The results of concentration of care: Surgical outcomes of neuroblastoma in the Netherlands

Alida F.W. van der Steeg*, Merel Jans, Godelieve Tytgat, Marta F. Fiocco, Cornelis van de Ven, Cecilia E.J. Terwisscha van Scheltinga, Rob Pieters, Max M. van Noesel, Anton H. van Dijk, Caroline C.C. Hulsker, Marc H.W.A. Wijnen

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

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    Introduction. In the Netherlands pediatric oncological care for solid tumours is concentrated in one centre since November 2014. One of the most frequently diagnosed solid non-brain tumours in children is the neuroblastoma. Results of surgical treatment of neuroblastoma since the start of this centralization are presented and compared to a historic cohort. Methods. The new national cohort of neuroblastoma (n = 111) consists of all consecutive patients treated between January 1st, 2015 and April 1st, 2021. The historic neuroblastoma cohort consists of all operated neuroblastoma patients in the Netherlands between 1998 and 2014 (n = 244). Intra-operative complications and surgical outcome were registered. Post-operative complications were divided in short (<30 days after surgery) and long term (>30 days). The severity of complications was graded using the Clavien Dindo Classification (CDC) system. Results. Intraoperative outcomes showed significant differences in favour of the new cohort with less blood loss (p < 0.001), fewer vascular complications (p < 0.001) and shorter duration of surgery (p < 0.001). Short term complications were comparable in numbers, but significantly more patients had CDC grade 3/4/5 complications in the historic cohort (p = 0.005). Long term complications did not differ. Estimated overall survival showed a better survival in the new cohort (log rank 0.022). Conclusion. Centralization of care for neuroblastoma patients has led to a significant improvement of both intraoperative outcomes and short term complications.

    Original languageEnglish
    Pages (from-to)505-511
    Number of pages7
    JournalEuropean Journal of Surgical Oncology
    Issue number2
    Publication statusPublished - Feb-2023


    • Complications
    • Concentration of care
    • Neuroblastoma
    • Pediatric oncology
    • Surgery


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