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Pediatric Surgical Oncology
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Intermediate risk neuroblastoma patients receive neoadjuvant chemotherapy with 2, 4, 6, or 8 cycles depending on chromosomal factors, followed by surgical resection. — Meera Kotagal, Neuroblastoma with Dr. Meera Kotagal · 7:15
Overview & Management4 items
Neuroblastoma
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Neuroblastoma (NB) is the most common extracranial pediatric solid tumor. The most common location for development of NB is in the adrenal glands, but primary tumors may develop along the developmental pathway of neural crest progenitor cel
article · Nov 2026
Neuroblastoma with Dr. Meera Kotagal
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In this podcast, we cover the basics of neuroblastoma including presentation, differentiation, diagnosis and management with Dr. Meera Kotagal.
Host: Em Gootee
video14:02 · Sep 2024
Clinical & Research Update: Neuroblastoma with Drs. Katherine Somers, Cara Morin, Juan Gurria, and Meera Kotagal
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This comprehensive tumor board discussion features pediatric specialists from Cincinnati Children's, Drs. Katherine Somers, Cara Morin, Juan Gurria, and Meera Kotagal, analyzing a complex case of high-risk neuroblastoma in a 2-year-old. The
video1:07:10 · Sep 2026
Neuroblastoma: Optimal Surgery Timing After Cycle Four of Chemotherapy w/ Dr. Katherine Somers & Dr. Meera Kotagal
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This video explains why surgery for high-risk neuroblastoma is ideally performed after the fourth cycle of induction chemotherapy. Pediatric Oncologist Dr. Katherine Somers and Pediatric Surgeon Dr. Meera Kotagal from Cincinnati Children's
video0:24 · Oct 2026
Surgical Outcomes2 items
Neuroblastoma Surgery: How ERAS Protocol Improved Pediatric Outcomes w/ Dr. Meera Kotagal
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Dr. Meera Kotagal, a Pediatric Surgeon at Cincinnati Children's, discusses the profound impact of the Enhanced Recovery After Surgery (ERAS) protocol on neuroblastoma surgery. She highlights significant improvements for pediatric patients,
video0:19 · Oct 2026
Pancreas, Muscle, and Subcutaneous Fat Atrophy in Patients Undergoing Radiation for Neuroblastoma
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Pradipta Debnath, Marissa Ray, Luke Pater, Alexandra O Glenn, Stephen Hartman, Elanchezhian Somasundaram, Todd Jenkins, Juan P Gurria, Katherine Somers, Andrew T Trout, Meera KotagalBackground/objectives: Radiation therapy (RT) is part of s
video1:10 · Apr 2026
Bilateral focal anaplasia Wilms tumor (stage 5, local stage 2 and 1) is treated with bilateral flank radiation and regimen DD4A (vincristine, dactinomycin, doxorubicin over 24-25 weeks). — Lindsay Haacker, Clinical & Research Update: Renal Tumors with Drs. Ethan Smith, Lindsay Haacker, Michael Daugherty, and Meera Kotagal · 41:29
Wilms Tumor4 items
Nephron sparing surgery and surgical management of intravascular extension of Wilms tumor
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Although general treatment approaches for Wilms tumor differ between Children's Oncology Group and Société Internationale d'Oncologie Pédiatrique-Renal Tumors Study Group protocols, complex tumors that may be candidates for nephron sparing
article · Nov 2026
IVC Thrombus in Wilms Tumor: Resection First or Chemo First? w/ Dr. Meera Kotagal
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This video discusses the management of inferior vena cava (IVC) thrombus in patients with Wilms tumor, focusing on the critical decision of whether to perform upfront resection or neo-adjuvant chemotherapy. Pediatric Surgeon Dr. Meera Kotag
video0:19 · Oct 2026
Association of Systemic Inflammatory Markers and Clinical Outcomes Among Children With Wilms Tumor
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Background: Elevated pre-treatment inflammatory markers predict disease progression and overall survival among adults with renal tumors, including elevated neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lympho
article · Nov 2026
Race and Ethnic Group Enrollment and Outcomes for Wilms Tumor: Analysis of the Current Era Children's Oncology Group Study, AREN03B2
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Background: To review race and ethnic group enrollment and outcomes for Wilms tumor (WT) across all 4 risk-assigned therapeutic trials from the current era Children's Oncology Group Renal Tumor Biology and Risk Stratification Protocol, AREN
article · Nov 2026
General Renal Tumors5 items
Current surgical approaches to pediatric renal tumors
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Pediatric renal tumors are among the most common pediatric solid malignancies. Surgical resection is a key component in the multidisciplinary therapy for children with kidney tumors. Therefore, it is imperative that surgeons caring for chil
article · Nov 2026
Renal Tumors
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… The goal of this chapter is to provide a thorough understanding of pediatric renal tumors, with a particular focus on WT. The discussion will include tumor formation, molecular genetics, …
article · Nov 2026
Aggressive pediatric renal tumors
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… Surgical principles in the management of aggressive renal tumors Surgical principles for the management of pediatric … a topic with controversy in the management of pediatric RCC. …
article · Nov 2026
Clinical & Research Update: Renal Tumors with Drs. Ethan Smith, Lindsay Haacker, Michael Daugherty, and Meera Kotagal
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This video features a multidisciplinary panel from Cincinnati Children's, Drs. Ethan Smith, Lindsay Haacker, Michael Daugherty, & Meera Kotagal, discussing pediatric renal tumors, primarily Wilms tumor. Led by a pediatric oncology fellow, t
video1:11:52 · Sep 2026
Pediatric Renal Mass: Lymph Node Sampling & Nodal Positivity Insights
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This video delves into the critical role of lymph node sampling in pediatric renal masses. Drs. Michael Daugherty, Meera Kotagal, & Ethan Smith from Cincinnati Children's discuss the necessity of lymph node evaluation for all pediatric rena
video0:21 · Oct 2026
Systemic Therapy1 item
What Every Pediatric Surgeon Should Know About Common Systemic Therapies for the Treatment of Renal Tumors in Children and Adolescents
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Introduction: Renal tumors are among the most common solid pediatric malignancies. The mainstay of treatment is surgical intervention, with chemotherapy and radiation given according to risk stratification schemes. Given the potential for s
article · Nov 2026
Social Determinants of Health Influence on Survival in Wilms Tumor, Neuroblastoma, and Hepatoblastoma
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Background: The influence of social determinants of health (SDOH) on childhood cancer outcomes is complex and understudied. This study aimed to elucidate the influence of socioeconomic status (SES) and race on survival in Wilms tumor (WT),
article · Nov 2026
Broader ERAS guidelines were developed for essentially all neonatal surgery following the initial intestinal surgery guidelines. — Cassie Hoffman, 2025 Pediatric Surgery Update Course - Updates in Enhanced Recovery After Surgery (ERAS) Protocols · 4:06
Protocol Development3 items
Development of an enhanced recovery after surgery program for pediatric solid tumors
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Introduction: Enhanced recovery after surgery (ERAS) is an evidence-based, multi-modal approach to decrease surgical stress, expedite recovery, and improve postoperative outcomes. ERAS is increasingly being utilized in pediatric surgery. It
article · Nov 2026
Frontiers | Development of an enhanced recovery after surgery program for pediatric solid tumors
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Enhanced recovery after surgery (ERAS) is an evidence-based, multi-modal approach to decrease surgical stress, expedite recovery, and improve postoperative o...
article · Nov 2026
Enhanced Recovery After Surgery for Pediatric Abdominal Tumor Resections: A Prospective Multi-institution Study.
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Enhanced recovery after surgery (ERAS) protocols are multi-disciplinary approaches to standardize perioperative care. This is the first prospective, multi-institutional study to evaluate ERAS in pediatric patients undergoing abdominal tumor
article · Nov 2026
Outcomes & Implementation4 items
Enhanced Recovery After Surgery (ERAS) Improves Length of Stay and Decreases Complications After Resection of Abdominal Neuroblastoma
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Background: Enhanced recovery after surgery (ERAS) pathways are multidisciplinary strategies to return patients to their physiologic baseline as efficiently as possible. This study aims to evaluate the feasibility and benefits of an ERAS pa
article · Nov 2026
Enhanced Recovery After Surgery (ERAS) Improves Length of Stay and Decreases Complications After Resection of Abdominal Neuroblastoma
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Sara A Mansfield, Meera Kotagal, Stephen J Hartman, Andrew J Murphy, Brady Hogan, Darren Ha, Doralina L Anghelescu, Marc Mecoli, Nicholas G Cost, Andrew M Davidoff, Kyle O RoveBackground: Enhanced recovery after surgery (ERAS) pathways are
video1:02 · Feb 2026
Enhanced Recovery After Surgery (ERAS) Improves Length of Stay and Decreases Complications After Resection of Abdominal Neuroblastoma
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Sara A Mansfield, Meera Kotagal, Stephen J Hartman, Andrew J Murphy, Brady Hogan, Darren Ha, Doralina L Anghelescu, Marc Mecoli, Nicholas G Cost, Andrew M Davidoff, Kyle O RoveBackground: Enhanced recovery after surgery (ERAS) pathways are
article · Mar 2026
2025 Pediatric Surgery Update Course - Updates in Enhanced Recovery After Surgery (ERAS) Protocols
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On August 26th, the largest Pediatric Surgery course in the world each year was held, where top hospital experts from around the US will discuss this year’s changes in practices and innovation. Learn more about the future of pediatric surge
video32:14 · Aug 2025
Extensive workup should be reserved for patients who are hemodynamically unstable or have more overt signs of infection — Sophia Schermerhorn, Early Postoperative Fever in Pediatric Oncology Patients Undergoing Solid Tumor Resection · 0:45
Postoperative Fever2 items
Early postoperative fever in pediatric oncology patients undergoing solid tumor resection
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John Lundstedt, Emily Vore, Joseph Brungardt, Meera Kotagal, Todd Jenkins, Chloe Boehmer, Roshni DasguptaAbstract
Background: Postoperative fever is common following cancer resection and often prompts extensive, costly workups. The purpose
article · Nov 2025
Early Postoperative Fever in Pediatric Oncology Patients Undergoing Solid Tumor Resection
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John Lundstedt, Emily Vore, Joseph Brungardt, Meera Kotagal, Todd Jenkins, Chloe Boehmer, Roshni DasguptaBackgroundPostoperative fever is common following cancer resection and often prompts extensive, costly workups. The purpose of this stu
video0:51 · Dec 2025
Management of Pediatric Breast Masses for the Pediatric Surgeon: Expert Consensus Recommendations From the APSA Cancer Committee
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Background: The pathology and management of breast masses in pediatric patients is markedly different than in adults. The vast majority of lesions in children and adolescents are benign, but the rare malignant breast masses require prompt r
article · Nov 2026
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Enhanced Recovery After Surgery (ERAS) Improves Length of Stay and Decreases Complications After Resection of Abdominal Neuroblastoma
A multi-center prospective study evaluated a structured ERAS pathway for children undergoing abdominal neuroblastoma resection
clinicalSophia Schermerhorn0:03 ↗
The ERAS protocol included 20 evidence-based elements spanning the entire perioperative process
clinicalSophia Schermerhorn0:13 ↗
ERAS protocol elements included preoperative counseling, hydrate loading, standardized multimodal analgesia, early feeding, and early mobilization
clinicalSophia Schermerhorn0:13 ↗
Length of stay decreased from about 7 days to 3.7 days
clinicalSophia Schermerhorn0:28 ↗
Post-operative opioid use dropped by over half
clinicalSophia Schermerhorn0:32 ↗
Patients resumed regular diets and ambulated about 3 days earlier
clinicalSophia Schermerhorn0:32 ↗
The proportion of patients experiencing any postoperative complication decreased by over 50%
clinicalSophia Schermerhorn0:39 ↗
Patients were cleared to resume adjuvant chemotherapy earlier at around 8 days as opposed to 10 days
clinicalSophia Schermerhorn0:46 ↗
A structured ERAS pathway meaningfully improves recovery even after complex neuroblastoma resections
opinionSophia Schermerhorn0:51 ↗
ERAS represents a tangible opportunity to standardize perioperative care for neuroblastoma resection
opinionSophia Schermerhorn0:51 ↗
Pancreas, Muscle, and Subcutaneous Fat Atrophy in Patients Undergoing Radiation for Neuroblastoma
Radiation improves survival in high-risk neuroblastoma
clinicalSophia Schermerhorn0:00 ↗
This is a retrospective study of 50 children with high-risk neuroblastoma undergoing abdominal radiation therapy
clinicalSophia Schermerhorn0:13 ↗
The authors use CT and MRI body segmentation to measure pancreatic volume, subcutaneous fat, and muscle area before and after treatment
clinicalSophia Schermerhorn0:19 ↗
There was a significant decrease in pancreatic volume after radiation
clinicalSophia Schermerhorn0:27 ↗
Very few patients developed clinically apparent pancreatic insufficiency
clinicalSophia Schermerhorn0:31 ↗
Pancreatic insufficiency wasn't systematically screened for in this study
clinicalSophia Schermerhorn0:31 ↗
Follow-up may not be long enough to detect pancreatic effects, especially given the young average age of these patients
opinionSophia Schermerhorn0:31 ↗
Pancreatic dysfunction could be an under-recognized late effect
opinionSophia Schermerhorn0:43 ↗
Patients had a significant drop in weight percentile with smaller decreases in fat and muscle
clinicalSophia Schermerhorn0:48 ↗
Body composition changes likely reflect the overall impact of cancer therapy overall rather than radiation alone
opinionSophia Schermerhorn0:48 ↗
These findings highlight the importance of nutritional screening during cancer treatments
opinionSophia Schermerhorn0:48 ↗
As survival improves, understanding and screening for long-term effects is becoming just as important as curing the cancer itself
opinionSophia Schermerhorn1:03 ↗
Early Postoperative Fever in Pediatric Oncology Patients Undergoing Solid Tumor Resection
42% of 220 oncology patients had a fever in the 48 hours following tumor resection
epidemiologicalSophia Schermerhorn0:12 ↗
Only 2 of the febrile patients (2.8%) had an actual infection
epidemiologicalSophia Schermerhorn0:19 ↗
The two patients with actual infection were hemodynamically unstable with positive blood cultures
clinicalSophia Schermerhorn0:19 ↗
Most fevers triggered a workup that costs on average about $500 per patient
epidemiologicalSophia Schermerhorn0:30 ↗
About a third of patients received empiric antibiotics that they did not need
epidemiologicalSophia Schermerhorn0:30 ↗
In the 48 hours following tumor resection, fever alone may not be a reason to panic
opinionSophia Schermerhorn0:40 ↗
Extensive workup should be reserved for patients who are hemodynamically unstable or have more overt signs of infection
guidelineSophia Schermerhorn0:45 ↗
Neuroblastoma with Dr. Meera Kotagal
Neuroblastoma makes up about 8 to 10% of all pediatric cancers and about 15% of cancer-related deaths.
epidemiologicalMeera Kotagal0:23 ↗
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