International patterns and disparities in functional sequelae (FUSE) follow-up after pediatric solid tumor resection: A report from the International Society of Pediatric Surgical Oncology
Year: 2025
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Pediatric cancer survivors face significant treatment-related morbidity from multimodal therapies. Although late effects of chemotherapy and radiation are well-documented, surgical sequelae regarding long-term functional outcomes remain inadequately studied. This international survey analyzed current follow-up practices and quantified variability in functional sequelae assessment after pediatric solid tumor surgical resections. METHODS: A 20-item survey was distributed through the International Society of Pediatric Surgical Oncology to pediatric surgical oncologists worldwide, assessing institutional practices regarding surgical follow-up periods, specialists involved, and organ-specific protocols. Centers were categorized by surgical volume as low (<20 resections/year), medium (20-50), or high (>50) for comparative analyses. RESULTS: A total of 121 pediatric surgical centers from 46 countries responded. Functional follow-up was conducted primarily by surgeons and oncologists in most centers (56.2%), with limited specialist involvement (20.7%). Significant deficiencies were identified in standardized protocols, particularly for fertility assessment after bladder/prostate resections (62.8% without structured follow-up) and pulmonary function testing after thoracic interventions (67.8% not routinely performed). High-volume centers demonstrated significantly better standardized follow-up practices for biliary (82.5% vs 54.3%, P = .003) and pulmonary sequelae compared with lower-volume centers. All respondents acknowledged the crucial importance of functional follow-up, with 97.5% stating improvements were needed. DISCUSSION: This exploratory survey reveals significant gaps and variability in functional follow-up practices, suggesting many survivors may not receive optimal surveillance. The identified deficiencies, particularly in standardized protocols for fertility and pulmonary assessment, highlight urgent needs for evidence-based guideline development in pediatric surgical oncology.
Source: Surgery
Authors: Luca Pio, Pablo Lobos, Simone Abib, Jonathan Karpelowsky, Sharon Cox, Israel Fernandez Pineda, Andrew M. Davidoff, Marc Wijnen, Suraj Sarvode Mothi, Paul D. Losty, Hafeez H. Abdelhafeez, Tarek Zaghloul, Murad Habib, Gloria Gonzalez, Amabelle Moreno, Shahnoor Islam, Theodoros Dionysis, Gabriela Ambriz González, Michael Nightingale, Sarah Braungart, Moritz Markel, Calogero Virgone, Omid Madadi-Sanjani, Vishesh Jain, Kristy Smith, Wojtylko Anna Garnier Hanna, Uchechukwu Ezomike, Amon Ngongola, Gidein Sandler, Hilmican Ulman, Maria Molina Mata, Fatima Majeed, Pablo Lezama-Del Valle, David Del Cerro Rodríguez, Tristan Boam, Mathurshnavi Manoharan, Timothy Rogers, Nicolas Jauquier, Derek Harrison, Natalia Ybarra, Laura Balanescu, Mario Cuesta, Rajendra Nerli, Max Pachl, Isaac Chukwu, Nicholas Cost, Huanmin Wang, Anna Wojtylko, Amos Loh, Santos Kumar Mahalik, Okechukwu Ekwunife, Julio César Moreno-Alfonso, Bruno Catoia Fonseca, Stefano Giuliani, Olivier Moulot, Oscar Giron Vallejo, Paolo Gasparella, Stefano Avanzini, Hau Le, Peter Ehrlich Isaac Chukwu, Gideon Sandler, Ahmet Çelik, Chiara Grimaldi, Alessandro Crocoli, Katherine Valeriano, Kristy Smith, Michael Jacovides, Sabine Sarnacki, Sabine Irtan Matthieu Peycelon, Jaime Shalkow, Hemal Kodikara, Daniel S. Rhee, Erin Brown, Juliana Mancera, Jinhu Wang, Huanmin Wang, Claudia Filisetti, Urgen Celtik, Jorge Cortés Sáez, Alexander Siles Hinojosa, Sophie Brancherau, Hajime Uchida, Riccardo Superina, Reto Baertschiger, Laura Balanescu, Erin Brown, Juli Mancera, Monica Bhagat, Hanna Garnier, Kagiso Batka, Lucas Krauel, Olivier Abbo, Michael Jacovides, Gabriela Gullien Burrieza, Jose Beniche, Christian Prado, Julio Moreno, Max Pachl, Mario Rui Correia, Florent Guerin, Kristin Bjornland, Nitin James Peters, Ibiyeye Taiiye, Hau D. Le, Tomoro Hishiki, Devasenathipathy Kandasamy, Santosh Kumar Mahalik, Murali Krishna Nagendla, Haidar Alathari, Antti Koivusalo, Giorgos Spyridis, Jaime Perez, Daniel S. Ree, Nicholas Cost, Murad Habib, Florin Filip, Albert Pasten, Yusran Othman, Shahnoor Islam, Alida FW. van der Steeg, Peul Farrelly, Gideon Sandler, Anna Wojtylko, Timothy Lautz, Aydin Yagmurlu, Stephanie Polites, Felix Alakaloko, Vishesh Jain, Lucas Matthyssens, Natacha Boumas, Huanmin Wang, Benjamin Mayer, Tristan Boam, Fatima Majeed
Institutions: St. Jude Children's Research Hospital, Université Paris-Saclay, Assistance Publique – Hôpitaux de Paris, Bicêtre Hospital, Hospital Italiano de Buenos Aires, Support group for adolescents and children with cancer, Universidade Federal de São Paulo, The University of Sydney, Children's Hospital at Westmead, University of Cape Town, Red Cross War Memorial Children's Hospital, Children's Health Ireland at Crumlin, Princess Máxima Center, University of Liverpool, Mahidol University, Ramathibodi Hospital, University of Rochester Medicine, Golisano Children's Hospital
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,130
OpenAlex ID: W4415930764