Surgery for Neuroblastoma

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

Surgical biopsy

In many cases, doctors need to get a sample of the tumor to be sure it is neuroblastoma before deciding on a treatment plan. Tumor samples are removed during a surgical biopsy for testing to make a diagnosis.

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

Surgery to treat neuroblastoma

After neuroblastoma is confirmed, surgery is often used to try to remove as much of the tumor as possible. In some cases, surgery can remove all (or almost all) of the tumor, and no additional treatments are needed.

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

Surgery for neuroblastoma can be challenging and should be specific to the patient and the expertise of the cancer center surgeon. The surgeon may try to remove the entire tumor or only a part of it. If the tumor is near vital structures or wrapped around large blood vessels it may not be possible to remove it completely. Even if some of the tumor is left behind, that does not always mean the tumor will come back. Whether chemotherapy or other treatments will be needed after surgery depends on the child's risk group.

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 of the tumor, the extent of the operation, and the child’s health beforehand. Speak to your child’s surgeon about their specific surgical risks.

Serious complications, although rare, can include:

• Problems with anesthesia
• Excess bleeding
• Infections
• Damage to blood vessels, kidneys or 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 be treated with medicines if needed.