Surgery for Neuroblastoma

At Hassenfeld Children’s Hospital at NYU Langone, doctors sometimes perform surgery to remove a neuroblastoma. This may be the only treatment required, particularly for children under 18 months or those with cancer that has not spread.

Children with high-risk neuroblastomas, which grow quickly and are more likely to return after treatment, require more aggressive therapies. In this case, doctors may use a combination of surgery, chemotherapy, radiation therapy, or stem cell transplantation.

The goal of surgery is to remove as much of the tumor as possible. Sometimes, the entire tumor can be removed, leading to remission—an absence of cancer cells in the body.

Surgery to remove a neuroblastoma can be complicated, because the tumors are frequently located near blood vessels that supply blood to vital organs, such as the kidneys or stomach. If the tumor is entangled with large blood vessels or pressed against vital organs or the spinal cord, removing the entire tumor could damage healthy tissue and organs.

In these situations, parts of the tumor may be left in the body after surgery, and additional treatments—such as chemotherapy or, less frequently, radiation—may be necessary. Sometimes, a second surgery is performed to evaluate the success of these treatments and to remove the remaining tumor.

During surgery, doctors also remove nearby lymph nodes—small vessels located throughout the body that filter fluid from tissue and assist in trapping viruses and bacteria—which are then examined for cancer cells under a microscope. Lymph nodes are often the first place a cancer may spread. If cancer is found in the lymph nodes, additional therapies may be needed to eliminate neuroblastoma cells throughout the body.

Managing Side Effects

Complications of surgery for neuroblastoma depend on the tumor’s size, location, or aggressiveness, meaning how quickly it grows and spreads—as well as the child’s age and health at diagnosis. The side effects of surgery can include damage to blood vessels or organs near the tumor. Our doctors take care to minimize any side effects of neuroblastoma surgery, and provide additional treatment when they can’t be avoided.

Your child’s oncologist, surgeon, and other specialists provide support to help your family manage the physical and emotional effects of surgery for neuroblastoma.