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Tumor-Specific Critical Intraoperative Findings Influence Multidisciplinary Therapy.

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Accurate intraoperative documentation for pediatric solid tumors is crucial for treatment decisions. Consensus was reached on key elements, highlighting the need for tumor-specific surgical reporting guidelines to improve care.

Keywords:
narrative operative reportpediatric surgical oncologysynoptic operative report

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Area of Science:

  • Pediatric Oncology
  • Surgical Oncology
  • Cancer Reporting

Background:

  • Local control in pediatric oncology requires disease-specific strategies.
  • Intraoperative event documentation is vital for treatment decisions but varies significantly by tumor type.
  • Accurate surgical reporting for pediatric solid tumors remains a challenge.

Purpose of the Study:

  • To achieve consensus on critical intraoperative oncologic observations for pediatric solid tumors.
  • To enhance surgical reporting standards in pediatric oncology.
  • To optimize subsequent treatment strategies through improved documentation.

Main Methods:

  • A Delphi consensus process involving 16 international childhood cancer specialists.
  • Literature review and multiple voting rounds to identify essential documentation elements.
  • Achieved consensus on 15 key statements regarding intraoperative oncologic observations.

Main Results:

  • Consensus reached on essential documentation including resection completeness, locoregional spread, and vascular involvement.
  • Identified tumor-specific variations in documentation needs (e.g., neuroblastoma resection percentage, sarcoma biopsy tract).
  • Noted deficiencies in current operative reports, such as omissions of tumor spillage and lymph node sampling.

Conclusions:

  • Precise intraoperative documentation is critical for multidisciplinary pediatric solid tumor care.
  • Tailored documentation guidelines are necessary due to tumor-type variability.
  • A hybrid reporting model combining universal and tumor-specific elements may improve consistency and communication.