Pediatric Surgical Oncology Fellowship Program

Since St. Jude opened its surgical complex in 1996, our surgeons have been an integral part of the diagnosis and treatment team, working closely with oncologists, radiation therapist, radiologists, pathologists, hematologists and basic scientists. The surgical program is a national and international referral center for patients with complex pediatric tumors requiring surgery. Faculty have special clinical expertise in:

• Neuroblastoma: We are a leader in the management of children with neuroblastoma and have developed protocols for gaining gross total resection of tumors in children with high-risk neuroblastoma with imaging-defined risk factors, including vascular encasement.
• Wilms tumor: We have performed nephron-sparing procedures in more than 80% of children who have been treated at St. Jude for bilateral Wilms tumors. We also perform surgical resection for Wilms tumor patients with vascular extension.
• Hepatic tumors: Faculty are skilled at resection of primary tumors and pulmonary metastatic disease for hepatoblastoma, hepatocellular carcinoma and other pediatric liver tumors.
• Bone tumors: Our department has been recognized nationally and internationally for its limb salvage program in the management of bone tumors.
• Soft tissue sarcomas: We see a high volume of patients with rhabdomyosarcoma and non-rhabdomyosarcoma soft tissue sarcomas.
• Minimally invasive surgery: We perform an array of thoracoscopic procedures for pulmonary metastatic and mediastinal tumors. We also perform laparoscopic, retroperitoneoscopic and single-site procedures for abdominal tumors and other abdominal pathology.
• Procedures in hematology patients: Our hematology patients routinely undergo minimally invasive total and partial splenectomies and cholecystectomies.
• Melanoma: In collaboration with the Solid Tumor Division, our department manages the treatment of children with this rare condition, establishing sentinel lymph node biopsy as the standard of care.

The Department of Surgery actively participates in St. Jude clinical protocols, as well as Children’s Oncology Group (COG) protocols. We have several open prospective clinical trials for patients undergoing pediatric cancer surgery. We are leading an active clinical trial in the use of near infrared spectroscopy with indocyanine green guidance to facilitate resection of primary tumors and to identify occult metastatic disease. We participate in a multi-institutional prospective clinical trial to evaluate enhanced recovery after surgery (ERAS) protocols in patients undergoing pediatric cancer surgery.

We have two current clinical trials investigating adeno-associated viral vectors (AAV)–medicated gene therapy for both hemophilia A and B.

Our department also conducts innovative basic and translational scientific research.