Abdominal Neuroblastoma Laparoscopic Surgery Risk Factors Stratification

After signing informed consent and surgical risk factors assessment (see Study Documents), eligible patients received surgical treatment - laparoscopic neuroblastoma resection. Parameters to be assessed are: duration of surgery intervention, intraoperative complications, blood loss volume, cases and volume of blood transfusion, conversion from laparoscopic to cavity access, surgeon's visual assessment completeness of the tumor resection. During 5 postoperative days patients undergo contrast-enhanced abdominal computed tomography (CT) to control completeness of the tumor resection assessment. Postoperative complications during 30 postoperative days to be accessed. In follow up period 1-, 3- and 5 years local recurrence-free survival to be accessed.

Inclusion criteria

• Patients with neurogenic tumors meeting the criteria of groups I-III:

Group I

• low or moderate risk group according to pilot difficulty scoring system (less than 5 points, see supplementary material);
• no IDRF;

Group II:

• low or moderate risk group according to pilot difficulty scoring system (less than 5 points);
• patients with any number of IDRFs and without central tumor location and/or tumor extension across the midline and/or tumor volume (cm3)/patient height (m) ratio = 28 or more.

Group III:

• 2 and more IDRF + central tumor location and/or tumor extension across the midline;
• 2 and more IDRF + tumor volume (cm3)/patient height (m) ratio = 28 or more;
• 2 and more IDRF + 2 and more other risk factors according to pilot difficulty scoring system;
• 1 IDRF + tumor extension across the midline + tumor volume (cm3)/patient height (m) ratio = 28 or more.
• Age from 0 to 18 years.
• Preoperative imaging (abdominal contrast-enhanced computed tomography (CT), performed no later than 14 days before the planned surgery).
• Indications for surgery based on the decision of multidisciplinary experts board in centers- participants.
• Written voluntary informed consent of the patient and / or his legal representative.

Exclusion criteria

• 3 and more IDRF + central tumor location and/or tumor extension across the midline and/or tumor volume (cm3)/patient height (m) ratio = 28 or more.
• Severe concomitant pathology, increasing anesthesiologic and surgical risks, via the desicion of the research physician or conclusion by multidisciplinary team in centers- participants.
• Tumor volume does not technically allow to provide minimally-invasive surgery, based on the conclusion of multidisciplinary experts board team in centers- participants.
• Therapy strategy: observation

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