Cecchetto et al listed a number of risk factors for surgical resection in a child with neuroblastoma. These can help identify a child who may have an adverse outcome following surgical resection of the tumor. The authors are multiple pediatric oncology centers in Europe.
Risk factors associated with difficult surgery:
(1) encasement of a major artery and/or vein
(2) encasement of a major nerve or plexus
(3) encasement of the trachea, major bronchus, or other major organ
(4) infiltration of the porta hepatis, renal hilum, muscle or other organ
(5) dumbbell shaped tumor
(6) tumor crossing the midline
(7) tumor extending from the region of origin into an adjacent region (from neck into thorax, from thorax into abdomen, etc.)
(8) infiltration of intervertebral foramina
(9) involvement of the lower mediastinum
Risk factors associated with tumor rupture during resection:
(1) large size relative to the size of the child
(2) extensive necrosis causing tumor fragility
