Tumor-Specific Critical Intraoperative Findings Influence Multidisciplinary Therapy

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.