What Is Pediatric Surgical Oncology?
Pediatric surgical oncology is a specialty focused on the surgical treatment and management of tumors and other types of cancer in children. These doctors may be called pediatric surgical oncologists or cancer surgeons. They treat children from infancy to adolescence and young adulthood.
Our pediatric cancer surgeons have trained at the nation’s top children’s cancer centers. They are among the country’s most experienced surgeons in performing complicated cytoreductive surgeries and resections on the smallest patients.
What conditions do you treat?
We are experts in the treatment of:
- Germ cell tumors – Rare cancers of the reproductive cells that develop into testicles or ovaries.
- Kidney tumors – Include a variety of tumor types, the most common of which are Wilms tumors.
- Liver tumors – Masses caused by the overgrowth of liver cells at an abnormally fast rate.
- Mediastinal and chest wall tumors – Tumors of the torso, which can be the primary site or the secondary site of cancer that has spread.
- Neuroblastomas – The most common tumor in children under age 1 and the most common solid tumor outside of the brain in children. Neuroblastomas are found mainly in the adrenal gland (above the kidney) and sometimes in the chest, neck, or pelvis.
- Pulmonary and lung metastases – Cancer that has spread from its source to the breathing organs.
- Rare tumors — Our surgeons have expertise in treating rare pediatric cancers, including adrenocortical carcinoma and rhabdoid tumor, two rare cancers that may require complex surgery.
- Soft-tissue sarcomas – Cancers found in the muscles, tendons, ligaments, fat, blood vessels, or nerves, mainly in the abdomen, pelvis, chest, arms, or legs.
What Pediatric Surgical Oncology Procedures Do You Offer?
Our pediatric surgical oncologists perform resections for all types of pediatric cancer. They have specialized expertise in these key procedures:
Neuroblastoma resection
Neuroblastoma resection is a surgery to remove as much of the neuroblastoma tumor as possible. Neuroblastomas are solid tumors made up of immature nerve cells left over from fetal development in infants and small children.
The surgical treatment of neuroblastoma can be incredibly complicated, sometimes with long periods between diagnosis and surgery. Depending on the stage of cancer, location of tumors, and other factors, treatment may also include chemotherapy before or after surgery, as well as other therapies.
Liver tumor resection
Surgical resection or removal is the standard procedure for treating a liver tumor. Chemotherapy may be combined with surgery to shrink the size of the tumor before removal.
In cases where liver tumors have grown too large or are too likely to regrow, the liver may be removed and replaced with a healthy liver. The new liver may come from a deceased donor or be part of a liver from a healthy living donor, which will regrow due to the liver’s remarkable abilities. Learn about our Pediatric Liver Transplant Program.
Intraoperative molecular imaging for cancer margins
Intraoperative molecular imaging (IMI) is a surgical technique that helps doctors visualize cancer cells during a procedure.
Special medications, called tracers, light up under specific imaging technology to help surgeons better see and remove cancerous tissues. This technique is especially helpful during minimally invasive surgeries where surgeons cannot feel tumors or organs with their own hands, and for trickier cancer surgeries where cancer cells may be hidden or microscopic.
Marcus Malek, MD, director of Pediatric Surgical Oncology at UPMC Children's, is a world leader in IMI research. Learn about the Malek Lab.
Partial nephrectomy
This surgery removes part of a kidney that contains a small- to medium-sized cancerous tumor.
Larger tumors of the kidney may require a radical nephrectomy (neff-RECK-toe-mee), which removes the entire kidney. However, a partial nephrectomy keeps the healthy part of the affected kidney to preserve kidney function.
This surgery can be performed traditionally through open incisions using laparoscopic techniques. Expertise in this procedure is important. It can be a challenge to balance the removal of the tumor while maintaining a healthy kidney and avoiding complications.
Pulmonary lung metastatic tumor resection and lung nodule removal
Open surgery is often the traditional approach for resecting or removing pulmonary nodules because the surgeon can touch the tumors to understand more about them. However, recent advances in video-assisted thoracoscopic surgery (VATS) now offer a minimally invasive tumor resection option for some children with metastatic disease.
Our surgeons have expertise in both open and VATS for pulmonary nodules and tumors.
Sentinel lymph node biopsy
Sentinel lymph node biopsy is when a dye or radioactive tracer is injected near the cancer to identify which sentinel lymph nodes the cancer cells drain into first. These nodes may then be removed surgically to be tested for cancer cells.
If cancer is found, metastasis (cancer spread) is indicated, and further lymph node removal may be necessary. If no cancer is found, further lymph node removal may not be needed.
Cytoreductive surgery for DSRCT
Cytoreductive surgery (CRS) is a cancer treatment to reduce the number and size of tumors and cancer cells in the abdomen. It treats certain diseases, including desmoplastic small round cell tumors (DSRCT), a rare soft tissue cancer.
CRS is usually paired with other treatments, such as standard chemotherapy or hyperthermic intraperitoneal chemotherapy (HIPEC), a type of heated chemotherapy applied directly inside the belly. For children with DSRCT, cytoreductive surgery helps remove as much of the cancer as possible before or after other therapies.
HIPEC
Heated intraperitoneal chemotherapy (HIPEC) treats advanced tumors of the abdomen and supportive tissues of the abdominal cavity.
Sometimes, cancer can spread along the peritoneum — the inner lining of the abdomen. This type of cancer is called peritoneal metastasis. It is hard to treat because classic chemotherapy given through the veins often is ineffective against it.
Hyperthermic intraperitoneal chemotherapy (HIPEC) is a special kind of heated chemotherapy treatment for peritoneal metastases and other abdominal cancers. UPMC Children's is one of only a handful of U.S. pediatric medical centers offering HIPEC for treating late-stage abdominal tumors in children, teens, and young adults.
Do I Need a Referral to Pediatric Surgical Oncology?
You may be referred to UPMC Children’s for pediatric surgical oncology treatment from your child’s pediatrician or primary health care provider. You may also be referred to our pediatric surgical oncologists from the pediatric cancer program doctors at UPMC Children’s.
Why Choose UPMC Children’s for Pediatric Surgical Oncology Care?
At UPMC Children’s, every child who needs cancer surgery receives an individualized treatment plan and family-centered care.
- Surgeons at UPMC Children’s have trained at the nation’s leading pediatric surgery treatment centers. They are among the country’s most experienced in performing pediatric cancer surgeries.
- In addition, surgeons at UPMC Children’s are pioneering the use of Intraoperative Molecular Imaging to help guide the most complete and safest resection of tumors as possible.
