Neuroblastoma is a tumor of the sympathetic nervous system that occurs mainly in young children. Every year, 25 children in the Netherlands receive this diagnosis. Surgery to remove the tumor tissue forms an important part of the treatment plan. Since November 2014, care for children in the Netherlands with a solid tumor, including neuroblastoma, has been concentrated in one national research hospital, the Princess Máxima Center for pediatric oncology in Utrecht.
Comparison
To investigate the effect of concentrating surgery for children with neuroblastoma, researchers from the Princess Máxima Center looked at the medical records of 244 children who had undergone surgery in the five former pediatric oncology centers in the Netherlands between 1998 and 2014. They compared this data with that of the 111 children whose surgery was performed in the Princess Máxima Center between 2014 and 2021. The research was published in the European Journal of Surgical Oncology, and was partly funded by KiKa.
Shorter operations
The researchers saw that operations took 40% less time after the concentration of care: the procedure took an average of two hours and forty-five minutes, an hour and forty-five minutes less than before. In addition, the amount of blood loss during the operation was strongly reduced, from an average of 450 milliliters to just 50 milliliters.
Fewer repeat surgeries
The number of side effects in the first month after surgery remained the same, the researchers found, but the severity of the side effects decreased. Before the concentration of surgery, there were more frequent side effects of the operation that required repeat surgery, and which in some cases were life-threatening.
The researchers also found tentative evidence of an improvement in survival rates for children operated on for neuroblastoma, but further research is needed to establish this difference with more certainty.
Prof. dr. Marc Wijnen, pediatric oncology surgeon and research group leader at the Princess Máxima Center, led the study. He says:
‘With this analysis we show concrete results of bringing together all care and research for children with cancer. Less damage was done to the healthy tissue during the operation, resulting in fewer complications for the child.
‘As a general rule, the more experience a surgeon has, the better the results. The outcome of the investigation did not surprise me. It shows that we can now offer children with cancer the best possible treatment.’
The scientific article can be found here: Van der Steeg AFW, et al. The results of concentration of care: Surgical outcomes of neuroblastoma in the Netherlands. Eur J Surg Oncol. 2023 Feb;49(2):505-511.