Usually, after induction chemotherapy, surgery will be performed to remove as much of the primary tumour as possible. 

At this point, the hope is that the tumour will have reduced in size since diagnosis so that the surgery will be as successful as it can be. 

The surgeon will remove the tumour along with a margin of healthy cells while trying to cause little disruption to surrounding structures and organs. 

The tumour that has been removed is then sent for further testing in the laboratory. This can provide a clearer picture of the genetic makeup of that tumour as well as identifying how much or how little of the tumour remains active tissue. 

Following surgery, a child with high-risk neuroblastoma will have high-dose chemotherapy to clear any remaining cancer cells. Read more about high-dose chemotherapy.