Metastatic Disease
Everything in the library about metastatic disease — built automatically from the recorded discussions that name it
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
Evidence & Research
3 items
BOB in Ped Surg 2023 - IPSO Winner - Steven Scoville, MD
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Watch the IPSO winner, Steven Scoville MD, present his presentation on "Comparison of outcomes between surveillance ultrasound and completion lymph node dissection in children and adolescents with sentinel lymph node positive cutaneous mela
video · Feb 2023
BOB Ped Surg 2023 - Andrew Fleming, AAP - Presentation
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Watch Andrew Fleming, MD, present his presentation on "Aggressive Pursuit of No Evidence of Disease Status in Hepatoblastoma Improves Survival."
video · Feb 2023
Malignant peripheral nerve sheath tumors: a report from Children’s Oncology Group study ARST0332
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Jacquelyn N Crane, Wei Xue, Amira Qumseya, Donald A Barkauskas, Khang Chau, Serena Y Tan, Susan Hiniker, Roshni Dasgupta, Rajkumar Venkatramani, Sheri L Spunt, Aaron R Weiss, Theodore W LaetschBackground: The cornerstone of the treatment of
video1:11 · Mar 2026
In-Depth Reviews
1 item
Topics in 10: Neuroblastoma
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Drs Daniel von Allmen, Todd Ponsky and Rae Hanke come together to provide you the essentials on the diagnosis and management of Neuroblastoma. Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist U
podcast10:25 · Dec 2020
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Every expert statement below comes from the recorded discussions, with its speaker and moment.
Malignant peripheral nerve sheath tumors: a report from Children’s Oncology Group study ARST0332
The Children's Oncology Group published a prospective trial on malignant peripheral nerve sheath tumors in the Journal of the National Cancer Institute in 2025.
clinicalJill Knepprath0:11 ↗
Patients were assigned to four treatment groups: observation, adjuvant radiation, adjuvant chemoradiation, and neoadjuvant chemoradiation.
clinicalJill Knepprath0:24 ↗
Resection has a major influence on survival for patients with malignant peripheral nerve sheath tumors.
clinicalJill Knepprath0:35 ↗
Female patients with malignant peripheral nerve sheath tumors had improved outcomes.
epidemiologicalJill Knepprath0:40 ↗
Patients without metastatic disease had improved outcomes.
clinicalJill Knepprath0:40 ↗
Low-risk patients had improved outcomes.
clinicalJill Knepprath0:40 ↗
In patients receiving neoadjuvant therapy, 23% showed a response.
clinicalJill Knepprath0:46 ↗
In patients receiving neoadjuvant therapy, 45% were stable.
clinicalJill Knepprath0:46 ↗
In patients receiving neoadjuvant therapy, 32% had progressive disease.
clinicalJill Knepprath0:46 ↗
There was no difference in survival based on the response to neoadjuvant therapy among patients who went on to have resection.
clinicalJill Knepprath0:59 ↗
Resection should be done for patients with malignant peripheral nerve sheath tumors whenever possible, even if they show a good response to chemoradiation.
guidelineJill Knepprath1:03 ↗
BOB in Ped Surg 2023 - IPSO Winner - Steven Scoville, MD
Pediatric melanoma has approximately 500 new cases diagnosed annually in children less than or equal to 18 years old
epidemiologicalStephen Scoville3:01 ↗
Childhood melanoma is associated with delayed diagnosis and more frequently has nodal involvement compared to adults
clinicalStephen Scoville3:01 ↗
Management of pediatric melanoma is based on adult studies despite differences in disease mechanisms
clinicalStephen Scoville3:01 ↗
Tumors less than 8 millimeters thick are largely managed with wide local excision
guidelineStephen Scoville3:01 ↗
Tumors greater than or equal to 8 millimeters or less than 8 millimeters with high risk features without metastatic involvement typically undergo wide local excision with sentinel lymph node biopsies
guidelineStephen Scoville3:01 ↗
Two adult trials (Decog SLT and MSLT2) showed no significant difference in outcomes for patients with positive sentinel lymph node biopsies followed with ultrasound observation versus completion lymph node dissections
clinicalStephen Scoville3:01 ↗
There is no pediatric data to support ultrasound observation versus completion lymph node dissection
clinicalStephen Scoville3:01 ↗
Study included 252 patients less than or equal to 18 years old diagnosed with cutaneous melanoma between 2010 and 2020 from 14 institutions
clinicalStephen Scoville4:10 ↗
Breslow depth ranged from 2 millimeters to 20 millimeters with a median of 2.55 millimeters
clinicalStephen Scoville4:10 ↗
Of 227 patients who underwent wide local excision with sentinel lymph node biopsies, 115 had positive sentinel lymph node biopsies (approximately 51%)
clinicalStephen Scoville5:20 ↗
Patients who underwent completion lymph node dissection were significantly older and more likely to receive adjuvant therapy
clinicalStephen Scoville6:30 ↗
There was no significant difference in recurrence or death from disease between ultrasound observation and completion lymph node dissection groups
clinicalStephen Scoville6:30 ↗
Positive sentinel lymph node biopsies had significantly higher rate of disease recurrence at 18% compared to 3% for negative sentinel lymph node biopsy group
clinicalStephen Scoville7:30 ↗
Only 21% of those who underwent completion lymph node dissection had additional positive nodal disease
clinicalStephen Scoville7:30 ↗
Rate of recurrence was not significantly different between completion lymph node dissection patients with or without additional nodal burden
clinicalStephen Scoville7:30 ↗
Recurrence was associated with positive nodal disease, deeper Breslow depth, greater use of adjuvant therapy, and higher rate of death
clinicalStephen Scoville8:00 ↗
Pediatric melanoma presents as advanced disease with nearly 50% positive sentinel lymph node biopsy rate
clinicalStephen Scoville8:31 ↗
Management of nodal disease had no significant impact on disease outcomes with respect to recurrence or death from disease
clinicalStephen Scoville8:31 ↗
Before the Decog and MSLT2 trials, there was a much higher rate of completion lymph node dissection in children, and after those trials the rate has gone down but is still higher than in adults
clinicalStephen Scoville9:15 ↗
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