Diagnosis and management of neuroblastoma in children

Neuroblastoma constitutes the most common extracranial solid tumor encountered in children under 5 years of age. The clinical course is highly variable, ranging from spontaneous tumor regression in very young infants to a highly aggressive disease in older children. 5-year survival of > 90% in low and intermediate-risk disease compares to < 60% in those with high-risk neuroblastoma despite recent genetic and clinical advances. Treatment strategies vary significantly in intensity depending on the aggressiveness of disease with surgery playing a pivotal role in the management. A solid understanding of different risk groups, individualized management, and outcomes is important for pediatric surgeons to achieve best outcomes, and provide highest quality advice at the multidisciplinary tumor board meeting. This article offers a narrative update on the diagnosis and management of neuroblastoma in childhood and highlights some of the key controversies in the surgical management of the disease.