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Minimally invasive surgery to treat embryonal tumors of childhood

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Abstract

Minimally invasive surgery (MIS) to resect primary and metastatic pediatric embryonal tumors offers the potential for reduced postoperative morbidity with smaller wounds, less pain, fewer surgical site infections, decreased blood loss, shorter hospital stays, and less disruption to treatment regimens. However, significant controversy surrounds the question of whether a high-fidelity oncologic resection of childhood embryonal tumors with gross total resection, negative margins, and appropriate lymph node sampling can be achieved through MIS. This review outlines the diverse applications of MIS to treat definitively pediatric embryonal malignancies, including this approach to metastatic deposits. It outlines specific patient populations and presentations that may be particularly amenable to the minimally invasive approach. This work further summarizes the current evidence supporting the efficacy of MIS to accomplish a definitive, oncologic resection without compromising relapse-free or overall survival. Finally, the review offers technical considerations to consider in order to achieve a safe and complete resection.

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Acknowledgments

The authors would like to acknowledge the support of the Surgical Outcomes Center for Kids of Monroe Carrell, Jr. Children’s Hospital.

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Authors and Affiliations

  1. Department of Surgery, Washington University School of Medicine, 9901 Wohl Hospital, Campus Box 8109, St. Louis, MO, 63110, USA

    Hannah M. Phelps

  2. Department of Pediatric Surgery, Vanderbilt University Medical Center, 2200 Children’s Way Doctor’s Office Tower Suite 7102, Nashville, TN, 37232, USA

    Harold N. Lovvorn III

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Correspondence to Hannah M. Phelps.

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Portions of this manuscript (specifically “Pearls and Pitfalls” and Table 1) are adapted from work previously published in the November 2018 issue of Children [12]. Appropriate citations are provided in accordance with the journal’s open access copyright policy, which can be found at https://www.mdpi.com/authors/rights.

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Phelps, H.M., Lovvorn, H.N. Minimally invasive surgery to treat embryonal tumors of childhood. Cancer Metastasis Rev 38, 695–708 (2019). https://doi.org/10.1007/s10555-019-09830-4

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