Surgery for neuroblastoma

Surgery is an important stage of treatment for many children with neuroblastoma. It focuses on removing as much of the primary tumour (the tumour that appeared first) as safely as possible. In most cases, surgery takes place after induction chemotherapy, when the tumour has already reduced in size, making it safer and easier to remove. 

What surgery aims to achieve 

The goal of surgery is to remove the tumour while protecting nearby organs, nerves and blood vessels. Surgeons aim to take out as much of the tumour as possible, along with a small margin of surrounding healthy tissue when it is safe to do so. 

Because neuroblastoma tumours often grow close to major blood vessels or vital structures, the surgical team will carefully plan the operation using scans and information gathered throughout treatment. 

Before surgery 

Before surgery takes place, your child will usually have: 

• Updated scans (e.g., MRI or CT) to see precisely where the tumour is
  
• A review of their response to induction chemotherapy if they have already received this 
• A full assessment by the surgical and anaesthetic teams 
• An explanation of what to expect before, during and after the procedure 

During surgery 

During the operation, the surgeon will carefully remove the tumour and assess the surrounding area. Some healthy tissue may also be removed to ensure no active tumour cells remain. The aim is always to minimise disruption to surrounding structures. 

What happens to the tumour after it’s removed 

Once the tumour is removed this is sent to the laboratory for detailed testing. These tests help the clinical team understand: 

• The tumour’s genetic features 
• How much of the tumour was active or inactive 
• How well the tumour responded to chemotherapy 

This information helps shape the next steps of treatment. 

Recovery after surgery 

Recovery times vary depending on the complexity of the operation, your child’s overall health, and how well they responded to chemotherapy. Your child may need: 

• Pain relief - where appropriate this may include an epidural
  
• Support with feeding 
• Time to regain mobility 
• Close monitoring for infection or complications 

Your clinical team will explain what to expect during recovery, including when your child may go home and what follow‑up appointments will look like.

Side effects

Surgery can cause short‑term and long‑term side effects, which vary from child to child. 

Read more about the side effects of surgery. 

If you have any concerns, your child’s clinical team will explain what to expect and how side effects can be managed. 

Animated video on surgery during treatment for high-risk neuroblastoma 

This video was produced as part of the SIOPEN High-Risk Neuroblastoma 2 Trial.