Advanced pediatric solid tumors

Surgery plays a key role in the therapy of most advanced pediatric extracerebral solid tumors. Especially resection of metastasized or relapsed tumors can be a special challenge since most of these tumors have been heavily pretreated with chemotherapy and/or irradiation. Surgery of advanced pediatric tumors has been relevantly improved over recent years resulting in superior resection rates and thus contributing to an improved survival of the patients. This article highlights three examples for innovations of pediatric oncological surgery: CT-based three-dimensional imaging and virtual resection planning of complex hepatic tumors, pre- or intraoperative labeling of lung metastases which are otherwise difficult to detect, and longitudinal partial nephrectomy for central bilateral nephroblastoma involving the renal hilus.