia Schermerhorn (clinical) [Ep 23 · 0:46](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=46)
- "A structured ERAS pathway meaningfully improves recovery even after complex neuroblastoma resections" — Sophia Schermerhorn (opinion) [Ep 23 · 0:51](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=51)
- "ERAS represents a tangible opportunity to standardize perioperative care for neuroblastoma resection" — Sophia Schermerhorn (opinion) [Ep 23 · 0:51](https://library.globalcastmd.com/watch/enhanced-recovery-after-surgery-improves-length-of-stay-and-decreases-complications-after-resection-of-abdominal-neuroblastoma-11522?t=51)
- "This single institution cohort followed survivors for a mean of 27 years after open oncologic resection for Wilms tumor and neuroblastoma" — Sophia Schermerhorn (epidemiological) [Ep 24 · 0:11](https://library.globalcastmd.com/watch/long-term-follow-up-of-surgical-outcomes-for-patients-with-wilms-tumor-and-neuroblastoma-11581?t=11)
- "14% of patients required a repeat laparotomy" — Sophia Schermerhorn (epidemiological) [Ep 24 · 0:20](https://library.globalcastmd.com/watch/long-term-follow-up-of-surgical-outcomes-for-patients-with-wilms-tumor-and-neuroblastoma-11581?t=20)
- "The most common indications for repeat laparotomy were small bowel obstruction or tumor recurrence" — Sophia Schermerhorn (clinical) [Ep 24 · 0:21](https://library.globalcastmd.com/watch/long-term-follow-up-of-surgical-outcomes-for-patients-with-wilms-tumor-and-neuroblastoma-11581?t=21)
- "In Wilms tumor, obstruction typically occurred within the first year" — Sophia Schermerhorn (clinical) [Ep 24 · 0:26](https://library.globalcastmd.com/watch/long-term-follow-up-of-surgical-outcomes-for-patients-with-wilms-tumor-and-neuroblastoma-11581?t=26)
- "In neuroblastoma, obstruction often developed more than a decade later, well beyond routine follow-up" — Sophia Schermerhorn (clinical) [Ep 24 · 0:29](https://library.globalcastmd.com/watch/long-term-follow-up-of-surgical-outcomes-for-patients-with-wilms-tumor-and-neuroblastoma-11581?t=29)
- "Radiation dose was not associated with re-operation risk" — Sophia Schermerhorn (clinical) [Ep 24 · 0:34](https://library.globalcastmd.com/watch/long-term-follow-up-of-surgical-outcomes-for-patients-with-wilms-tumor-and-neuroblastoma-11581?t=34)
- "Secondary malignancy was uncommon in this cohort" — Sophia Schermerhorn (epidemiological) [Ep 24 · 0:37](https://library.globalcastmd.com/watch/long-term-follow-up-of-surgical-outcomes-for-patients-with-wilms-tumor-and-neuroblastoma-11581?t=37)
- "Hypertension after nephrectomy was not increased compared to population norms" — Sophia Schermerhorn (clinical) [Ep 24 · 0:37](https://library.globalcastmd.com/watch/long-term-follow-up-of-surgical-outcomes-for-patients-with-wilms-tumor-and-neuroblastoma-11581?t=37)
- "Scoliosis occurred in roughly 10 to 13% of patients, higher than the general population" — Sophia Schermerhorn (epidemiological) [Ep 24 · 0:45](https://library.globalcastmd.com/watch/long-term-follow-up-of-surgical-outcomes-for-patients-with-wilms-tumor-and-neuroblastoma-11581?t=45)
- "Scoliosis has multi-factorial contributors including surgery and possibly radiation" — Sophia Schermerhorn (clinical) [Ep 24 · 0:45](https://library.globalcastmd.com/watch/long-term-follow-up-of-surgical-outcomes-for-patients-with-wilms-tumor-and-neuroblastoma-11581?t=45)
- "Even decades after treatment, these patients remain at risk for late complications that warrant long-term counseling and follow-up" — Sophia Schermerhorn (guideline) [Ep 24 · 0:58](https://library.globalcastmd.com/watch/long-term-follow-up-of-surgical-outcomes-for-patients-with-wilms-tumor-and-neuroblastoma-11581?t=58)
- "IDRFs are necessary knowledge for clinicians treating neuroblastoma to determine safety of surgical intervention" — Sophia Schermerhorn (clinical) [Ep 25 · 0:00](https://library.globalcastmd.com/watch/the-international-neuroblastoma-risk-group-staging-system-an-inrg-task-force-report-11727?t=0)
- "IDRFs are imaging findings on CT or MRI that predict when neuroblastoma may be difficult or dangerous to remove surgically" — Sophia Schermerhorn (clinical) [Ep 25 · 0:14](https://library.globalcastmd.com/watch/the-international-neuroblastoma-risk-group-staging-system-an-inrg-task-force-report-11727?t=14)
- "The IDRF concept was first introduced in 2009 by the International Neuroblastoma Risk Group" — Sophia Schermerhorn (guideline) [Ep 25 · 0:21](https://library.globalcastmd.com/watch/the-international-neuroblastoma-risk-group-staging-system-an-inrg-task-force-report-11727?t=21)
- "The International Neuroblastoma Risk Group defined 20 specific imaging risk factors" — Sophia Schermerhorn (guideline) [Ep 25 · 0:21](https://library.globalcastmd.com/watch/the-international-neuroblastoma-risk-group-staging-system-an-inrg-task-force-report-11727?t=21)
- "Most IDRFs relate to how the tumor interacts with critical anatomy" — Sophia Schermerhorn (clinical) [Ep 25 · 0:29](https://library.globalcastmd.com/watch/the-international-neuroblastoma-risk-group-staging-system-an-inrg-task-force-report-11727?t=29)
- "In the abdomen, a tumor that infiltrates the portahepati or hepatoduodenal ligament is considered to contain an IDRF" — Sophia Schermerhorn (clinical) [Ep 25 · 0:34](https://library.globalcastmd.com/watch/the-international-neuroblastoma-risk-group-staging-system-an-inrg-task-force-report-11727?t=34)
- "The presence of an IDRF does not mean a tumor cannot be resected" — Sophia Schermerhorn (clinical) [Ep 25 · 0:41](https://library.globalcastmd.com/watch/the-international-neuroblastoma-risk-group-staging-system-an-inrg-task-force-report-11727?t=41)
- "IDRF presence signals that surgery may be technically more complex" — Sophia Schermerhorn (clinical) [Ep 25 · 0:41](https://library.globalcastmd.com/watch/the-international-neuroblastoma-risk-group-staging-system-an-inrg-task-force-report-11727?t=41)
- "Patients with IDRFs often receive neoadjuvant therapy first to try to shrink the tumor" — Sophia Schermerhorn (clinical) [Ep 25 · 0:41](https://library.globalcastmd.com/watch/the-international-neuroblastoma-risk-group-staging-system-an-inrg-task-force-report-11727?t=41)
- "Surgeons use IDRFs to predict surgical risk and guide the safest treatment approach using imaging" — Sophia Schermerhorn (clinical) [Ep 25 · 0:52](https://library.globalcastmd.com/watch/the-international-neuroblastoma-risk-group-staging-system-an-inrg-task-force-report-11727?t=52)
- "Radiation improves survival in high-risk neuroblastoma" — Sophia Schermerhorn (clinical) [Ep 26 · 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 26 · 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 26 · 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 26 · 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 26 · 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 26 · 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 26 · 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 26 · 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 26 · 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 26 · 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 26 · 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 26 · 1:03](https://library.globalcastmd.com/watch/pancreas-muscle-and-subcutaneous-fat-atrophy-in-patients-undergoing-radiation-for-neuroblastoma-11866?t=63)
- "Neuroblastoma makes up about 8 to 10% of all pediatric cancers and about 15% of cancer-related deaths" — Meera Kotagal (epidemiological) [Ep 17 · 0:23](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=23)
- "For folks who have relapsed high risk neuroblastoma, the survival rate is 0" — Meera Kotagal (clinical) [Ep 17 · 0:48](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=48)
- "Neuroblastoma cells often make catecholamines like epinephrine and norepinephrine" — Em Gootee (clinical) [Ep 17 · 1:57](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=117)
- "90% of neuroblastomas have elevated HVA and VMA" — Meera Kotagal (clinical) [Ep 17 · 2:17](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=137)
- "For the neuroblastomas, we don't think of them as causing blood pressure" — Meera Kotagal (clinical) [Ep 17 · 2:22](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=142)
- "The Curie score is specifically used to assess the extent of metastasis in neuroblastoma patients based on MIBG scans, with the body divided into 10 regions each scored 0 to 3, producing a maximum score of 30" — Em Gootee (clinical) [Ep 17 · 3:03](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=183)
- "The INSS takes into account the results of surgery to remove the tumor and cannot help doctors determine a stage before any treatment has started" — Em Gootee (clinical) [Ep 17 · 4:08](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=248)
- "INRG is a preoperative staging system designed to allow thinking about how difficult patients may be to resect and how to compare patients preoperatively" — Em Gootee (clinical) [Ep 17 · 4:26](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=266)
- "IDRFs are things that touch things that are important: touching the vessels, touching the brachial plaque, touching the trachea" — Meera Kotagal (clinical) [Ep 17 · 5:09](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=309)
- "For many cancer patients, 2/3 of them will have some long term morbidity from their chemo" — Em Gootee (clinical) [Ep 17 · 6:11](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=371)
- "The intermediate risk patients will get neoadjuvant chemotherapy depending on the degree of the chromosomal factors, getting 2, 4, 6, or 8 cycles" — Meera Kotagal (clinical) [Ep 17 · 7:12](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=432)
- "With neuroblastoma resections, we divide them into tiny, tiny pieces while we're taking them out" — Em Gootee (clinical) [Ep 17 · 7:29](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=449)
- "The biggest thing to do with neuroblastoma is stay on the vessels - find yourself a normal vessel and work from normal to abnormal" — Em Gootee (clinical) [Ep 17 · 7:38](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=458)
- "IDRFs really are associated with risk of complications" — Meera Kotagal (clinical) [Ep 17 · 8:22](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=502)
- "When corneal biopsies are performed by experienced practitioners who ensure to obtain multiple cores, the adequacy of these biopsies significantly improves" — Em Gootee (clinical) [Ep 17 · 9:13](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=553)
- "Our radiologists usually get 25 cores from different parts of the tumor" — Meera Kotagal (clinical) [Ep 17 · 9:33](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=573)
- "Percutaneous biopsy is not inferior to open surgical biopsies" — Meera Kotagal (clinical) [Ep 17 · 9:36](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=576)
- "For neuroblastoma, unlike most tumors that we resect, we would like to get as much of it we can, but we would expect that we're not possibly getting every single ounce of tumor" — Em Gootee (clinical) [Ep 17 · 10:44](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=644)
- "Your goal is to get as much of the tumor as you can without causing harm" — Em Gootee (clinical) [Ep 17 · 11:01](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=661)
- "In the COG study of 87 patients less than 6 months of age with a small adrenal mass, the 4 year event free survival for patients with neuroblastoma was 97%" — Em Gootee (clinical) [Ep 17 · 12:21](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=741)
- "The observation approach studied for primary adrenal masses has been expanded and used for L1 tumors in kids under 6 months" — Meera Kotagal (clinical) [Ep 17 · 12:48](https://library.globalcastmd.com/watch/neuroblastoma-with-dr-meera-kotagal-9212?t=768)
- "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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 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 18 · 7:45](https://library.globalcastmd.com/watch/dr-yujie-ma-best-of-the-best-in-pediatric-surgery-2025-10036?t=465)
- "Patients with high-risk neuroblastoma require chemotherapy, immunotherapy, radiotherapy, and surgery to be cured." — Sabine Irtan (clinical) [Ep 19 · 0:40](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=40)
- "The role of surgery in high-risk neuroblastoma remains controversial." — Sabine Irtan (opinion) [Ep 19 · 0:48](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=48)
- "Kewarm's 2020 JCO paper stated that complete macroscopic excision of the primary tumor improved both overall and event-free survival in 1,531 patients with stage 4 neuroblastoma." — Sabine Irtan (clinical) [Ep 19 · 0:52](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=52)
- "Kewarm's study based success of intervention and judgment on post-operative residue on the operative report, with no systematic radiological assessment." — Sabine Irtan (clinical) [Ep 19 · 1:08](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=68)
- "The study included 283 patients (108 females, 175 males) diagnosed at a median age of 35 months." — Sabine Irtan (epidemiological) [Ep 19 · 1:48](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=108)
- "The primary tumor site was the abdomen in 95% of patients." — Sabine Irtan (epidemiological) [Ep 19 · 1:57](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=117)
- "The tumor origin was the adrenal gland in 81% of patients." — Sabine Irtan (epidemiological) [Ep 19 · 2:02](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=122)
- "Post-operative imaging was performed at a median of 62 days after surgery and was mainly CT scan or MRI." — Sabine Irtan (clinical) [Ep 19 · 2:06](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=126)
- "Residue was present in half of the patients." — Sabine Irtan (epidemiological) [Ep 19 · 2:17](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=137)
- "The median volume of the residue was 0.27 mL." — Sabine Irtan (epidemiological) [Ep 19 · 2:20](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=140)
- "In 28 patients the residue was a microcalcification." — Sabine Irtan (clinical) [Ep 19 · 2:25](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=145)
- "Excluding patients with microcalcifications, the median residue volume was 1.04 mL." — Sabine Irtan (epidemiological) [Ep 19 · 2:29](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=149)
- "Only 11% of patients had a residue of more than 5 mL." — Sabine Irtan (epidemiological) [Ep 19 · 2:29](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=149)
- "The residue was linked to the presence of IDRF in 71% of patients." — Sabine Irtan (epidemiological) [Ep 19 · 2:40](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=160)
- "MIBG positivity of the residue was present in 70.5% of patients with a post-operative MIBG available." — Sabine Irtan (epidemiological) [Ep 19 · 2:40](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=160)
- "Radiological post-operative residue showed no impact on event-free survival and overall survival." — Sabine Irtan (clinical) [Ep 19 · 2:58](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=178)
- "MIBG-positive residue had an impact on event-free survival and overall survival with a difference of more than 20% of survival." — Sabine Irtan (clinical) [Ep 19 · 3:08](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=188)
- "Patients with MIBG-positive residue had 25% and 27% five-year event-free survival." — Sabine Irtan (epidemiological) [Ep 19 · 3:20](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=200)
- "Patients with no residue or no MIBG-positive residue had 51% five-year event-free survival." — Sabine Irtan (epidemiological) [Ep 19 · 3:20](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=200)
- "The survival difference between MIBG-positive and MIBG-negative residue groups was confirmed for five-year overall survival." — Sabine Irtan (clinical) [Ep 19 · 3:20](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=200)
- "External validation on the entire high-risk neuroblastoma cohort in patients with stage 4 neuroblastoma who had surgery and post-surgical MIBG evaluation confirmed the results." — Sabine Irtan (clinical) [Ep 19 · 3:45](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=225)
- "The survival difference between MIBG-positive residue and no/MIBG-negative residue was present even for patients with partial or minimal metastatic response, with a 10% survival difference." — Sabine Irtan (clinical) [Ep 19 · 4:04](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=244)
- "Half of patients operated on in expert centers have a tumor residue objectively identified on post-operative images of less than 1 mL." — Sabine Irtan (epidemiological) [Ep 19 · 4:26](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=266)
- "The residue was MIBG-positive in around 20% of patients." — Sabine Irtan (epidemiological) [Ep 19 · 4:36](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=276)
- "Radiologically detected post-operative tumor residues impact outcomes only if active disease was demonstrated through post-operative MIBG scanning." — Sabine Irtan (clinical) [Ep 19 · 4:40](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=280)
- "Complete resection should be maintained as a major surgical goal." — Sabine Irtan (guideline) [Ep 19 · 4:54](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=294)
- "Metastatic response is an important prognostic cofactor." — Sabine Irtan (clinical) [Ep 19 · 4:59](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=299)
- "In COG data, there was zero correlation between what the surgeon said they resected and what was actually present on post-operative imaging." (clinical) [Ep 19 · 5:19](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=319)
- "For patients where the surgeon reported leaving nothing, almost half had residue on post-operative images." — Sabine Irtan (clinical) [Ep 19 · 5:43](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=343)
- "For patients where the surgeon reported leaving residue, imaging found residue in two-thirds and no residue in one-third." — Sabine Irtan (clinical) [Ep 19 · 5:57](https://library.globalcastmd.com/watch/dr-sabine-irtan-best-of-the-best-in-pediatric-surgery-2025-10044?t=357)
- "Study was a retrospective analysis of 12,000 patients with neuroblastoma, Wilms tumor, and hepatoblastoma from the National Cancer Database" — Sophia Schermerhorn (epidemiological) [Ep 22 · 0:12](https://library.globalcastmd.com/watch/social-determinants-of-health-influence-on-survival-in-wilms-tumor-neuroblastoma-and-hepatoblastoma-11371?t=12)
- "Socioeconomic disadvantage score was created for each patient based on median household income and education level in their local communities" — Sophia Schermerhorn (epidemiological) [Ep 22 · 0:20](https://library.globalcastmd.com/watch/social-determinants-of-health-influence-on-survival-in-wilms-tumor-neuroblastoma-and-hepatoblastoma-11371?t=20)
- "The most disadvantaged children were more likely to have worse survival for Wilms tumor and neuroblastoma" — Sophia Schermerhorn (epidemiological) [Ep 22 · 0:31](https://library.globalcastmd.com/watch/social-determinants-of-health-influence-on-survival-in-wilms-tumor-neuroblastoma-and-hepatoblastoma-11371?t=31)
- "After adjusting for tumor size, grade, treatment, and comorbidities, socioeconomic effects on survival remained present" — Sophia Schermerhorn (epidemiological) [Ep 22 · 0:37](https://library.globalcastmd.com/watch/social-determinants-of-health-influence-on-survival-in-wilms-tumor-neuroblastoma-and-hepatoblastoma-11371?t=37)
- "Hazard ratio for socioeconomic disadvantage was 2.02 for Wilms tumor" — Sophia Schermerhorn (epidemiological) [Ep 22 · 0:44](https://library.globalcastmd.com/watch/social-determinants-of-health-influence-on-survival-in-wilms-tumor-neuroblastoma-and-hepatoblastoma-11371?t=44)
- "Hazard ratio for socioeconomic disadvantage was 1.29 for hepatoblastoma" — Sophia Schermerhorn (epidemiological) [Ep 22 · 0:44](https://library.globalcastmd.com/watch/social-determinants-of-health-influence-on-survival-in-wilms-tumor-neuroblastoma-and-hepatoblastoma-11371?t=44)
- "Pediatric oncology outcomes depend on tumor biology, treatment received, and social determinants of health" — Sophia Schermerhorn (opinion) [Ep 22 · 0:51](https://library.globalcastmd.com/watch/social-determinants-of-health-influence-on-survival-in-wilms-tumor-neuroblastoma-and-hepatoblastoma-11371?t=51)
- "Identifying socioeconomic risk factors is necessary to close equity gaps and improve survival for all children with solid tumors" — Sophia Schermerhorn (opinion) [Ep 22 · 1:00](https://library.globalcastmd.com/watch/social-determinants-of-health-influence-on-survival-in-wilms-tumor-neuroblastoma-and-hepatoblastoma-11371?t=60)
- "High-risk neuroblastoma patients continue to have a survival rate in the 38 to 40% range" — Dan (epidemiological) [Ep 1 · 0:30](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=30)
- "The complication rate for aggressive neuroblastoma resection is about 30% morbidity with mortality less than 1%" — Dan (clinical) [Ep 1 · 12:55](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=775)
- "The biggest volume response of neuroblastoma tumor is with the first two cycles of chemotherapy, with very little response after that" — Dan (clinical) [Ep 1 · 9:53](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=593)
- "More chemotherapy or other agents like MIBG make the tumor more fibrotic and make the subadventitial dissection technique more difficult" — Dan (opinion) [Ep 1 · 10:09](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=609)
- "Surgeons overestimated their degree of resection two-thirds of the time compared to postoperative imaging in a pilot tandem transplant study" — Dan (clinical) [Ep 1 · 6:53](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=413)
- "In a repeat COG study, there was only 66% concordance between surgeon assessment and radiologist assessment of resection extent, with surgeons underestimating and radiologists overcalling" — Dan (clinical) [Ep 1 · 7:22](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=442)
- "The German study of 278 stage 4 high-risk neuroblastoma patients achieved complete resection in almost half and >90% resection in another quarter, totaling 75% with >90% resection" — Dan (clinical) [Ep 1 · 16:31](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=991)
- "The German study showed overall survival of 45%, event-free survival of 33%, and local progression-free survival of 58%" — Dan (epidemiological) [Ep 1 · 16:57](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1017)
- "The German study found 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)
- "The European study from Sien included 1,324 patients and achieved 76% with >95% resection" — Dan (clinical) [Ep 1 · 18:09](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1089)
- "The European study had 0.5% mortality and 10% morbidity for major complications, with total complications around 30%" — Dan (epidemiological) [Ep 1 · 18:45](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1125)
- "The European study showed significant improvement in event-free survival and overall survival with >95% resection, the first study to show significant improvement in overall survival" — Dan (clinical) [Ep 1 · 19:01](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1141)
- "The COG 3973 study of about 230 patients showed statistically significant improvement in local relapse-free survival and event-free survival with aggressive resection" — Dan (clinical) [Ep 1 · 21:15](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1275)
- "The COG 3973 study was not able to demonstrate improvement in overall survival, possibly due to type 2 error from insufficient patient numbers compared to the European study" — Dan (clinical) [Ep 1 · 21:35](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1295)
- "The safest surgical technique is to get on the vessels and stay on the vessels rather than getting close to the vessels" — Dan (opinion) [Ep 1 · 6:02](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=362)
- "If you have only one kidney after nephrectomy, you cannot get as much chemotherapy and that probably impacts overall survival" — Dan (clinical) [Ep 1 · 24:12](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1452)
- "Older data shows that if you take out the kidney during neuroblastoma resection, survival is worse" — Dan (clinical) [Ep 1 · 23:56](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1436)
- "Immunotherapy is effective in the setting of minimal residual disease" — Dan (clinical) [Ep 1 · 25:21](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1521)
- "In European studies, neuroblastoma procedures are done in more than 200 hospitals" — Dan (epidemiological) [Ep 1 · 23:16](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=1396)
- "High-risk neuroblastoma treatment includes 9 different drugs, bone marrow transplantation, and in some cases total body radiation" (clinical) [Ep 1 · 14:38](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=878)
- "Current protocols for high-risk neuroblastoma include tandem peripheral blood stem cell transplants, followed by immunotherapy and Retin-A" — Dan (guideline) [Ep 1 · 14:53](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=893)
- "High-risk neuroblastoma survival has increased 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" (epidemiological) [Ep 1 · 16:05](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=965)
- "In the Georgia study, many deaths were not due to cancer but due to intensified treatment" (clinical) [Ep 1 · 16:05](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2016-434?t=965)
- "High-risk neuroblastoma patients continue to have a survival rate 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)
- "The complication rate for aggressive neuroblastoma resection is about 30% morbidity with mortality less than 1%" — Daniel von Allmen (clinical) [Ep 2 · 13:12](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=792)
- "The biggest volume response of neuroblastoma tumor is with the first two cycles of chemotherapy, with very little response after that" — Daniel von Allmen (clinical) [Ep 2 · 10:00](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=600)
- "More chemotherapy or other agents like MIBG make the 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)
- "There is only 66% concordance between surgeon's operative assessment of resection completeness and postoperative imaging assessment" — Daniel von Allmen (clinical) [Ep 2 · 6:52](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=412)
- "In the German study of 278 stage 4 patients, 75% achieved greater than 90% resection with overall survival 45% and event-free survival 33%" — Daniel von Allmen (clinical) [Ep 2 · 16:48](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1008)
- "The German study showed no difference in overall survival, event-free survival, or local progression-free survival based on completeness of resection" — Daniel von Allmen (clinical) [Ep 2 · 17:32](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1052)
- "The European study of 1,324 patients showed significant improvement in both event-free survival and overall survival with greater than 95% resection" — Daniel von Allmen (clinical) [Ep 2 · 19:17](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1157)
- "The COG 3973 study of 230 patients showed significant improvement in local relapse-free survival and event-free survival but not overall survival" — Daniel von Allmen (clinical) [Ep 2 · 21:32](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1292)
- "If you take out the kidney during neuroblastoma resection, survival is worse, likely because patients cannot receive as much chemotherapy with only one kidney" — Daniel von Allmen (clinical) [Ep 2 · 24:12](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1452)
- "Immunotherapy is effective 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)
- "The safest surgical technique is to get on the vessels and stay on the vessels rather than getting close to the vessels" — Daniel von Allmen (opinion) [Ep 2 · 6:12](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=372)
- "There is pretty good evidence that aggressive resection improves survival in stage 3 patients" (clinical) [Ep 2 · 12:09](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=729)
- "The only survivors with stage 4 disease in the Riley study were the ones that had primary tumor resection" (clinical) [Ep 2 · 14:07](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=847)
- "High-risk neuroblastoma patients eventually get 9 different drugs and bone marrow transplantation, with some receiving total body radiation" (clinical) [Ep 2 · 14:55](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=895)
- "With dose intensification including tandem transplants, immunotherapy, and Retin-A, survival has increased from 10% to 30-40%, with the Georgia study showing 46% survival" (epidemiological) [Ep 2 · 16:01](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=961)
- "Deaths in intensively treated neuroblastoma patients were not due to cancer in many instances but due to the intensified treatment" (clinical) [Ep 2 · 16:22](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=982)
- "The European study had surgical mortality of 0.5% and morbidity of 10%, though lower-grade complications reached 30%" — Daniel von Allmen (clinical) [Ep 2 · 19:02](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1142)
- "Aggressive neuroblastoma resections using the Kiely subadventitial approach should not be performed by occasional pediatric oncological surgeons" (opinion) [Ep 2 · 22:12](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1332)
- "In European studies, neuroblastoma procedures are done in more than 200 hospitals" — Daniel von Allmen (epidemiological) [Ep 2 · 23:33](https://library.globalcastmd.com/watch/neuroblastoma-update-course-2014-651?t=1413)
- "The curation process reviews 33 journals including top pediatric, surgical, and clinical journals (NEJM, Lancet, JAMA), averaging 1200 articles monthly" — Todd (clinical) [Ep 10 · 1:53](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=113)
- "Upper GI contrast study is very dependent on the person who performs it and availability varies by institution" (opinion) [Ep 10 · 8:08](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=488)
- "Reversal of vessels at the root of the mesentery on ultrasound is not a very reliable way to make the diagnosis of malrotation" (clinical) [Ep 10 · 8:35](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=515)
- "Presence of an appendicolith has about a 50% failure rate with non-operative management of appendicitis" — Todd (clinical) [Ep 10 · 10:22](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=622)
- "Most surgeons use the presence of appendicolith as a contraindication for non-operative management" — Todd (clinical) [Ep 10 · 10:43](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=643)
- "In the non-surgical appendicitis management group, 46% of patients required appendectomy during 5-year follow-up" — Todd (clinical) [Ep 10 · 11:52](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=712)
- "The surgical appendicitis group had no readmissions while half of the non-surgical group presented to the emergency room" — Todd (clinical) [Ep 10 · 12:04](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=724)
- "Complete resection of intermediate risk neuroblastoma doesn't provide any surgical benefit" (clinical) [Ep 10 · 13:59](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=839)
- "In stage 4 high-risk neuroblastoma, 5-year event-free survival and overall survival were significantly higher with complete resection" (clinical) [Ep 10 · 14:29](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=869)
- "Local progression in stage 4 neuroblastoma was lower with complete resection compared with incomplete resection" (clinical) [Ep 10 · 14:36](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=876)
- "Fetal endoscopic tracheal occlusion (FETO) resulted in 40% survival to discharge versus 15% with expectant care for severe left CDH" (clinical) [Ep 10 · 16:36](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=996)
- "FETO was associated with increased risk of preterm pre-labor rupture of membranes and preterm labor" (clinical) [Ep 10 · 16:44](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=1004)
- "Whole blood transfusion as adjunct to component therapy resulted in decreased transfusion volume at 24 hours" — Todd (clinical) [Ep 10 · 18:33](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=1113)
- "The whole blood group required fewer ventilation days compared to component therapy alone" — Todd (clinical) [Ep 10 · 18:33](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=1113)
- "Mortality, length of stay, and major complications were the same between whole blood and component therapy groups" — Todd (clinical) [Ep 10 · 18:33](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=1113)
- "Ambulance rigs nationwide in adults are starting to travel with whole blood capabilities and use it earlier" — Todd (clinical) [Ep 10 · 19:40](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=1180)
- "Current ATLS guidelines suggest initial bolus with normal saline or crystalloid solution before moving to blood products" — Todd (guideline) [Ep 10 · 19:51](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=1191)
- "Some centers are limiting whole blood use to males and children older than 15 years" — Todd (clinical) [Ep 10 · 21:10](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=1270)
- "Pediatric centers don't use massive transfusion protocols as frequently as adult centers" — Todd (clinical) [Ep 10 · 20:49](https://library.globalcastmd.com/watch/update-course-2021-top-publications-in-non-ped-surg-journals-5404?t=1249)
- "The systematic review and meta-analysis was conducted by IPSO" — Cecilia Gigena (clinical) [Ep 13 · 0:09](https://library.globalcastmd.com/watch/image-guided-core-needle-or-surgical-biopsy-for-neuroblastoma-diagnosis-in-children-7988?t=9)
- "The review analyzed the accuracy and safety of image-guided core needle biopsy for neuroblastoma" — Cecilia Gigena (clinical) [Ep 13 · 0:09](https://library.globalcastmd.com/watch/image-guided-core-needle-or-surgical-biopsy-for-neuroblastoma-diagnosis-in-children-7988?t=9)
- "The review included 8 retrospective studies with 490 patients" — Cecilia Gigena (epidemiological) [Ep 13 · 0:23](https://library.globalcastmd.com/watch/image-guided-core-needle-or-surgical-biopsy-for-neuroblastoma-diagnosis-in-children-7988?t=23)
- "Tissue adequacy was not significantly different between image-guided core needle biopsy and surgical biopsy groups" — Cecilia Gigena (clinical) [Ep 13 · 0:23](https://library.globalcastmd.com/watch/image-guided-core-needle-or-surgical-biopsy-for-neuroblastoma-diagnosis-in-children-7988?t=23)
- "Biological characterization of the biopsy was not significantly different between image-guided core needle biopsy and surgical biopsy groups" — Cecilia Gigena (clinical) [Ep 13 · 0:23](https://library.globalcastmd.com/watch/image-guided-core-needle-or-surgical-biopsy-for-neuroblastoma-diagnosis-in-children-7988?t=23)
- "Intraoperative transfusions were higher in the surgical biopsy group compared to image-guided core needle biopsy" — Cecilia Gigena (clinical) [Ep 13 · 0:23](https://library.globalcastmd.com/watch/image-guided-core-needle-or-surgical-biopsy-for-neuroblastoma-diagnosis-in-children-7988?t=23)
- "Complications were higher in the surgical biopsy group compared to image-guided core needle biopsy" — Cecilia Gigena (clinical) [Ep 13 · 0:23](https://library.globalcastmd.com/watch/image-guided-core-needle-or-surgical-biopsy-for-neuroblastoma-diagnosis-in-children-7988?t=23)
- "Image-guided core needle biopsy is safe and effective for diagnosing neuroblastoma" — Cecilia Gigena (opinion) [Ep 13 · 0:43](https://library.globalcastmd.com/watch/image-guided-core-needle-or-surgical-biopsy-for-neuroblastoma-diagnosis-in-children-7988?t=43)
- "Dr. Bailey Roberts from IPSO presented on extracellular vesicles for metastatic osteosarcoma contributing to the creation of pre-metastatic niche" — Cecilia (clinical) [Ep 16 · 0:08](https://library.globalcastmd.com/watch/heat-2-winner-matthew-urichuk-phd-best-of-the-best-in-pediatric-surgery-2024-8013?t=8)
- "Dr. Dominic Simons from IPSO presented on multimodal 3D visualization of pediatric neuroblastoma aiding surgical planning beyond anatomical information" — Cecilia (clinical) [Ep 16 · 0:19](https://library.globalcastmd.com/watch/heat-2-winner-matthew-urichuk-phd-best-of-the-best-in-pediatric-surgery-2024-8013?t=19)
- "Dr. Miyake from CAPS presented on using microinjection for drug delivery with nanoparticles in lung explants to study prenatal treatment of CDH" — Cecilia (clinical) [Ep 16 · 0:31](https://library.globalcastmd.com/watch/heat-2-winner-matthew-urichuk-phd-best-of-the-best-in-pediatric-surgery-2024-8013?t=31)
- "Dr. Urichuk from CAPS presented that individuals with thoracoabdominal congenital surgical anomalies are at increased risk of adverse mental health outcomes" — Cecilia (clinical) [Ep 16 · 0:47](https://library.globalcastmd.com/watch/heat-2-winner-matthew-urichuk-phd-best-of-the-best-in-pediatric-surgery-2024-8013?t=47)
- "Dr. Matthew Urichuk won Heat 2 of the Best of the Best in Pediatric Surgery 2024 competition" — Cecilia (clinical) [Ep 16 · 1:27](https://library.globalcastmd.com/watch/heat-2-winner-matthew-urichuk-phd-best-of-the-best-in-pediatric-surgery-2024-8013?t=87)
- "Neuroblastoma is surgically challenging to resect mainly due to adhesion and encasement to important structures, heterogeneity, and therapy-induced changes" — Dominique Simmons (clinical) [Ep 15 · 0:35](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009?t=35)
- "The surgical goal is to resect more than 95% of tumor tissue while sparing anatomical structures" — Dominique Simmons (guideline) [Ep 15 · 0:45](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009?t=45)
- "In ADC imaging, diffusion restriction is associated with viable tumor tissue and appears as low signal" — Dominique Simmons (clinical) [Ep 15 · 1:36](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009?t=96)
- "In MIBG SPECT-CT imaging, high uptake is associated with viable tumor tissue" — Dominique Simmons (clinical) [Ep 15 · 1:36](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009?t=96)
- "Uptake and diffusion restriction change over time, suggesting tumor biology and vitality may change" — Dominique Simmons (clinical) [Ep 15 · 1:52](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009?t=112)
- "Dice coefficient measures overlap between two structures in image registration" — Dominique Simmons (clinical) [Ep 15 · 2:18](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009?t=138)
- "Target registration error measures distance between two points in image registration" — Dominique Simmons (clinical) [Ep 15 · 2:18](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009?t=138)
- "Seven patients with abdominal neuroblastoma eligible for surgery were included prospectively" — Dominique Simmons (epidemiological) [Ep 15 · 2:58](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009?t=178)
- "Accurate initial registration was achieved for all patients with median Dice of 0.81 for ADC" — Dominique Simmons (clinical) [Ep 15 · 3:10](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009?t=190)
- "Median Dice coefficient was 0.77 for MIBG registration" — Dominique Simmons (clinical) [Ep 15 · 3:10](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009?t=190)
- "Median target registration error was 5.3mm for ADC and 4.3mm for MIBG" — Dominique Simmons (clinical) [Ep 15 · 3:10](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009?t=190)
- "In some cases, ADC and MIBG risk models showed similar patterns, with lateral tumor marked high-risk and medial tumor marked low-risk" — Dominique Simmons (clinical) [Ep 15 · 3:37](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009?t=217)
- "In other cases, ADC and MIBG identified completely different regions as high-risk, with ADC marking cranial portions and MIBG marking different regions" — Dominique Simmons (clinical) [Ep 15 · 3:52](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009?t=232)
- "The workflow uses Elastix software for image registration" — Dominique Simmons (clinical) [Ep 15 · 5:50](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009?t=350)
- "Image registration can be performed in Python or MATLAB" — Dominique Simmons (clinical) [Ep 15 · 5:50](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009?t=350)
- "Tumor segmentation is the most time-consuming step in the workflow" — Dominique Simmons (clinical) [Ep 15 · 6:14](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009?t=374)
- "The actual image registration process takes only a few minutes" — Dominique Simmons (clinical) [Ep 15 · 6:14](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009?t=374)
- "Current clinical belief is that MIBG-positive areas should be resected" — Dominique Simmons (opinion) [Ep 15 · 7:22](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009?t=442)
- "The thresholds used for risk stratification are based on limited literature, which questions the reliability of the ADC and MIBG values" — Dominique Simmons (opinion) [Ep 15 · 4:53](https://library.globalcastmd.com/watch/dominique-simons-msc-best-of-the-best-in-pediatric-surgery-2024-8009?t=293)
- "The 12th annual update course in pediatric surgery was held in August 2024" — Em Gootee (clinical) [Ep 20 · 0:13](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=13)
- "Image-guided surgery session classifies as blue square for promising newer practice" — Em Gootee (guideline) [Ep 20 · 0:56](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=56)
- "Image-guided surgery uses real-time imaging including CT, MRI, ultrasound, or fluoroscopy to provide detailed views of internal structures" — Em Gootee (clinical) [Ep 20 · 1:15](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=75)
- "Surgeons may not know what is possible with image guidance so they don't know what to ask for" — Em Gootee (opinion) [Ep 20 · 1:39](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=99)
- "Interventional radiologists may not know what surgeons need so they might not know what to offer" — John Ricardo (opinion) [Ep 20 · 1:44](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=104)
- "A hybrid operating room is not required for image-guided surgery collaboration" — Timothy Lotz (clinical) [Ep 20 · 2:17](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=137)
- "Image-guided collaboration can occur in regular OR by bringing an ultrasound machine, in a hybrid OR, or in dual settings using CT scanner for localization then moving to OR" — Timothy Lotz (clinical) [Ep 20 · 2:23](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=143)
- "Cone beam CT is a CT scan performed on a C-arm fluoroscopy unit that rotates around the patient collecting multiple images which are stacked together" — Amanda Bellingford (clinical) [Ep 20 · 2:45](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=165)
- "Cone beam CT provides excellent visualization of bony structures making it valuable for maxillofacial, ENT, spine, and orthopedic surgeries" — Em Gootee (clinical) [Ep 20 · 2:59](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=179)
- "Many institutions have cone beam CT technology available and don't realize it even if not in a hybrid OR space" — Timothy Lotz (opinion) [Ep 20 · 3:15](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=195)
- "Cincinnati Children's hybrid OR has been open for about 7 years" — John Ricardo (clinical) [Ep 20 · 3:28](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=208)
- "Interventional radiologists at Cincinnati Children's help train pediatric surgery fellows including guidance for vascular access" — Em Gootee (clinical) [Ep 20 · 3:36](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=216)
- "Having a program manager as liaison between surgeons and interventional radiologists is important because nobody wants to try something new if it will be more complicated and take longer than normal practice" — Amanda Bellingford (opinion) [Ep 20 · 3:54](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=234)
- "Leadership engagement from both surgery and radiology chiefs has helped the collaborative program" — Amanda Bellingford (opinion) [Ep 20 · 4:11](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=251)
- "The hybrid OR at Cincinnati is used by multiple divisions including urology, neurosurgery, pulmonary, and gynecology for collaborative cases with multiple procedures" — Amanda Bellingford (clinical) [Ep 20 · 4:24](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=264)
- "For lymph node localization of difficult-to-palpate supraclavicular nodes, ultrasound guidance with Kopans needle wire can be used in one prep and drape" — Timothy Lotz (clinical) [Ep 20 · 4:44](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=284)
- "Ultrasound in OR can localize foreign bodies like glass, and IR colleagues should be called before air introduction makes things virtually invisible" — John Ricardo (clinical) [Ep 20 · 5:15](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=315)
- "During neuroblastoma excisions, ultrasound can be used every 5 minutes to identify celiac artery takeoff while dissecting along the aorta" — Timothy Lotz (clinical) [Ep 20 · 5:40](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=340)
- "Ultrasound can confirm vessel patency at end of case including renal flow after challenging neuroblastoma excision where renal hilum has been skeletonized" — Timothy Lotz (clinical) [Ep 20 · 5:52](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=352)
- "Pulmonary nodule localization can be done with wire, coil, or dye depending on institutional preference" — Timothy Lotz (clinical) [Ep 20 · 6:19](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=379)
- "At one institution, CT-guided coil placement by IR is followed by fluoroscopy in OR under two orthogonal planes to localize and remove pulmonary nodules" — Timothy Lotz (clinical) [Ep 20 · 6:35](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=395)
- "Coil approach for pulmonary nodule localization avoids risk of wire displacement" — Timothy Lotz (clinical) [Ep 20 · 6:56](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=416)
- "At Cincinnati Children's, pulmonary nodule localization uses methylene blue blood patch with cone beam CT in thoracoscopy position, tattooing visceral pleura with Kopans needle then deploying Kopans wire" — John Ricardo (clinical) [Ep 20 · 7:14](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=434)
- "Vascular malformations are often managed in multidisciplinary VLC clinic with IR offering sclerotherapy and surgeons offering resection" — Timothy Lotz (clinical) [Ep 20 · 7:38](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=458)
- "For vascular malformations not amenable to sclerotherapy, IR can do angiogram with direct contrast injection and glue placement to ensure complete resection of outpouchings" — Timothy Lotz (clinical) [Ep 20 · 7:52](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=472)
- "For transbronchial biopsies, cone beam CT with 3D anatomy segmentation taking about 1 minute allows live fluoroscopy to be superimposed over nodule in AP and lateral views" — John Ricardo (clinical) [Ep 20 · 8:20](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=500)
- "Augmented reality uses holographic display superimposed over patient on table by taking pre-procedure CT or MRI imaging, segmenting it out, and co-registering it to the patient" — John Ricardo (clinical) [Ep 20 · 8:46](https://library.globalcastmd.com/watch/update-course-rewind-highlighting-collaboration-from-surgery-interventional-radiology-in-the-or-2024-10109?t=526)
- "APSA created a peer support program for pediatric surgeons in 2020" — Lizzie Lee (clinical) [Ep 21 · 1:00](https://library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=60)
- "The program's goal was to support surgeons after traumatic events" — Lizzie Lee (clinical) [Ep 21 · 1:12](https://library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=72)
- "The most common referral reasons were toxic work environments and adverse events" — Lizzie Lee (epidemiological) [Ep 21 · 1:16](https://library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=76)
- "50 surgeons total agreed to receive training on how to be a supporter" — Lizzie Lee (epidemiological) [Ep 21 · 1:20](https://library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=80)
- "Over 80% of trained supporters were able to use peer support skills informally with colleagues, partners, and trainees" — Lizzie Lee (epidemiological) [Ep 21 · 1:25](https://library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=85)
- "Tracheomalacia was 5% more common in tracheal occluded infants with 4% more cases" — Carlos Colunga (epidemiological) [Ep 21 · 2:25](https://library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=145)
- "Tracheomalacia symptoms in tracheal occluded infants typically receded within 55 months" — Carlos Colunga (clinical) [Ep 21 · 2:25](https://library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=145)
- "Tracheal occluded infants typically showed a larger trachea, which was around 31% wider" — Carlos Colunga (clinical) [Ep 21 · 2:34](https://library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=154)
- "37% of tracheal occluded cases retained metallic balloon components" — Carlos Colunga (epidemiological) [Ep 21 · 2:34](https://library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=154)
- "No significant complications were reported from retained metallic balloon components" — Carlos Colunga (clinical) [Ep 21 · 2:34](https://library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=154)
- "While tracheal occlusion is effective in promoting lung growth, it is associated with a higher risk of tracheomalacia" — Carlos Colunga (clinical) [Ep 21 · 2:47](https://library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=167)
- "Most cases of tracheomalacia after tracheal occlusion resolve and do not appear to have long-term effects" — Carlos Colunga (clinical) [Ep 21 · 2:47](https://library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=167)
- "The IPSO meta-analysis gathered 8 retrospective studies with 490 patients" — Cecilia Gigena (epidemiological) [Ep 21 · 3:40](https://library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=220)
- "Tissue adequacy and biological characterization of the biopsy was not significantly different between image-guided core needle biopsy and surgical biopsy groups" — Cecilia Gigena (clinical) [Ep 21 · 3:40](https://library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=220)
- "Intraoperative transfusions were higher in the surgical biopsy group compared to image-guided core needle biopsy" — Cecilia Gigena (clinical) [Ep 21 · 3:54](https://library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=234)
- "Complications were higher in the surgical biopsy group compared to image-guided core needle biopsy" — Cecilia Gigena (clinical) [Ep 21 · 3:54](https://library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=234)
- "Image-guided core needle biopsy is safe and effective for diagnosing neuroblastoma" — Cecilia Gigena (clinical) [Ep 21 · 4:00](https://library.globalcastmd.com/watch/quick-literature-updates-ep-19-10465?t=240)
- "Adrenal hemorrhage is the most common differential diagnosis for prenatal suprarenal mass, more common with history of fetal stress" — Daniel von Allmen (clinical) [Ep 3 · 2:11](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=131)
- "Other differential diagnoses for suprarenal mass include neuroblastoma, pulmonary sequestration below the diaphragm, and misdiagnosed renal anomaly" — Daniel von Allmen (clinical) [Ep 3 · 2:11](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=131)
- "Familial neuroblastoma occurs in about 1% of patients" — Tony Sandler (epidemiological) [Ep 3 · 4:39](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=279)
- "For prenatal suprarenal mass, first postnatal study should be ultrasound of the abdomen" — Todd Ponsky (guideline) [Ep 3 · 5:07](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=307)
- "CT scan or MRI not needed for 3 cm lesion unless urine catecholamines are elevated" — Tony Sandler (guideline) [Ep 3 · 5:34](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=334)
- "MIBG scan is the next step if catecholamines are elevated" — Daniel von Allmen (guideline) [Ep 3 · 6:02](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=362)
- "Radiologists are quite good at identifying adrenal hemorrhage on ultrasound" — Daniel von Allmen (opinion) [Ep 3 · 6:02](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=362)
- "In perinatal phase, most common metastatic sites are liver, bone, skin, and lymph nodes" — Daniel von Allmen (clinical) [Ep 3 · 8:14](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=494)
- "Nocktern study data supports observation of prenatal neuroblastoma with careful ultrasound surveillance" — Daniel von Allmen (guideline) [Ep 3 · 8:44](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=524)
- "Of 84 observed patients in Nocktern study, 16 (approximately 20%) underwent resection for growth or family preference" — Tony Sandler (epidemiological) [Ep 3 · 10:39](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=639)
- "Nocktern study showed approximately 98% event-free survival and 100% overall survival in observed prenatal neuroblastoma" — Erika Newman (epidemiological) [Ep 3 · 11:07](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=667)
- "First-year surveillance protocol: ultrasound and catecholamines at birth, 3 weeks, 6 weeks, 12 weeks, then spaced out to one year" — Erika Newman (guideline) [Ep 3 · 11:37](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=697)
- "After one year, surveillance becomes every six months, then yearly" — Erika Newman (guideline) [Ep 3 · 11:37](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=697)
- "Case report: child with observed prenatal adrenal mass that resolved presented at age 3 with widely metastatic high-risk neuroblastoma" — Daniel von Allmen (clinical) [Ep 3 · 12:27](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=747)
- "5 centimeters is used as size cutoff for surgical intervention in observed prenatal masses" — Tony Sandler (guideline) [Ep 3 · 14:36](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=876)
- "Volume increase of more than 50% is criterion for considering surgery" — Todd Ponsky (guideline) [Ep 3 · 15:08](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=908)
- "50% increase in VMA or HVA prompts consideration of surgery" — Todd Ponsky (guideline) [Ep 3 · 15:08](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=908)
- "Laparoscopic approach is reasonable for masses less than 6 centimeters" — Erika Newman (guideline) [Ep 3 · 16:07](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=967)
- "Lymph node status in neuroblastoma is not as important for therapy changes as in Wilms tumor" — Daniel von Allmen (clinical) [Ep 3 · 16:36](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=996)
- "Biology of neuroblastoma is more important than lymph node status for treatment decisions" — Erika Newman (clinical) [Ep 3 · 17:00](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1020)
- "Stage MS (formerly 4S) with skin lesions and liver mets still tends to have good biology" — Erika Newman (clinical) [Ep 3 · 17:30](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1050)
- "Primary concern in stage MS with liver involvement is mass effect causing respiratory compromise" — Daniel von Allmen (clinical) [Ep 3 · 17:58](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1078)
- "Stage MS without distress can be treated with aggressive observation" — Erika Newman (guideline) [Ep 3 · 17:58](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1078)
- "Once respiratory compromise begins, treatment options include chemotherapy, radiation, or emergent decompressive laparotomy" — Erika Newman (guideline) [Ep 3 · 17:58](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1078)
- "Classic findings of stage MS (high catecholamines, blue blebs on skin, liver metastasis, adrenal mass) may not require biopsy" — Daniel von Allmen (opinion) [Ep 3 · 19:06](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1146)
- "Liver biopsy in newborns is difficult because bleeding is hard to control" — Erika Newman (clinical) [Ep 3 · 19:52](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1192)
- "If NMYC is amplified in stage MS, staging changes from MS to M" — Todd Ponsky (clinical) [Ep 3 · 20:40](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1240)
- "VIP secretion can cause severe diarrhea in neuroblastoma" — Erika Newman (clinical) [Ep 3 · 21:05](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1265)
- "Initial workup for abdominal mass includes ultrasound to determine solid vs cystic, then CT with PO and IV contrast if solid" — Erika Newman (guideline) [Ep 3 · 21:05](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1265)
- "Ultrasound is important for Wilms tumor to assess venous extension" — Tony Sandler (clinical) [Ep 3 · 22:56](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1376)
- "Large mass encasing aorta and celiac axis with microcalcifications represents L2 INRG classification" — Tony Sandler (clinical) [Ep 3 · 23:50](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1430)
- "Complete staging workup includes bone marrow biopsy, MIBG scan, chest CT to rule out metastasis, and head CT if clinical symptoms present" — Tony Sandler (guideline) [Ep 3 · 23:50](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1430)
- "10% of neuroblastomas are not MIBG avid" — Daniel von Allmen (epidemiological) [Ep 3 · 25:06](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1506)
- "PET scan may detect metastases in MIBG-negative neuroblastomas" — Daniel von Allmen (clinical) [Ep 3 · 25:06](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1506)
- "PET scan is not part of routine initial diagnostic workup but may be used for MIBG-negative soft tissue areas to distinguish recurrence from scar" — Erika Newman (guideline) [Ep 3 · 26:03](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1563)
- "Open retroperitoneal biopsy provides adequate tissue size for pathology and biology studies" — Tony Sandler (opinion) [Ep 3 · 27:10](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1630)
- "Transperitoneal laparoscopic biopsy may not allow adequate bleeding control for large tumors" — Tony Sandler (opinion) [Ep 3 · 27:10](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1630)
- "Multiple percutaneous biopsies may not provide adequate tissue for biology studies" — Tony Sandler (opinion) [Ep 3 · 27:10](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1630)
- "NMYC amplification can be obtained from bone marrow, but additional biology studies require tumor tissue" — Tony Sandler (clinical) [Ep 3 · 27:10](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1630)
- "Biology studies beyond NMYC include ALK mutation and ploidy status" — Tony Sandler (clinical) [Ep 3 · 28:28](https://library.globalcastmd.com/watch/neuroblastoma-2534?t=1708)
- "Hepatoblastoma is the most common malignant liver tumor in the pediatric population" (epidemiological) [Ep 9 · 0:00](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=0)
- "There are around 250 new cases of hepatoblastoma per year" (epidemiological) [Ep 9 · 0:20](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=20)
- "Treatment strategies for hepatoblastoma have changed dramatically over the past 25 years" (clinical) [Ep 9 · 0:10](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=10)
- "Hepatoblastoma is nowhere near the most common liver tumor or the most common abdominal tumor in children" — Greg Tiao (epidemiological) [Ep 9 · 0:46](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=46)
- "Neuroblastoma is the most common solid malignancy in the pediatric population" (epidemiological) [Ep 9 · 1:14](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=74)
- "Hemangioma is the most common liver lesion in children" (epidemiological) [Ep 9 · 1:40](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=100)
- "Hepatoblastoma can present as an asymptomatic abdominal mass, tumor rupture, or respiratory distress due to tumor size" — Greg Tiao (clinical) [Ep 9 · 2:20](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=140)
- "Hepatoblastoma can present as a paraneoplastic syndrome like precocious puberty" (clinical) [Ep 9 · 2:46](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=166)
- "An elevated alpha fetoprotein (AFP) is a key component in the workup and is critical for the diagnostic algorithm and treatment response" (clinical) [Ep 9 · 2:46](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=166)
- "Most experts rely on MRI to delineate anatomy and evaluate the extent of liver involvement in hepatoblastoma" — Greg Tiao (clinical) [Ep 9 · 3:13](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=193)
- "Eovist is an MRI contrast agent taken up by hepatocytes and then excreted, providing the best definition when looking at the liver on imaging" — Greg Tiao (clinical) [Ep 9 · 3:13](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=193)
- "To establish a diagnosis of hepatoblastoma, four things are needed: history, abdominal imaging, AFP check, and liver biopsy" (clinical) [Ep 9 · 3:39](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=219)
- "The most important intervention for survival is to achieve complete resection" (clinical) [Ep 9 · 3:39](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=219)
- "Aggressive resections include trisectionectomy, mesohepatectomy, resection with additional procedure in remnant liver, and liver transplantation" — Greg Tiao (clinical) [Ep 9 · 4:25](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=265)
- "Couinaud labeled liver segments in a counterclockwise fashion by injecting portal vessels, similar to how districts of Paris are labeled" (clinical) [Ep 9 · 4:50](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=290)
- "The right hepatic vein differentiates anterior and posterior sections of the right liver" — Greg Tiao (clinical) [Ep 9 · 5:41](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=341)
- "The right portal vein separates superior and inferior segments of the right liver" — Greg Tiao (clinical) [Ep 9 · 6:02](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=362)
- "The pre-text staging system classifies tumors based on the number of contiguous liver sections free of disease (minus four equals pre-text stage)" — Greg Tiao (clinical) [Ep 9 · 6:51](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=411)
- "Pre-text 1 has three contiguous sections free of disease, pre-text 2 has two, pre-text 3 has one, and pre-text 4 has no free sections or diffuse tumor" — Greg Tiao (clinical) [Ep 9 · 6:51](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=411)
- "Pre-text 1 and 2 tumors with greater than 1 cm margin from middle hepatic vein and portal bifurcation should be considered for resection at diagnosis" (clinical) [Ep 9 · 8:01](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=481)
- "Pre-text 3 and 4 tumors represent a big game changer in practice that improved survival from less than 30% in the 1970s-80s to 80-90% today" — Greg Tiao (clinical) [Ep 9 · 8:15](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=495)
- "Pre-text 3 tumors should generally be biopsied at diagnosis, started on neoadjuvant chemotherapy, then referred to transplant center or center with expertise in advanced liver resections" — Greg Tiao (clinical) [Ep 9 · 8:15](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=495)
- "Indications for transplant in pre-text 3 or 4 disease include unresectable disease, unsafe resection, or inadequate liver remnant" (clinical) [Ep 9 · 9:12](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=552)
- "It is important to consult a transplant center early for pre-text 3 and 4 tumors" — Greg Tiao (clinical) [Ep 9 · 9:35](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=575)
- "The PHITT (Pediatric Hepatic International Tumor Trial) is an ongoing multinational trial to identify high and low risk features for each pre-text stage" — Greg Tiao (clinical) [Ep 9 · 10:27](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=627)
- "The PHITT study has been ongoing for three years" — Greg Tiao (clinical) [Ep 9 · 10:27](https://library.globalcastmd.com/watch/hepatoblastoma-with-dr-greg-tiao-5256?t=627)
- "The presented case is a 16-month-old with a right adrenal mass measuring 8 centimeters" (clinical) [Ep 12 · 0:00](https://library.globalcastmd.com/watch/update-course-rewind-staging-and-management-of-neuroblastoma-2022-6710?t=0)
- "Biopsy showed favorable cell neuroblastoma biology with no MYCN amplification but with segmental chromosomal abnormalities" (clinical) [Ep 12 · 0:00](https://library.globalcastmd.com/watch/update-course-rewind-staging-and-management-of-neuroblastoma-2022-6710?t=0)
- "The Children's Oncology Group neuroblastoma classification tree is constantly changing as new information is added" — Paul Yasurjak (guideline) [Ep 12 · 0:24](https://library.globalcastmd.com/watch/update-course-rewind-staging-and-management-of-neuroblastoma-2022-6710?t=24)
- "Based on the 2021 COG classification, the presented tumor would be classified as higher risk" — Paul Yasurjak (guideline) [Ep 12 · 0:24](https://library.globalcastmd.com/watch/update-course-rewind-staging-and-management-of-neuroblastoma-2022-6710?t=24)
- "COG reviewed patients enrolled in trials between 2007 and 2017" — Paul Yasurjak (epidemiological) [Ep 12 · 0:24](https://library.globalcastmd.com/watch/update-course-rewind-staging-and-management-of-neuroblastoma-2022-6710?t=24)
- "The presence of segmental chromosomal aberrations such as loss or gain of a portion of the chromosomal arm can have a negative impact on patient outcomes" — Paul Yasurjak (clinical) [Ep 12 · 0:24](https://library.globalcastmd.com/watch/update-course-rewind-staging-and-management-of-neuroblastoma-2022-6710?t=24)
- "The updated schema classifies tumors as high risk when there is no MYCN amplification but segmental chromosomal abnormalities are present" — Paul Yasurjak (guideline) [Ep 12 · 0:24](https://library.globalcastmd.com/watch/update-course-rewind-staging-and-management-of-neuroblastoma-2022-6710?t=24)
- "In North America, the preferred approach for resectable renal tumors is primary nephrectomy and ureterectomy with lymph node sampling" — Peter Ehrlich (guideline) [Ep 8 · 6:23](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=383)
- "Preoperative chemotherapy is recommended if tumor extends into IVC beyond the infrahepatic vena cava" — Peter Ehrlich (guideline) [Ep 8 · 7:33](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=453)
- "Wilms tumors tend to push structures out of the way rather than growing around them, unlike neuroblastoma" — Peter Ehrlich (clinical) [Ep 8 · 4:16](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=256)
- "The claw sign on CT scan—normal kidney displaced into horseshoe pattern with tumor in the center—is classic for Wilms tumor" — Peter Ehrlich (clinical) [Ep 8 · 3:49](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=229)
- "Tumors between 13-15 centimeters or larger have higher risk of rupture and may warrant preoperative chemotherapy" — Peter Ehrlich (clinical) [Ep 8 · 14:33](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=873)
- "Core needle biopsy should include 10-20 cores to increase diagnostic accuracy; fine needle aspiration cannot diagnose anaplasia" — Peter Ehrlich (guideline) [Ep 8 · 18:03](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1083)
- "Stage 1 and 2 Wilms tumor patients receive only two-drug chemotherapy (vincristine and dactinomycin) for 19 weeks without radiation" — Peter Ehrlich (guideline) [Ep 8 · 20:36](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1236)
- "Stage 3 patients receive three-drug chemotherapy (adding doxorubicin) plus abdominal radiation" — Peter Ehrlich (guideline) [Ep 8 · 20:28](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1228)
- "A patient with lung metastases but stage 1-2 abdominal disease does not require abdominal radiation if primary tumor is completely resected with negative lymph nodes" — Peter Ehrlich (clinical) [Ep 8 · 24:15](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1455)
- "Approximately 40% of patients with pulmonary metastases achieve complete response by 6 weeks of chemotherapy and can avoid pulmonary radiation" — Peter Ehrlich (clinical) [Ep 8 · 26:44](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1604)
- "Fifteen percent of girls who receive pulmonary radiation for Wilms tumor develop breast cancer as a late effect" — Peter Ehrlich (epidemiological) [Ep 8 · 26:08](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1568)
- "The main late effects of Wilms tumor treatment are renal failure, second malignancies, pregnancy complications, hypertension, and cardiovascular disease, primarily from radiation and doxorubicin" — Peter Ehrlich (clinical) [Ep 8 · 23:37](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1417)
- "Loss of heterozygosity at both 1p and 16q occurs in 5-7% of patients and predicts 10% lower survival in stage 1-2 and 18% lower survival in stage 3-4" — Peter Ehrlich (clinical) [Ep 8 · 54:41](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3281)
- "Patients with tumors less than 550g, stage 1, favorable histology, and age under 2 years can be treated with surgery alone with greater than 95% survival" — Peter Ehrlich (clinical) [Ep 8 · 43:41](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2621)
- "IVC tumor thrombus extension is not a negative prognostic factor if completely resected" — Peter Ehrlich (clinical) [Ep 8 · 46:14](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2774)
- "Major complication rate for tumors extending beyond infrahepatic IVC operated upfront is 26-30% with documented mortality" — Peter Ehrlich (clinical) [Ep 8 · 48:49](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2929)
- "Bilateral Wilms tumor occurs in 8-10% of cases with historically lower survival: 61% event-free and 80% overall compared to 88% and 95% for unilateral disease" — Peter Ehrlich (epidemiological) [Ep 8 · 58:51](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3531)
- "Maximum tumor response to chemotherapy typically occurs by 12 weeks, with early response at 6 weeks predicting late response" — Peter Ehrlich (clinical) [Ep 8 · 59:37](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3577)
- "In bilateral Wilms tumor, there is discordant pathology between kidneys in up to 20% of cases" — Peter Ehrlich (clinical) [Ep 8 · 62:14](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3734)
- "SIOP protocols use preoperative chemotherapy for all patients with post-treatment staging based on blastemal predominance" — Peter Ehrlich (guideline) [Ep 8 · 30:31](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1831)
- "Lymph node positivity is the main prognostic factor in stage 3 disease" — Peter Ehrlich (clinical) [Ep 8 · 32:45](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=1965)
- "Acquired von Willebrand disease occurs in Wilms tumor patients and may rarely cause significant intraoperative bleeding" — Peter Ehrlich (clinical) [Ep 8 · 35:11](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2111)
- "Minimum lymph node sampling should be 5-6 nodes, though more than one may be better based on secondary evidence" — Peter Ehrlich (guideline) [Ep 8 · 39:49](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2389)
- "Taking a rim of adherent diaphragm or liver capsule to avoid tumor violation does not upstage the tumor if the tumor itself is not divided" — Peter Ehrlich (clinical) [Ep 8 · 42:31](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2551)
- "Positive surgical margins automatically make a tumor stage 3" — Peter Ehrlich (guideline) [Ep 8 · 41:24](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=2484)
- "Favorable histology Wilms tumor has three components: blastemal, stromal, and epithelial; tumors with only two components are still considered favorable" — Peter Ehrlich (clinical) [Ep 8 · 52:52](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3172)
- "In COG protocols, the amount of blastema in favorable histology tumors has never correlated with outcome" — Peter Ehrlich (clinical) [Ep 8 · 53:13](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3193)
- "Stage 2 patients receive vincristine and dactinomycin for 19 weeks; stage 3 patients receive DD4A regimen (adding doxorubicin) for 25 weeks" — Peter Ehrlich (guideline) [Ep 8 · 53:56](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3236)
- "Renal cell carcinoma is the second most common renal tumor in children, with no effective therapy for metastatic disease" — Peter Ehrlich (clinical) [Ep 8 · 56:51](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3411)
- "Rhabdoid tumors have terrible outcomes except for stage 1; most present at stage 3 or 4" — Peter Ehrlich (clinical) [Ep 8 · 57:27](https://library.globalcastmd.com/watch/wilms-tumor-audio-chapter-3487?t=3447)
- "Neuroblastoma is the most common extracranial solid tumor in children" — Rae Hanke (epidemiological) [Ep 5 · 0:00](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=0)
- "The majority of neuroblastoma cases occur in children less than a year old" — Rae Hanke (epidemiological) [Ep 5 · 0:00](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=0)
- "Younger patients are often picked up prenatally on ultrasound or as a solid abdominal mass in two- or three-year-olds" — Daniel von Allmen (clinical) [Ep 5 · 0:41](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=41)
- "Patients with metastatic disease may present with bony pain or neurologic symptoms from cord compression" — Daniel von Allmen (clinical) [Ep 5 · 0:41](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=41)
- "Catecholamines (urine or serum) are one of the most diagnostic laboratory tests for neuroblastoma" — Daniel von Allmen (clinical) [Ep 5 · 1:07](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=67)
- "Cross-sectional imaging (CT or MRI) is obtained after initial ultrasound and laboratory workup" — Daniel von Allmen (clinical) [Ep 5 · 1:39](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=99)
- "MIBG study is helpful for confirming neuroblastoma diagnosis and demonstrating metastatic disease" — Daniel von Allmen (clinical) [Ep 5 · 1:39](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=99)
- "About 10% of neuroblastomas are MIBG negative" — Daniel von Allmen (clinical) [Ep 5 · 2:20](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=140)
- "Some centers obtain a PET scan for MIBG-negative cases to look for tumor uptake and metastatic disease" — Daniel von Allmen (clinical) [Ep 5 · 2:20](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=140)
- "The INRGSS staging system allows stage assignment before any invasive procedure" — Daniel von Allmen (guideline) [Ep 5 · 2:45](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=165)
- "Localized tumors without image-defined risk factors are categorized as L1" — Daniel von Allmen (guideline) [Ep 5 · 2:45](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=165)
- "Localized tumors with image-defined risk factors (encasing nerves or vessels) are L2" — Daniel von Allmen (guideline) [Ep 5 · 2:45](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=165)
- "Tumors with metastatic disease are categorized as M" — Daniel von Allmen (guideline) [Ep 5 · 2:45](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=165)
- "MS category is for children less than 18 months with metastases to bone marrow or skin" — Daniel von Allmen (guideline) [Ep 5 · 2:45](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=165)
- "The INRGSS was created to allow studies from different centers and countries to be compared based on pre-surgical staging" — Daniel von Allmen (guideline) [Ep 5 · 3:36](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=216)
- "The prior staging system required tissue diagnosis before assigning a stage" — Daniel von Allmen (guideline) [Ep 5 · 3:36](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=216)
- "A patient with a resectable adrenal mass and positive MIBG without metastases can be treated with primary resection via laparotomy or laparoscopy" — Daniel von Allmen (clinical) [Ep 5 · 4:06](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=246)
- "For large central abdominal tumors that encase major vasculature, only tissue for diagnosis is needed via open biopsy, laparoscopic biopsy, or core needle biopsy" — Daniel von Allmen (clinical) [Ep 5 · 4:44](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=284)
- "NMIC status is the most important biologic risk determinant from biopsy tissue" — Daniel von Allmen (clinical) [Ep 5 · 5:14](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=314)
- "1P and 11Q deletions should be assessed in biopsy tissue along with Shimada histology" — Daniel von Allmen (clinical) [Ep 5 · 5:14](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=314)
- "Neuroblastoma risk categories are very low risk, low risk, intermediate risk, or high risk" — Daniel von Allmen (guideline) [Ep 5 · 5:45](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=345)
- "Risk distribution is approximately 50-50 between low risk categories and high risk, with a smaller percentage intermediate risk" — Daniel von Allmen (epidemiological) [Ep 5 · 5:45](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=345)
- "NMIC amplification and age greater than 18 months are the most important prognostic determinants for neuroblastoma" — Daniel von Allmen (clinical) [Ep 5 · 6:06](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=366)
- "High-risk patients receive aggressive chemotherapy including peripheral stem cell transplant times 2, aggressive surgery with >90% resection goal, radiation, immunotherapy, and potentially retinoic acid therapy" — Daniel von Allmen (guideline) [Ep 5 · 6:06](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=366)
- "Intermediate risk tumors receive varying cycles of chemotherapy based on biologic risk factors" — Daniel von Allmen (guideline) [Ep 5 · 6:51](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=411)
- "For intermediate risk tumors, the surgical goal is at least 50% response from initial primary tumor volume combining neoadjuvant chemotherapy and surgical resection" — Daniel von Allmen (guideline) [Ep 5 · 6:51](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=411)
- "Low risk patients, depending on age and diagnosis timing, could be followed with observation alone" — Daniel von Allmen (guideline) [Ep 5 · 7:22](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=442)
- "A Children's Oncology Group study led by Jed Nocturne showed patients less than six months with prenatally or early postnatally diagnosed localized mass can be observed with expectation that most will avoid surgery" — Daniel von Allmen (guideline) [Ep 5 · 7:22](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=442)
- "Patients with metastatic disease typically receive four or five cycles of neoadjuvant chemotherapy and are then reassessed" — Daniel von Allmen (guideline) [Ep 5 · 7:55](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=475)
- "If metastatic disease is responding to chemotherapy, the primary tumor site should be resected with attempted >90% resection" — Daniel von Allmen (guideline) [Ep 5 · 7:55](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=475)
- "If metastatic disease is progressing on chemotherapy, surgery is not indicated" — Daniel von Allmen (guideline) [Ep 5 · 7:55](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=475)
- "MS disease is for patients less than 18 months with primary site and metastases to liver, skin, or bone marrow (specifically not cortical bone)" — Daniel von Allmen (guideline) [Ep 5 · 7:55](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=475)
- "MS disease patients can be managed with simple observation; treatment is only elected if they progress or develop complications like respiratory issues from enlarging liver mass" — Daniel von Allmen (guideline) [Ep 5 · 7:55](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=475)
- "Skin lesions in MS disease can be biopsied to provide diagnosis" — Daniel von Allmen (clinical) [Ep 5 · 8:55](https://library.globalcastmd.com/watch/topics-in-10-neuroblastoma-1659?t=535)
- "Dr. Vogel completed fellowships in both pediatric surgery and surgical critical care, with research interests in viscoelastic monitoring and goal-directed hemostatic resuscitation" — Alexander Gibbons (clinical) [Ep 4 · 0:00](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=0)
- "In coagulopathy assessment, trending values over time is more valuable than a single point measurement" — Vogel (clinical) [Ep 4 · 1:53](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=113)
- "Viscoelastic monitoring provides four key values: time to clot formation, rate of clot progression, clot strength, and fibrinolytic activity" — Vogel (clinical) [Ep 4 · 7:10](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=430)
- "The time to clot formation phase primarily depends on factor function and is treated with plasma" — Vogel (clinical) [Ep 4 · 7:10](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=430)
- "The amplification phase (alpha angle) is primarily determined by fibrinogen function and treated with cryoprecipitate or fibrinogen" — Vogel (clinical) [Ep 4 · 7:10](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=430)
- "Clot strength (maximal amplitude on TEG) reflects platelet function and is treated with platelets or DDAVP in certain conditions" — Vogel (clinical) [Ep 4 · 7:10](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=430)
- "Hyperfibrinolysis shown by rapid drop in clot strength may be treated with tranexamic acid or aminocaproic acid" — Vogel (clinical) [Ep 4 · 7:10](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=430)
- "Viscoelastic monitoring results are available within 5-15 minutes compared to 30-45 minutes for conventional coagulation tests" — Vogel (clinical) [Ep 4 · 11:42](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=702)
- "Severely injured children exhibit two fibrinolytic phenotypes: hyperfibrinolysis and fibrinolytic shutdown" — Vogel (clinical) [Ep 4 · 14:38](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=878)
- "TXA may be detrimental in fibrinolytic shutdown patients by making them hypercoagulable" — Vogel (clinical) [Ep 4 · 14:38](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=878)
- "In adults, balanced resuscitation (1:1:1 ratio of red cells:plasma:platelets) improves mortality in prospective observational and randomized studies" — Vogel (clinical) [Ep 4 · 16:16](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=976)
- "Balanced resuscitation improves kidney injury, ventilator duration, ICU length of stay, and infection rates in adults" — Vogel (clinical) [Ep 4 · 16:16](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=976)
- "Balanced resuscitation achieves more efficient resuscitation using less overall blood product volume" — Vogel (clinical) [Ep 4 · 16:16](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=976)
- "Retrospective pediatric studies using National Trauma Databank and TQIP show improved outcomes with 1:1 red cell to plasma ratio" — Vogel (clinical) [Ep 4 · 16:16](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=976)
- "The Atomic Group study of over 100 massively transfused pediatric trauma patients showed best survival with balanced resuscitation closer to 1:1:1" — Vogel (clinical) [Ep 4 · 16:16](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=976)
- "The American College of Surgeons Committee on Trauma verifies that trauma centers have massive transfusion protocols delivering products in 1:1:1 ratio" — Vogel (guideline) [Ep 4 · 19:07](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=1147)
- "Multimodal analgesia approach includes narcotics, NSAIDs, regional anesthesia, gabapentinoids, and non-pharmacologic therapies" — Vogel (clinical) [Ep 4 · 19:56](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=1196)
- "Regional analgesia techniques include epidural catheters, ultrasound-guided nerve blocks, and indwelling analgesic catheters for local anesthetic delivery" — Vogel (clinical) [Ep 4 · 19:56](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=1196)
- "Non-pharmacologic pain management includes child-friendly environment, family support, pet therapy, and augmented virtual reality for complex dressing changes" — Vogel (clinical) [Ep 4 · 19:56](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=1196)
- "Common ICU sedation agents include benzodiazepines (midazolam, lorazepam), narcotics (fentanyl, morphine, dilaudid), and dexmedetomidine" — Vogel (clinical) [Ep 4 · 25:56](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=1556)
- "Validated pediatric pain scores include FLACC (Faces, Legs, Activity, Cry, Consolability) for preverbal children, Faces Pain Scale Revised, Visual Analog Score, Color Analog Score, and Non-Communicating Children's Pain Checklist" — Vogel (clinical) [Ep 4 · 27:51](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=1671)
- "The Richmond Agitation Sedation Score (RAS) is commonly used in adults; the State Behavioral Score (SBS) is commonly used in pediatric ICUs" — Vogel (clinical) [Ep 4 · 27:51](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=1671)
- "The Society of Critical Care Medicine ABCDEF bundle includes: Assess pain, Both spontaneous awakening and breathing trials, Choice of analgesia/sedation, Delirium assessment/prevention/management, Early mobility, and Family engagement" — Vogel (guideline) [Ep 4 · 31:24](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=1884)
- "Spontaneous awakening trials and breathing trials decrease duration of mechanical ventilation, intubation, and ICU stay in both adults and children" — Vogel (clinical) [Ep 4 · 31:24](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=1884)
- "Approximately 40% of pediatric ICU patients will experience delirium at some point during their ICU stay" — Vogel (epidemiological) [Ep 4 · 36:04](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=2164)
- "Pediatric delirium risk factors include age less than 2 years, mechanical ventilation, benzodiazepine use, narcotic use, and physical restraints" — Vogel (clinical) [Ep 4 · 36:04](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=2164)
- "Validated delirium assessment tools include CAM-ICU (Confusion Assessment Method for ICU), pediatric CAM-ICU, preschool CAM-ICU, and CAP-D (Cornell Assessment of Pediatric Delirium)" — Vogel (clinical) [Ep 4 · 36:04](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=2164)
- "Delirium assessment requires the patient to be in an appropriate sedation state, not comatose" — Vogel (clinical) [Ep 4 · 36:04](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=2164)
- "Non-pharmacologic delirium management includes maintaining sleep-wake cycles with lights-on during day and lights-off at night, family involvement, child life services, and pet therapy" — Vogel (clinical) [Ep 4 · 36:04](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=2164)
- "Pharmacologic delirium management includes melatonin for sleep and atypical antipsychotics like risperidone started at low doses" — Vogel (clinical) [Ep 4 · 36:04](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=2164)
- "Minimizing benzodiazepine use and considering alpha-2 agonists like dexmedetomidine or clonidine can reduce delirium risk" — Vogel (clinical) [Ep 4 · 36:04](https://library.globalcastmd.com/watch/coagulopathy-and-analgesia-1793?t=2164)
- "Microaggressions are verbal, nonverbal, environmental slights, snubs, invalidations, or insults that send hostile, derogatory, or negative messages to individuals based solely on their marginalized group membership" — Craig Lillehei (clinical) [Ep 11 · 3:30](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=210)
- "Microaggressions have a cumulative impact causing isolation and self-doubt despite being termed 'micro'" — Craig Lillehei (clinical) [Ep 11 · 4:00](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=240)
- "In the TOTAL trial for severe CDH, FETO significantly improved survival" — Craig Lillehei (clinical) [Ep 11 · 10:00](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=600)
- "In the TOTAL trial for moderate CDH, FETO showed some improvement in survival but did not approach statistical significance" — Craig Lillehei (clinical) [Ep 11 · 10:20](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=620)
- "The TOTAL trial was conducted over an 11-year period at multiple centers with variable CDH management protocols" — Craig Lillehei (clinical) [Ep 11 · 10:50](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=650)
- "FETO is associated with prematurity and premature rupture of membranes as complications" — Craig Lillehei (clinical) [Ep 11 · 11:20](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=680)
- "NPO guidelines for children are based on very poor evidence and vary significantly between institutions" (clinical) [Ep 11 · 15:00](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=900)
- "Pulmonary aspiration during elective pediatric surgery is very rare and usually occurs in emergency surgeries in high-risk children" (epidemiological) [Ep 11 · 15:20](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=920)
- "Clear liquids containing carbohydrates empty the stomach very quickly regardless of patient age" (clinical) [Ep 11 · 15:50](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=950)
- "British and Irish consensus recommends one hour NPO for clear liquids, four hours for breast milk, six hours for solid foods in children under 17" (guideline) [Ep 11 · 16:10](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=970)
- "ASA currently recommends two hours for clear liquids, four hours for breast milk, six hours for non-human milk and light meals, eight hours for heavy meals" (guideline) [Ep 11 · 16:40](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=1000)
- "European Society of Anesthesia recommends one hour for clear liquids, three hours for breast milk, four hours for formula, six hours for everything else" (guideline) [Ep 11 · 17:10](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=1030)
- "Prolonged NPO periods cause ketone body generation, hypoglycemia, and patient irritability" (clinical) [Ep 11 · 17:40](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=1060)
- "In standard C-arm configuration, the x-ray source is below the table and the image intensifier is above" (clinical) [Ep 11 · 23:20](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=1400)
- "Placing lead shields on top of the patient during fluoroscopy does nothing to protect them because radiation comes from below the table" (clinical) [Ep 11 · 23:40](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=1420)
- "If a shield is in the fluoroscopy field, automatic brightness control increases x-ray energy, increasing patient exposure" (clinical) [Ep 11 · 24:10](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=1450)
- "Collimation focuses the x-ray beam to a specific area, increasing detail while decreasing total patient dose by reducing the irradiated surface area" (clinical) [Ep 11 · 25:00](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=1500)
- "Magnification setting on fluoroscopy significantly increases radiation dose to both patient and room personnel" (clinical) [Ep 11 · 25:30](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=1530)
- "Pulse mode fluoroscopy is feasible for most pediatric surgery applications and reduces radiation compared to continuous mode" (clinical) [Ep 11 · 25:50](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=1550)
- "CT scan for suspected airway foreign body has 94% accuracy in identifying foreign bodies when present" (clinical) [Ep 11 · 33:20](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=2000)
- "CT scan can identify non-radiopaque foreign bodies including plastic" (clinical) [Ep 11 · 33:40](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=2020)
- "In the Midwest Pediatric Surgery Consortium study of 521 primary lung lesions, none of the prenatally diagnosed lesions were malignant" (clinical) [Ep 11 · 36:40](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=2200)
- "Approximately 10% of postnatally diagnosed lung lesions were malignant in the consortium study" (epidemiological) [Ep 11 · 37:10](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=2230)
- "About half of malignant lung lesions were associated with DICER1 mutation" (clinical) [Ep 11 · 37:30](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=2250)
- "No malignant lung lesion had a systemic feeding vessel in the consortium study" (clinical) [Ep 11 · 37:50](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=2270)
- "CT scan sensitivity and specificity for detecting malignancy in lung lesions was poor with low inter-rater reliability among radiologists" (clinical) [Ep 11 · 38:10](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=2290)
- "The IMPACT study showed piperacillin-tazobactam had significantly lower postoperative abscess rate, ER visit rate, and CT scan rate compared to ceftriaxone-metronidazole for perforated appendicitis" (clinical) [Ep 11 · 43:20](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=2600)
- "A NSQIP study of 654 patients showed opposite results, suggesting ceftriaxone-metronidazole was preferred over piperacillin-tazobactam" (clinical) [Ep 11 · 44:00](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=2640)
- "Mechanical bowel preparation has no effect on surgical site infection rates" — Paul Yzotrak (clinical) [Ep 11 · 50:00](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=3000)
- "Some data suggests mechanical bowel prep actually increases surgical site infections" — Paul Yzotrak (clinical) [Ep 11 · 50:20](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=3020)
- "The NEC trial showed neurodevelopmental outcomes are improved with laparotomy compared to peritoneal drainage" — Paul Yzotrak (clinical) [Ep 11 · 53:20](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=3200)
- "The NEC trial cutoff for laparotomy was approximately one kilogram" — Paul Yzotrak (clinical) [Ep 11 · 53:50](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=3230)
- "Neuroblastoma with segmental chromosomal abnormalities but no MYCN amplification is now classified as high risk based on 2020-21 COG data" — Paul Yzotrak (guideline) [Ep 11 · 62:30](https://library.globalcastmd.com/watch/update-course-2022-apsa-pdc-updates-mary-edwards-paul-jeziorczak-craig-lillehei-and-charles-snyder-5820?t=3750)
- "Adrenal hemorrhage is the most common prenatal suprarenal mass, more common with history of fetal stress" — Daniel von Allmen (clinical) [Ep 6 · 2:00](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=120)
- "Familial neuroblastoma occurs in about 1% of patients" — Tony Sandler (epidemiological) [Ep 6 · 3:27](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=207)
- "The GetNucturne study showed that many prenatally diagnosed neuroblastomas can be safely observed without surgery" — Daniel von Allmen (clinical) [Ep 6 · 7:24](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=444)
- "Of 84 prenatally diagnosed cases observed in the GetNucturne study, 16 (about 20%) underwent resection, with 98% event-free survival and 100% overall survival" — Tony Sandler (clinical) [Ep 6 · 9:09](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=549)
- "Surveillance for prenatally diagnosed neuroblastoma is intensive in the first year with ultrasound and urine catecholamines at birth, 3 weeks, 6 weeks, 12 weeks, then spacing out" — Erika Newman (guideline) [Ep 6 · 9:58](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=598)
- "A case occurred where a prenatally diagnosed adrenal mass resolved but the child presented at age 3 with widely metastatic high-risk neuroblastoma" — Daniel von Allmen (clinical) [Ep 6 · 10:23](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=623)
- "Five centimeters is used as a size threshold for considering surgical resection of observed neuroblastoma" — Tony Sandler (opinion) [Ep 6 · 12:31](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=751)
- "A 50% increase in tumor volume or 50% increase in urine VMA or HVA prompts consideration of surgery" — Erika Newman (guideline) [Ep 6 · 13:20](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=800)
- "Lymph node status in neuroblastoma is not as important for changing therapy as it is in Wilms tumor" — Daniel von Allmen (clinical) [Ep 6 · 14:21](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=861)
- "Stage MS (formerly 4S) neuroblastoma with liver metastases can cause respiratory compromise from mass effect" — Erika Newman (clinical) [Ep 6 · 15:14](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=914)
- "Stage MS neuroblastoma can be treated with aggressive observation, chemotherapy, radiation, or emergent decompressive laparotomy if respiratory compromise occurs" — Erika Newman (clinical) [Ep 6 · 15:42](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=942)
- "Classic findings of stage MS include high urine catecholamines, blue blebs on skin, liver metastases, and adrenal mass" — Tony Sandler (clinical) [Ep 6 · 16:32](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=992)
- "NMYC amplification in stage MS changes classification from MS to M (stage 4) and makes it high-risk" — Erika Newman (clinical) [Ep 6 · 17:32](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=1052)
- "Ten percent of neuroblastomas are not MIBG-avid and might be detected by PET scan" — Daniel von Allmen (clinical) [Ep 6 · 22:12](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=1332)
- "Open biopsy allows adequate tissue for NMYC amplification, ALK mutation, and ploidy studies" — Tony Sandler (clinical) [Ep 6 · 23:50](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=1430)
- "Approximately half of children's hospitals use percutaneous biopsy for suspected neuroblastoma" — Erika Newman (epidemiological) [Ep 6 · 26:56](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=1616)
- "Percutaneous biopsy is equivalent to open biopsy for diagnosis, high versus low risk determination, and NMYC amplification, but falls short for determining 11q loss of heterozygosity" — Erika Newman (clinical) [Ep 6 · 28:10](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=1690)
- "Optimizing percutaneous biopsy requires 10-12 cores, higher gauge needle, and pathologist performing frozen section to confirm viable tumor" — Erika Newman (clinical) [Ep 6 · 29:10](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=1750)
- "Open biopsy patients had higher risk of blood transfusion, higher narcotic use, and more hospital admissions compared to percutaneous biopsy" — Erika Newman (clinical) [Ep 6 · 30:17](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=1817)
- "NMYC amplification automatically makes neuroblastoma high-risk regardless of other factors" — Tony Sandler (clinical) [Ep 6 · 31:38](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=1898)
- "Loss of heterozygosity at 11q is the most common segmental chromosomal alteration and can bump NMYC non-amplified patients to high or intermediate risk" — Erika Newman (clinical) [Ep 6 · 33:49](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2029)
- "Age cutoff for risk stratification is now 18 months rather than 12 months" — Tony Sandler (guideline) [Ep 6 · 35:25](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2125)
- "High-risk neuroblastoma patients require double lumen external central line for bone marrow transplant" — Erika Newman (clinical) [Ep 6 · 37:20](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2240)
- "Stem cell harvesting for high-risk neuroblastoma is usually after the second cycle of chemotherapy" — Tony Sandler (clinical) [Ep 6 · 45:31](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2731)
- "Optimal timing for surgical resection is after cycle 3-4 of induction chemotherapy" — Erika Newman (opinion) [Ep 6 · 41:49](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2509)
- "Tumor volume does not significantly decrease after cycle 2-3 of chemotherapy" — Daniel von Allmen (clinical) [Ep 6 · 43:17](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2597)
- "After 5-6 cycles of chemotherapy, tumors become more fibrotic and harder to resect" — Erika Newman (clinical) [Ep 6 · 43:17](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2597)
- "Goal of surgery is greater than 90% tumor resection based on COG study showing improved event-free survival" — Daniel von Allmen (clinical) [Ep 6 · 44:04](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2644)
- "European neuroblastoma group study of nearly 1000 cases showed >90% resection improved both event-free and overall survival" — Daniel von Allmen (clinical) [Ep 6 · 45:28](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2728)
- "About 70% of patients can achieve greater than 90% resection" — Daniel von Allmen (epidemiological) [Ep 6 · 45:28](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2728)
- "High-risk neuroblastoma responds well to chemotherapy due to high proliferative rate" — Tony Sandler (clinical) [Ep 6 · 45:31](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2731)
- "Recent German/European publication stated that amount of local disease resection does not make a difference in outcome" — Tony Sandler (clinical) [Ep 6 · 46:00](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2760)
- "Patients with high-risk neuroblastoma die of systemic metastatic disease, not local disease" — Tony Sandler (clinical) [Ep 6 · 46:40](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2800)
- "Good local control is achieved with combination of radiation and aggressive surgery" — Daniel von Allmen (clinical) [Ep 6 · 47:40](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=2860)
- "There is zero correlation between surgeon's operative note description of resection extent and post-operative imaging findings" — Daniel von Allmen (clinical) [Ep 6 · 52:19](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=3139)
- "Surgeons frequently overestimate the amount of tumor resection achieved" — Daniel von Allmen (opinion) [Ep 6 · 52:19](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=3139)
- "Nephrectomy should be avoided in neuroblastoma surgery because it requires reduction of chemotherapy doses" — Tony Sandler (clinical) [Ep 6 · 53:13](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=3193)
- "Monoclonal antibody against ganglioside GD2 improved two-year survival in high-risk neuroblastoma from 46% to 60%" — Tony Sandler (clinical) [Ep 6 · 53:44](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=3224)
- "Checkpoint inhibitors have not been successful in neuroblastoma because it is not an immunogenic tumor" — Tony Sandler (clinical) [Ep 6 · 54:40](https://library.globalcastmd.com/watch/neuroblastoma-1620?t=3280)

## Changelog
- Aug 31: 36 doctors auto-found from episode dossiers
- Aug 30: 29 doctors auto-found from episode dossiers
- Aug 30: 21 doctors auto-found from episode dossiers
- Aug 30: Members-only episodes removed from this collection
- Aug 29: 22 doctors auto-found from episode dossiers
- Aug 29: 23 doctors auto-found from episode dossiers
- Aug 29: Collection generated from campaign corpus: 29 items, 18 dossiers, summaries for 2 audience(s)
- Aug 29: Collection reviewed and published
- Aug 29: Collection generated from campaign corpus: 20 items, 18 dossiers, summaries for 1 audience(s)
- Aug 29: Collection generated from campaign corpus: 20 items, 18 dossiers, summaries for 3 audience(s)

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Educational content from recorded physician discussions — not medical advice. Cite the canonical URL or the ?t= deep link. Policy: https://library.globalcastmd.com/ai