TY - JOUR
T1 - Robotic Surgery in Pediatric Oncology
T2 - Lessons Learned from the First 100 Tumors—A Nationwide Experience
AU - Blanc, Thomas
AU - Meignan, Pierre
AU - Vinit, Nicolas
AU - Ballouhey, Quentin
AU - Pio, Luca
AU - Capito, Carmen
AU - Harte, Caroline
AU - Vatta, Fabrizio
AU - Galmiche-Rolland, Louise
AU - Minard, Véronique
AU - Orbach, Daniel
AU - Berteloot, Laureline
AU - Muller, Cécile
AU - Kohaut, Jules
AU - Broch, Aline
AU - Braik, Karim
AU - Binet, Aurélien
AU - Heloury, Yves
AU - Fourcade, Laurent
AU - Lardy, Hubert
AU - Sarnacki, Sabine
N1 - Publisher Copyright:
© 2021, Society of Surgical Oncology.
PY - 2022/2/1
Y1 - 2022/2/1
N2 - Background: While robotics has become commonplace in adult oncology, it remains rare in pediatric oncology due to the rarity of childhood cancers. We present the results of a large nationwide experience with robotic oncology, with the aim of providing practical and feasible guidelines for child selection. Methods: This was a prospective analysis performed over a period of 4 years. Treatment was delivered according to the Société Internationale d’Oncologie Pédiatrique/International Society of Paediatric Oncology Europe Neuroblastoma Group (SIOP/SIOPEN) protocols. Indications were approved by a certified tumor board. Results: Overall, 100 tumors were resected during 93 procedures (abdomen, 67%; thorax, 17%; pelvis, 10%; retroperitoneum, 6%) in 89 children (56 girls). The median age at surgery was 8.2 years (range 3.6–13); 19 children (21%) harbored germinal genetic alterations predisposing to cancer. No intraoperative tumor ruptures occurred. Seven conversions (8%) to an open approach were performed. Neuroblastic tumors (n = 31) comprised the main group (18 neuroblastomas, 4 ganglioneuroblastomas, 9 ganglioneuromas) and renal tumors comprised the second largest group (n = 24, including 20 Wilms’ tumors). The remaining 45 tumors included neuroendocrine (n = 12), adrenal (n = 9), germ-cell (n = 7), pancreatic (n = 4), thymic (n = 4), inflammatory myofibroblastic (n = 4), and different rare tumors (n = 5). Overall, 51 tumors were malignant, 2 were borderline, and 47 were benign. The median hospital stay was 3 days (2–4), and five postoperative complications occurred within the first 30 days. During a median follow-up of 2.4 years, one child (Wilms’ tumor) presented with pleural recurrence. One girl with Wilms’ tumor died of central nervous system metastasis. Conclusions: Robotic surgery for pediatric tumors is a safe option in highly selected cases. Indications should be discussed by tumor boards to avoid widespread and uncontrolled application.
AB - Background: While robotics has become commonplace in adult oncology, it remains rare in pediatric oncology due to the rarity of childhood cancers. We present the results of a large nationwide experience with robotic oncology, with the aim of providing practical and feasible guidelines for child selection. Methods: This was a prospective analysis performed over a period of 4 years. Treatment was delivered according to the Société Internationale d’Oncologie Pédiatrique/International Society of Paediatric Oncology Europe Neuroblastoma Group (SIOP/SIOPEN) protocols. Indications were approved by a certified tumor board. Results: Overall, 100 tumors were resected during 93 procedures (abdomen, 67%; thorax, 17%; pelvis, 10%; retroperitoneum, 6%) in 89 children (56 girls). The median age at surgery was 8.2 years (range 3.6–13); 19 children (21%) harbored germinal genetic alterations predisposing to cancer. No intraoperative tumor ruptures occurred. Seven conversions (8%) to an open approach were performed. Neuroblastic tumors (n = 31) comprised the main group (18 neuroblastomas, 4 ganglioneuroblastomas, 9 ganglioneuromas) and renal tumors comprised the second largest group (n = 24, including 20 Wilms’ tumors). The remaining 45 tumors included neuroendocrine (n = 12), adrenal (n = 9), germ-cell (n = 7), pancreatic (n = 4), thymic (n = 4), inflammatory myofibroblastic (n = 4), and different rare tumors (n = 5). Overall, 51 tumors were malignant, 2 were borderline, and 47 were benign. The median hospital stay was 3 days (2–4), and five postoperative complications occurred within the first 30 days. During a median follow-up of 2.4 years, one child (Wilms’ tumor) presented with pleural recurrence. One girl with Wilms’ tumor died of central nervous system metastasis. Conclusions: Robotic surgery for pediatric tumors is a safe option in highly selected cases. Indications should be discussed by tumor boards to avoid widespread and uncontrolled application.
UR - http://www.scopus.com/inward/record.url?scp=85114855863&partnerID=8YFLogxK
U2 - 10.1245/s10434-021-10777-6
DO - 10.1245/s10434-021-10777-6
M3 - Article
C2 - 34523002
AN - SCOPUS:85114855863
SN - 1068-9265
VL - 29
SP - 1315
EP - 1326
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 2
ER -