Neuroblastoma Surgery

Surgery can be used both to help diagnose neuroblastoma and to treat it. For smaller tumors that have not spread, surgery is often the only treatment that is needed.

Surgical (open) biopsy

In many cases, doctors need to get a sample of the tumor to be sure it is a neuroblastoma before deciding which treatment might work best. Tumor samples are removed during a surgical biopsy to be looked at under a microscope and for other lab tests.

If the tumor is in the abdomen (belly), the surgeon may do the biopsy with the aid of a laparoscope. This is a long, thin tube with a tiny video camera on the end. It is put into the abdomen through a small incision to allow the surgeon to see inside. The surgeon then makes a second small incision to reach inside the abdomen with long, thin instruments and remove pieces of tumor.

Surgery as treatment

After neuroblastoma is diagnosed, surgery is often used to try to remove as much of the tumor as possible. In some cases, surgery can remove the entire tumor and bring about a cure.

During the operation, the surgeon looks carefully for signs of tumor spread to other organs. Nearby lymph nodes (small collections of immune system cells to which cancers often spread first) are removed and looked at under a microscope for cancer cells.

If possible, the surgeon will remove the entire tumor. This is less likely if the tumor is near vital structures or wrapped around large blood vessels. Even if some of the tumor is left behind, treatment with chemotherapy (and sometimes radiation therapy) after surgery may still result in a cure. Sometimes surgery is repeated after other treatments (chemotherapy and/or radiation therapy) to check the results of therapy and to remove any remaining cancer if possible.

If the tumor is very large, chemotherapy may be used before surgery to shrink the tumor and make it easier to remove.

Possible risks and side effects of surgery

The risks from surgery depend on the location and extent of the operation and the child’s health beforehand. Serious complications, although rare, can include problems with anesthesia, excess bleeding, infections, and damage to blood vessels, kidneys, other organs, or nerves. Complications are more likely if the tumor is large and growing into blood vessels or nerves. Most children will have some pain for a while after the operation, but this can usually be helped with medicines if needed.