Neuroblastoma

Background

Neuroblastoma (NBL) is the most common extra-cranial solid tumor in children. Depending on stage, treatment can consist of chemotherapy, autologous stem cell transplantation and immunotherapy; local control is achieved by surgical resection of the primary tumor and radiation therapy. Actual contribution of surgery to overall survival in high risk NBL is still subject of debate in current literature. No optimal extent of resection is known. 

Since extensive surgery for neuroblastoma is associated with significant morbidity and mortality, and impact on survival is not yet determined, more information is needed to guide surgeons and oncologists in clinical decision making.

Aims

• To determine the nature and prevalence of peri-operative complications of surgery for NBL in current literature

• To determine the nature and prevalence of peri-operative complications of surgery for NBL in the past 15 years in The Netherlands

• To identify the physiological sequalae leading to unexplained fatal circulatory failure after surgery for NBL

• To compare previous complication rate in a multi-center experience in The Netherlands (1998-2014), to complication rate after centralization of care in the Princess Maxima Center (2015-now)

• To determine actual contribution of surgical resection to overall survival of children with High Risk NBL

• To determine the effect of surgery vs. wait and see in Low Risk NBL

Project Outcome

• van der Steeg AFW, Jans M, Tytgat G, Fiocco M, van de Ven C, Terwisscha van Scheltinga CEJ, Pieters R, van Noesel MM, van Dijk AH, Hulsker CCC & Wijnen MHWA (2022). The results of concentration of care: Surgical outcomes of neuroblastoma in the Netherlands. European Journal of Surgical Oncology. doi: 10.1016/j.ejso.2022.10.005

Team

• Prof. dr. M. Fiocco, Mathematical Institute Leiden University, Department of Biomedical Data Sciences Leiden University Medical Center & Princess Máxima Center for Pediatric Oncology 

• Drs. M. Jans, MD collaborator at the Princess Maxima Center for Pediatric Oncology

• Dr. G.A.M. Tytga, MD, Pediatric Oncologist at the Princess Maxima Center for Pediatric Oncology

• Prof. dr. M.H.W.A. Wijnen, Pediatric Surgeon at the Princess Maxima Center for Pediatric Oncology