This pattern suggests that solitary pulmonary relapse may represent a biologically more favorable type of recurrence, one that's more amenable to achieving meaningful local control, with metacystectomy playing an important role as part of multimodal therapy.
The key takeaways long-term quality of life outcomes appear comparable between patients who undergo resection and liver transplantation. This means that the surgical strategy can really be focused on oncologic control.
The presence of an IDRF doesn't mean that a tumor can't be resected, but it does signal that the surgery may be technically more complex, and patients often receive neoadjuvant therapy first to try to shrink the tumor.
The takeaway image-guided percutaneous biopsy is safe, accurate, and should be strongly considered the diagnostic modality of choice for pediatric bone and soft tissue tumors.
Pediatric oncology outcomes aren't just about tumor biology or treatment received. It's about the social determinants of health for these children as well.
Pediatric oncology outcomes aren't just about tumor biology or treatment received. It's about the social determinants of health for these children as well.
Social Determinants of Health Influence on Survival in Wilms Tumor, Neuroblastoma, and Hepatoblastoma
▶Ep 11 · 0:03
quoteHow much does a child's social factors influence their chance of surviving cancer?↗
▶Ep 11 · 0:12
epidemiologicalStudy was a retrospective analysis of 12,000 patients with neuroblastoma, Wilms tumor, and hepatoblastoma from the National Cancer Database↗
▶Ep 11 · 0:20
epidemiologicalSocioeconomic disadvantage score was created for each patient based on median household income and education level in their local communities↗
▶Ep 11 · 0:31
epidemiologicalThe most disadvantaged children were more likely to have worse survival for Wilms tumor and neuroblastoma↗
▶Ep 11 · 0:37
epidemiologicalAfter adjusting for tumor size, grade, treatment, and comorbidities, socioeconomic effects on survival remained present↗
▶Ep 11 · 0:44
epidemiologicalHazard ratio for socioeconomic disadvantage was 1.29 for hepatoblastoma↗
▶Ep 11 · 0:44
epidemiologicalHazard ratio for socioeconomic disadvantage was 2.02 for Wilms tumor↗
▶Ep 11 · 0:51
opinionPediatric oncology outcomes depend on tumor biology, treatment received, and social determinants of health↗
▶Ep 11 · 0:51
quotePediatric oncology outcomes aren't just about tumor biology or treatment received. It's about the social determinants of health for these children as well.↗
▶Ep 11 · 1:00
opinionIdentifying socioeconomic risk factors is necessary to close equity gaps and improve survival for all children with solid tumors↗
Retreatment with Cisplatin May Provide a Survival Advantage for Children with Relapsed/Refractory Hepatoblastoma: An Institutional Experience
▶Ep 12 · 0:12
quoteIn relapse hepatoblastoma, there's no established standard salvage therapy regimen.↗
▶Ep 12 · 0:12
guidelineThere is no established standard salvage therapy regimen for relapsed hepatoblastoma↗
▶Ep 12 · 0:17
epidemiologicalThe Cincinnati Children's retrospective review of 30 patients represents one of the largest published cohorts evaluating patients with refractory or recurrent hepatoblastoma↗
▶Ep 12 · 0:25
clinicalThe overall survival for the cohort was about 50%↗
▶Ep 12 · 0:28
quoteChildren who received cisplatin as part of their salvage therapy had a much better survival than those who did not, about 80% compared to 25%.↗
▶Ep 12 · 0:28
clinicalChildren who received cisplatin as part of their salvage therapy had survival of about 80% compared to 25% for those who did not receive cisplatin↗
▶Ep 12 · 0:36
opinionThe improved survival outcomes with cisplatin may be due to persistent platinum sensitivity or better tumor biology rather than proving causality↗
▶Ep 12 · 0:49
clinicalMost patients underwent additional surgery as part of their salvage therapy, either liver resection, liver transplant, or pulmonary metastasectomy↗
▶Ep 12 · 0:57
quoteThis highlights that salvage therapy is multimodal.↗
▶Ep 12 · 0:57
clinicalSalvage therapy for relapsed hepatoblastoma is multimodal↗
▶Ep 12 · 0:59
opinionCisplatin retreatment should be balanced with the risk of cumulative toxicity↗
Indocyanine green is a sensitive adjunct in the identification and surgical management of local and metastatic hepatoblastoma
▶Ep 13 · 0:00
quoteAre you actually seeing all the hepatoblastoma during your resection?↗
▶Ep 13 · 0:12
clinicalThis is a single institution retrospective review of patients who received ICG prior to either pulmonary metastatectomy or liver resection for hepatoblastoma↗
▶Ep 13 · 0:22
clinicalICG was highly sensitive for detecting hepatoblastoma, about 90%↗
▶Ep 13 · 0:27
clinicalIn a meaningful number of cases, ICG was able to detect tumor deposits that were not visible, palpable, or detectable on preoperative imaging↗
▶Ep 13 · 0:39
clinicalSpecificity was lower than sensitivity with false positives↗
▶Ep 13 · 0:43
clinicalFalse positives often represented vascular changes or inflammation↗
▶Ep 13 · 0:46
clinicalThere were no adverse outcomes associated with any of the additional resections guided by ICG↗
▶Ep 13 · 0:50
clinicalICG was effective in both open and minimally invasive surgery↗
▶Ep 13 · 0:50
clinicalICG was effective in both relapse and primary disease↗
▶Ep 13 · 0:55
quoteICG is a valuable tool that can help increase confidence in achieving a complete resection for both primary and metastatic hepatoblastoma.↗
Quality of Life Outcomes for Patients Who Underwent Conventional Resection and Liver Transplantation for Locally Advanced Hepatoblastoma
▶Ep 14 · 0:18
epidemiologicalSurvival for hepatoblastoma continues to improve.↗
▶Ep 14 · 0:18
opinionLong-term quality of life is becoming a more important outcome as hepatoblastoma survival improves.↗
▶Ep 14 · 0:24
clinicalThis is a single institution cross-sectional study using validated pediatric quality of life surveys to evaluate long-term survivors of hepatoblastoma.↗
▶Ep 14 · 0:31
clinicalThere was no significant difference in emotional, social, physical, or school functioning outcomes between transplant and resection groups.↗
▶Ep 14 · 0:31
clinicalOverall quality of life outcomes were similar between liver transplant and resection groups for hepatoblastoma.↗
▶Ep 14 · 0:39
quoteThis challenges the assumption that liver transplantation necessarily leads to a worse. Long-term quality of life.↗
▶Ep 14 · 0:47
clinicalPatients who underwent resection had lower overall procedure anxiety scores than transplant patients.↗
▶Ep 14 · 0:53
clinicalThe finding of lower procedural anxiety in resection patients was mirrored in the parents' surveys.↗
▶Ep 14 · 0:55
quoteThe key takeaways long-term quality of life outcomes appear comparable between patients who undergo resection and liver transplantation. This means that the surgical strategy can really be focused on oncologic control.↗
▶Ep 14 · 0:55
clinicalLong-term quality of life outcomes appear comparable between patients who undergo resection and liver transplantation for hepatoblastoma.↗
▶Ep 14 · 1:02
opinionSurgical strategy for hepatoblastoma can be focused on oncologic control given comparable quality of life outcomes.↗
Social Determinants of Health Influence on Survival in Wilms Tumor, Neuroblastoma, and Hepatoblastoma
▶Ep 22 · 0:03
quoteHow much does a child's social factors influence their chance of surviving cancer?↗
▶Ep 22 · 0:12
epidemiologicalStudy was a retrospective analysis of 12,000 patients with neuroblastoma, Wilms tumor, and hepatoblastoma from the National Cancer Database↗
▶Ep 22 · 0:20
epidemiologicalSocioeconomic disadvantage score was created for each patient based on median household income and education level in their local communities↗
▶Ep 22 · 0:31
epidemiologicalThe most disadvantaged children were more likely to have worse survival for Wilms tumor and neuroblastoma↗
▶Ep 22 · 0:37
epidemiologicalAfter adjusting for tumor size, grade, treatment, and comorbidities, socioeconomic effects on survival remained present↗
▶Ep 22 · 0:44
epidemiologicalHazard ratio for socioeconomic disadvantage was 2.02 for Wilms tumor↗
▶Ep 22 · 0:44
epidemiologicalHazard ratio for socioeconomic disadvantage was 1.29 for hepatoblastoma↗
▶Ep 22 · 0:51
quotePediatric oncology outcomes aren't just about tumor biology or treatment received. It's about the social determinants of health for these children as well.↗
▶Ep 22 · 0:51
opinionPediatric oncology outcomes depend on tumor biology, treatment received, and social determinants of health↗
▶Ep 22 · 1:00
opinionIdentifying socioeconomic risk factors is necessary to close equity gaps and improve survival for all children with solid tumors↗
Enhanced Recovery After Surgery (ERAS) Improves Length of Stay and Decreases Complications After Resection of Abdominal Neuroblastoma
▶Ep 23 · 0:00
quoteDid you know there's an ERAS protocol for neuroblastoma?↗
▶Ep 23 · 0:03
clinicalA multi-center prospective study evaluated a structured ERAS pathway for children undergoing abdominal neuroblastoma resection↗
▶Ep 23 · 0:13
clinicalThe ERAS protocol included 20 evidence-based elements spanning the entire perioperative process↗
▶Ep 23 · 0:13
clinicalERAS protocol elements included preoperative counseling, hydrate loading, standardized multimodal analgesia, early feeding, and early mobilization↗
clinicalLength of stay decreased from about 7 days to 3.7 days↗
▶Ep 23 · 0:32
clinicalPost-operative opioid use dropped by over half↗
▶Ep 23 · 0:32
clinicalPatients resumed regular diets and ambulated about 3 days earlier↗
▶Ep 23 · 0:39
clinicalThe proportion of patients experiencing any postoperative complication decreased by over 50%↗
▶Ep 23 · 0:46
clinicalPatients were cleared to resume adjuvant chemotherapy earlier at around 8 days as opposed to 10 days↗
▶Ep 23 · 0:51
opinionA structured ERAS pathway meaningfully improves recovery even after complex neuroblastoma resections↗
▶Ep 23 · 0:51
opinionERAS represents a tangible opportunity to standardize perioperative care for neuroblastoma resection↗
Long-Term Follow-Up of Surgical Outcomes for Patients With Wilms Tumor and Neuroblastoma
▶Ep 24 · 0:00
quoteYou just surgically treated your patient with Wilms tumor or neuroblastoma. Now what?↗
▶Ep 24 · 0:11
epidemiologicalThis single institution cohort followed survivors for a mean of 27 years after open oncologic resection for Wilms tumor and neuroblastoma↗
▶Ep 24 · 0:20
epidemiological14% of patients required a repeat laparotomy↗
▶Ep 24 · 0:21
clinicalThe most common indications for repeat laparotomy were small bowel obstruction or tumor recurrence↗
▶Ep 24 · 0:26
clinicalIn Wilms tumor, obstruction typically occurred within the first year↗
▶Ep 24 · 0:29
clinicalIn neuroblastoma, obstruction often developed more than a decade later, well beyond routine follow-up↗
▶Ep 24 · 0:34
clinicalRadiation dose was not associated with re-operation risk↗
▶Ep 24 · 0:37
epidemiologicalSecondary malignancy was uncommon in this cohort↗
▶Ep 24 · 0:37
clinicalHypertension after nephrectomy was not increased compared to population norms↗
▶Ep 24 · 0:45
epidemiologicalScoliosis occurred in roughly 10 to 13% of patients, higher than the general population↗
▶Ep 24 · 0:45
clinicalScoliosis has multi-factorial contributors including surgery and possibly radiation↗
▶Ep 24 · 0:55
quoteThe takeaway is that surgical care does not end at resection.↗
▶Ep 24 · 0:58
guidelineEven decades after treatment, these patients remain at risk for late complications that warrant long-term counseling and follow-up↗
The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report
▶Ep 25 · 0:00
quoteIf you're someone who treats neuroblastoma, you need to know about IDRFs to know whether it's safe to go to the operating room.↗
▶Ep 25 · 0:00
clinicalIDRFs are necessary knowledge for clinicians treating neuroblastoma to determine safety of surgical intervention↗
▶Ep 25 · 0:14
clinicalIDRFs are imaging findings on CT or MRI that predict when neuroblastoma may be difficult or dangerous to remove surgically↗
▶Ep 25 · 0:14
quoteIDRFs are imaging findings on CT or MRIs that predict when a neuroblastoma may be difficult or dangerous to remove surgically.↗
▶Ep 25 · 0:21
guidelineThe IDRF concept was first introduced in 2009 by the International Neuroblastoma Risk Group↗
▶Ep 25 · 0:21
guidelineThe International Neuroblastoma Risk Group defined 20 specific imaging risk factors↗
▶Ep 25 · 0:29
clinicalMost IDRFs relate to how the tumor interacts with critical anatomy↗
▶Ep 25 · 0:34
clinicalIn the abdomen, a tumor that infiltrates the portahepati or hepatoduodenal ligament is considered to contain an IDRF↗
▶Ep 25 · 0:41
clinicalPatients with IDRFs often receive neoadjuvant therapy first to try to shrink the tumor↗
▶Ep 25 · 0:41
quoteThe presence of an IDRF doesn't mean that a tumor can't be resected, but it does signal that the surgery may be technically more complex, and patients often receive neoadjuvant therapy first to try to shrink the tumor.↗
▶Ep 25 · 0:41
clinicalThe presence of an IDRF does not mean a tumor cannot be resected↗
▶Ep 25 · 0:41
clinicalIDRF presence signals that surgery may be technically more complex↗
▶Ep 25 · 0:52
clinicalSurgeons use IDRFs to predict surgical risk and guide the safest treatment approach using imaging↗
Pancreas, Muscle, and Subcutaneous Fat Atrophy in Patients Undergoing Radiation for Neuroblastoma
▶Ep 26 · 0:00
clinicalRadiation improves survival in high-risk neuroblastoma↗
▶Ep 26 · 0:00
quoteSo, we know radiation improves survival in high-risk neuroblastoma, but what does it do to the rest of the body?↗
▶Ep 26 · 0:13
clinicalThis is a retrospective study of 50 children with high-risk neuroblastoma undergoing abdominal radiation therapy↗
▶Ep 26 · 0:19
clinicalThe authors use CT and MRI body segmentation to measure pancreatic volume, subcutaneous fat, and muscle area before and after treatment↗
▶Ep 26 · 0:27
clinicalThere was a significant decrease in pancreatic volume after radiation↗
▶Ep 26 · 0:31
opinionFollow-up may not be long enough to detect pancreatic effects, especially given the young average age of these patients↗
▶Ep 26 · 0:31
clinicalPancreatic insufficiency wasn't systematically screened for in this study↗
▶Ep 26 · 0:31
clinicalVery few patients developed clinically apparent pancreatic insufficiency↗
▶Ep 26 · 0:43
opinionPancreatic dysfunction could be an under-recognized late effect↗
▶Ep 26 · 0:43
quoteSo this raises concern that pancreatic dysfunction could be an Recognized late effect.↗
▶Ep 26 · 0:48
clinicalPatients had a significant drop in weight percentile with smaller decreases in fat and muscle↗
▶Ep 26 · 0:48
opinionThese findings highlight the importance of nutritional screening during cancer treatments↗
▶Ep 26 · 0:48
opinionBody composition changes likely reflect the overall impact of cancer therapy overall rather than radiation alone↗
▶Ep 26 · 1:03
opinionAs survival improves, understanding and screening for long-term effects is becoming just as important as curing the cancer itself↗
▶Ep 26 · 1:03
quoteSo, as survival improves, understanding and screening for these long-term effects is becoming just as important as curing the cancer itself.↗
Current management of pulmonary relapse in Ewing sarcoma: A report from the Pediatric Surgical Oncology Research Collaborative
▶Ep 31 · 0:05
clinicalWriter et al. published a multi-center retrospective study in the Journal of Pediatric Surgery through PeaceSOC in 2024↗
▶Ep 31 · 0:07
clinicalPeaceSOC is a network of over 50 centers in North America that work together to improve outcomes in pediatric surgical oncology↗
▶Ep 31 · 0:20
clinicalThe study examined patients less than 22 years old with initially localized Ewing sarcoma who developed first pulmonary relapse between 2007 and 2020 across 19 different centers↗
▶Ep 31 · 0:32
epidemiologicalAmong 33 patients studied, about 2/3 had relapse limited to the lungs↗
▶Ep 31 · 0:32
epidemiologicalNearly half of patients with lung-limited relapse had just a solitary pulmonary nodule↗
▶Ep 31 · 0:39
epidemiologicalPatients with solitary pulmonary nodule had the highest overall three-year survival at 73%↗
▶Ep 31 · 0:39
clinicalPatients with solitary pulmonary nodule were more likely to undergo metastasectomy and whole lung radiation↗
▶Ep 31 · 0:50
epidemiologicalThree-year survival for patients with extrapulmonary disease was 23%↗
▶Ep 31 · 0:50
epidemiologicalThree-year survival for patients with multiple nodules was 40%↗
▶Ep 31 · 0:57
opinionSolitary pulmonary relapse is more amenable to achieving meaningful local control↗
▶Ep 31 · 0:57
opinionMetastasectomy plays an important role as part of multimodal therapy for solitary pulmonary relapse in Ewing sarcoma↗
▶Ep 31 · 0:57
opinionSolitary pulmonary relapse may represent a biologically more favorable type of recurrence↗
▶Ep 31 · 0:57
quoteThis pattern suggests that solitary pulmonary relapse may represent a biologically more favorable type of recurrence, one that's more amenable to achieving meaningful local control, with metacystectomy playing an important role as part of multimodal therapy.↗
Early Postoperative Fever in Pediatric Oncology Patients Undergoing Solid Tumor Resection
▶Ep 32 · 0:00
quoteYour patients post-op day one from a hepatoblastoma resection, and they spike a fever. Do you think they need a big fever workup?↗
▶Ep 32 · 0:12
epidemiological42% of 220 oncology patients had a fever in the 48 hours following tumor resection↗
▶Ep 32 · 0:19
clinicalThe two patients with actual infection were hemodynamically unstable with positive blood cultures↗
▶Ep 32 · 0:19
epidemiologicalOnly 2 of the febrile patients (2.8%) had an actual infection↗
▶Ep 32 · 0:30
epidemiologicalMost fevers triggered a workup that costs on average about $500 per patient↗
▶Ep 32 · 0:30
epidemiologicalAbout a third of patients received empiric antibiotics that they did not need↗
▶Ep 32 · 0:39
quoteSo here's the big takeaway. In the 48 hours following a tumor resection, a fever alone may not be a reason to panic.↗
▶Ep 32 · 0:40
opinionIn the 48 hours following tumor resection, fever alone may not be a reason to panic↗
▶Ep 32 · 0:45
guidelineExtensive workup should be reserved for patients who are hemodynamically unstable or have more overt signs of infection↗
Pediatric and Young Adult Image-Guided Percutaneous Bone Biopsy-A New Standard of Care?
▶Ep 33 · 0:00
quoteAre you still doing open biopsy for pediatric bone tumors?↗
▶Ep 33 · 0:13
clinicalThe study evaluated 169 biopsies in 141 patients over a 10-year period at a single institution.↗
▶Ep 33 · 0:19
clinicalNearly 90% of the biopsies were core-needle biopsies.↗
▶Ep 33 · 0:22
clinicalAll biopsies were performed with image guidance, most commonly CT, sometimes combined with fluoroscopy and ultrasound.↗
▶Ep 33 · 0:28
clinicalAll biopsies were performed by interventional radiologists.↗
clinicalThe approach provided sufficient tissue for histology, immunostains, and molecular studies.↗
▶Ep 33 · 0:46
clinicalImmunostains and molecular studies are increasingly essential for modern risk stratification and targeted therapy.↗
▶Ep 33 · 0:56
opinionImage-guided percutaneous biopsy should be strongly considered the diagnostic modality of choice for pediatric bone and soft tissue tumors.↗
▶Ep 33 · 0:56
quoteThe takeaway image-guided percutaneous biopsy is safe, accurate, and should be strongly considered the diagnostic modality of choice for pediatric bone and soft tissue tumors.↗
Indocyanine green assists with sentinel lymph node mapping in pediatric and adolescent patients
▶Ep 34 · 0:00
quoteSo just how accurate is ICG for detecting sentinel lymph nodes in pediatric oncology?↗
▶Ep 34 · 0:05
clinicalThe study was a multi-center prospective study conducted by PeaceOC evaluating indocyanine green (ICG) for identifying sentinel lymph nodes in pediatric patients with skin and soft tissue malignancies↗
▶Ep 34 · 0:21
clinicalPeritumoral injection of ICG demonstrated almost 80% sensitivity for detecting a sentinel node↗
▶Ep 34 · 0:28
quoteall sentinel nodes that contained malignancy were ICG avid↗
▶Ep 34 · 0:28
clinicalAll sentinel nodes that contained malignancy were ICG avid↗
▶Ep 34 · 0:33
clinicalICG diagnostic performance is similar to smaller pediatric studies previously evaluating ICG and sentinel lymph node biopsy↗
▶Ep 34 · 0:33
opinionICG may outperform blue dye localization based on previously reported literature↗
▶Ep 34 · 0:45
clinicalThe study did not directly compare the effectiveness of ICG to blue dye localization↗
▶Ep 34 · 0:49
clinicalICG in most cases was used in conjunction with standard localization techniques such as technetium↗
▶Ep 34 · 0:58
clinicalNo adverse reactions to ICG were identified within 30 days of surgery↗
opinionICG has a favorable safety profile and lacks the permanent tattooing associated with blue dye, making it an attractive visualization adjunct for pediatric sentinel lymph node biopsy↗
Indocyanine green assists with sentinel lymph node mapping in pediatric and adolescent patients
▶Ep 15 · 0:00
quoteSo just how accurate is ICG for detecting sentinel lymph nodes in pediatric oncology?↗
▶Ep 15 · 0:05
clinicalThe study was a multi-center prospective study conducted by PeaceOC evaluating indocyanine green (ICG) for identifying sentinel lymph nodes in pediatric patients with skin and soft tissue malignancies↗
▶Ep 15 · 0:21
clinicalPeritumoral injection of ICG demonstrated almost 80% sensitivity for detecting a sentinel node↗
▶Ep 15 · 0:28
quoteall sentinel nodes that contained malignancy were ICG avid↗
▶Ep 15 · 0:28
clinicalAll sentinel nodes that contained malignancy were ICG avid↗
▶Ep 15 · 0:33
opinionICG may outperform blue dye localization based on previously reported literature↗
▶Ep 15 · 0:33
clinicalICG diagnostic performance is similar to smaller pediatric studies previously evaluating ICG and sentinel lymph node biopsy↗
▶Ep 15 · 0:45
clinicalThe study did not directly compare the effectiveness of ICG to blue dye localization↗
▶Ep 15 · 0:49
clinicalICG in most cases was used in conjunction with standard localization techniques such as technetium↗
▶Ep 15 · 0:58
clinicalNo adverse reactions to ICG were identified within 30 days of surgery↗
opinionICG has a favorable safety profile and lacks the permanent tattooing associated with blue dye, making it an attractive visualization adjunct for pediatric sentinel lymph node biopsy↗
Social Determinants of Health Influence on Survival in Wilms Tumor, Neuroblastoma, and Hepatoblastoma
▶Ep 17 · 0:03
quoteHow much does a child's social factors influence their chance of surviving cancer?↗
▶Ep 17 · 0:12
epidemiologicalStudy was a retrospective analysis of 12,000 patients with neuroblastoma, Wilms tumor, and hepatoblastoma from the National Cancer Database↗
▶Ep 17 · 0:20
epidemiologicalSocioeconomic disadvantage score was created for each patient based on median household income and education level in their local communities↗
▶Ep 17 · 0:31
epidemiologicalThe most disadvantaged children were more likely to have worse survival for Wilms tumor and neuroblastoma↗
▶Ep 17 · 0:37
epidemiologicalAfter adjusting for tumor size, grade, treatment, and comorbidities, socioeconomic effects on survival remained present↗
▶Ep 17 · 0:44
epidemiologicalHazard ratio for socioeconomic disadvantage was 1.29 for hepatoblastoma↗
▶Ep 17 · 0:44
epidemiologicalHazard ratio for socioeconomic disadvantage was 2.02 for Wilms tumor↗
▶Ep 17 · 0:51
opinionPediatric oncology outcomes depend on tumor biology, treatment received, and social determinants of health↗
▶Ep 17 · 0:51
quotePediatric oncology outcomes aren't just about tumor biology or treatment received. It's about the social determinants of health for these children as well.↗
▶Ep 17 · 1:00
opinionIdentifying socioeconomic risk factors is necessary to close equity gaps and improve survival for all children with solid tumors↗
Long-Term Follow-Up of Surgical Outcomes for Patients With Wilms Tumor and Neuroblastoma
▶Ep 18 · 0:00
quoteYou just surgically treated your patient with Wilms tumor or neuroblastoma. Now what?↗
▶Ep 18 · 0:11
epidemiologicalThis single institution cohort followed survivors for a mean of 27 years after open oncologic resection for Wilms tumor and neuroblastoma↗
▶Ep 18 · 0:20
epidemiological14% of patients required a repeat laparotomy↗
▶Ep 18 · 0:21
clinicalThe most common indications for repeat laparotomy were small bowel obstruction or tumor recurrence↗
▶Ep 18 · 0:26
clinicalIn Wilms tumor, obstruction typically occurred within the first year↗
▶Ep 18 · 0:29
clinicalIn neuroblastoma, obstruction often developed more than a decade later, well beyond routine follow-up↗
▶Ep 18 · 0:34
clinicalRadiation dose was not associated with re-operation risk↗
▶Ep 18 · 0:37
epidemiologicalSecondary malignancy was uncommon in this cohort↗
▶Ep 18 · 0:37
clinicalHypertension after nephrectomy was not increased compared to population norms↗
▶Ep 18 · 0:45
clinicalScoliosis has multi-factorial contributors including surgery and possibly radiation↗
▶Ep 18 · 0:45
epidemiologicalScoliosis occurred in roughly 10 to 13% of patients, higher than the general population↗
▶Ep 18 · 0:55
quoteThe takeaway is that surgical care does not end at resection.↗
▶Ep 18 · 0:58
guidelineEven decades after treatment, these patients remain at risk for late complications that warrant long-term counseling and follow-up↗