[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-447361-105":59,"doc-detail-447361-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","diagnosis-and-management-of-neuroblastoma-in-children","Diagnosis and management of neuroblastoma in children","","Neuroblastoma is the most common extracranial solid tumor in children under 5, with a highly variable clinical course from spontaneous regression in very young infants to highly aggressive disease in older children. Survival is >90% in low- and intermediate-risk disease versus \u003C60% in high-risk disease despite recent genetic and clinical advances. Treatment intensity varies by aggressiveness, with surgery pivotal to management. Clear risk-group understanding, individualized care, and outcomes support pediatric surgeons at multidisciplinary tumor board meetings, while the article highlights key surgical controversies.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/diagnosis-and-management-of-neuroblastoma-in-children/447361/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/diagnosis-and-management-of-neuroblastoma-in-children/447361.png","ImageObject",300,407,{"name":92,"@type":93},"dhado","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why does neuroblastoma show such variable outcomes in children?","Question",{"text":112,"@type":113},"The disease course ranges from spontaneous tumor regression in very young infants to highly aggressive behavior in older children, making prognosis highly dependent on disease biology and risk group.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How do risk categories influence treatment intensity and survival?",{"text":117,"@type":113},"Low and intermediate-risk neuroblastoma have 5-year survival above 90%, while high-risk disease has less than 60% survival. Treatment strategies are adjusted in intensity according to aggressiveness, with surgery playing a pivotal role.",{"name":119,"@type":110,"acceptedAnswer":120},"Where do neuroblastoma tumors most commonly originate, and how does location relate to prognosis?",{"text":121,"@type":113},"Most tumors arise in the abdomen (adrenal ~47% or non-adrenal abdominal/retroperitoneal ~24%), with intrathoracic sites next (~15%). Abdominal cases are often more challenging, while cervical and thoracic tumors tend to show more favorable biology.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},447361,1791100655,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},5909893218464,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Open access Review  \nDiagnosis and management of neuroblastoma in children  \nSarah Braungart  ,1 Paul D Losty  2  \nTo cite: Braungart S, Losty PD. Diagnosis and management of neuroblastoma in children. World J Pediatr Surg 2026;9:e001127 . doi:10.1136/wjps-2025-001127  \nReceived 8 November 2025 Accepted 25 December 2025  \n© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.  \n1Department of Paediatric Surgery, Royal Hospital for Children, Glasgow, UK 2Department of Paediatric Surgery, University of Liverpool, Liverpool, UK  \nCorrespondence to  \nSarah Braungart; sarah. [braungart@doctors.org.uk](braungart@doctors.org.uk)  \nABSTRACT  \nNeuroblastoma 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 toa highly aggressive disease in older children. 5-year survival of > 90% in low and intermediate-risk disease compares to \u003C 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.  \nEPIDEMIOLOGY  \nNeuroblastoma comprises 6%–7% of all malignancies diagnosed in children younger than 14 years of age, equating to ~100 newly diagnosed patients annually in the UK. Neuroblastoma is responsible for 15% of all pediatric cancer deaths.1 Neuroblastoma usually occurs sporadically. There are no widely accepted environmental risk factors for the disease and its etiology, therefore, remains largely unknown. A recent systematic review and meta-analysis including 50 studies with around 14 000 cases of neuroblastoma attempted to synthesize risk factors in children. Maternal occupational exposure to pesticides during pregnancy, birth weight >4000 g and delivery by caesarian section were somewhat found to be associated with an increased risk, whereas prolonged breastfeeding (> 6 months) appeared beneficial.2  \nIn 1%–2% of patients, however, neuroblastoma may occur as a familial variant. Hereditary neuroblastoma is notably associated with germline mutations of the tyrosine kinase domain of anaplastic lymphoma kinase (ALK) found on the short arm of chromosome 2 (2p23) .3 A number of syndromes are also associated with an increased risk for the  \ndevelopment of neuroblastoma, including Hirschsprung disease and congenital central hypoventilation syndrome when displaying a shared PHOX2b (paired-like homeobox 2b) mutation, as well as neurofibromatosis type 1.4 5 About 85% of index cases of familial neuroblastoma will typically display mutations in ALK or PHOX2b.  \nANATOMICAL DISTRIBUTION AND PATHOLOGY  \nNeuroblastoma originates from immature neural crest-derived sympathoadrenal precursor cells. The majority of neuroblastoma tumors arise in the abdomen in the adrenal gland (~47%) or in non-adrenal abdominal or retroperitoneal sites (~24%) . Intrathoracic location is the second most common anatomical site of origin (~15%) . Much less common are neuroblastoma tumors arising in the cervical/neck region(s) or pelvis (each ~3%) . Abdominal neuroblastoma tumors will often constitute the most challenging disease form, whereas cervical and thoracic tumors are generally believed to take a more benign course and have a tendency to harbor more favorable biology.6 7  \nShimada (1984) described a histological classification system for neuro","cbCailL59LLfP2zi","https://ap.wps.com/l/cbCailL59LLfP2zi","pdf",701729,"English","# Abstract\n# Epidemiology\n# Anatomical distribution and pathology\n# Molecular biology and genetics\n# Table 1: Tumor histology, patient age, and prognostic implications","[{\"question\":\"Why does neuroblastoma show such variable outcomes in children?\",\"answer\":\"The disease course ranges from spontaneous tumor regression in very young infants to highly aggressive behavior in older children, making prognosis highly dependent on disease biology and risk group.\"},{\"question\":\"How do risk categories influence treatment intensity and survival?\",\"answer\":\"Low and intermediate-risk neuroblastoma have 5-year survival above 90%, while high-risk disease has less than 60% survival. Treatment strategies are adjusted in intensity according to aggressiveness, with surgery playing a pivotal role.\"},{\"question\":\"Where do neuroblastoma tumors most commonly originate, and how does location relate to prognosis?\",\"answer\":\"Most tumors arise in the abdomen (adrenal ~47% or non-adrenal abdominal/retroperitoneal ~24%), with intrathoracic sites next (~15%). Abdominal cases are often more challenging, while cervical and thoracic tumors tend to show more favorable biology.\"}]","Diagnosis and management of neuroblastoma in children | PDF",1790719902,23]