Healthcare perceptions on surgical management for children diagnosed with neuroblastoma in South Africa
Background: Surgical management in neuroblastoma predicts survival and determines morbidity globally but is not standardized in South Africa. We evaluated South African healthcare workers’ perceptions of surgical management of neuroblastoma. Methods: A national survey on neuroblastoma surgical pract...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-09-01
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| Series: | Pediatric Hematology Oncology Journal |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468124525000555 |
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| Summary: | Background: Surgical management in neuroblastoma predicts survival and determines morbidity globally but is not standardized in South Africa. We evaluated South African healthcare workers’ perceptions of surgical management of neuroblastoma. Methods: A national survey on neuroblastoma surgical practices were developed by Delphi method and distributed to medical and surgical healthcare workers managing children diagnosed with neuroblastoma. Results: Thirty-five surveys were completed: 17 (49 %) were medical and 18 (51 %) were surgical disciplines. The median experience was 7.5 years (range 1–22 years). Twenty (57 %) respondents managed less than 5 cases/year. Twenty-seven (77 %) dealt with mainly metastasized tumours. The majority of tumours had more than one image-defined risk factor at presentation. Sixteen (46 %) stated that their decision to perform surgery was influenced by gaining metastatic complete remission , next followed by vascular encasement (25 %).Barriers to surgery were a lack of neuroblastoma-specific surgical skills (77 %), tumour operability (50 %) and operating time (21 %). Roughly half i.e. 49 % (n = 17) of respondents were in favour of centralizing neuroblastoma surgical management. Twenty-six (74 %) reported surgical management as part of a multi-disciplinary team until patients were discharged from intensive care. The number of years of a respondent's experience influenced the degree of resection achieved in HR tumours (p = 0.021). Conclusions: Non-standardized surgical practice in neuroblastoma management exists in South Africa. Optimizing surgical resources, management and skills may improve surgical outcomes. |
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| ISSN: | 2468-1245 |