Pediatric Surgical Oncology Program

Lurie Children’s Pediatric Surgical Oncology Program offers comprehensive multidisciplinary care for children and adolescents diagnosed with solid organ tumors, including sarcomas, kidney tumors, liver tumors, neuroblastoma, gonadal (ovarian and testicular) tumors and thyroid tumors, among other rare conditions.

Members of the team are board-certified pediatric specialists who work in close collaboration with each other, along with patients and with their families, to develop an optimal treatment plan for each child. The team includes the only pediatric surgeon in Chicago whose practice is focused on the surgical care of children with cancer. 

Lurie Children’s Pediatric Surgical Oncology Program patients have access to the latest and most cutting-edge treatment protocols through our team’s participation in the Children’s Oncology Group, a national consortium of oncologists, surgeons and other specialists exploring innovative treatments for kids with cancer, including access to clinical trials.  

Our team combines nationally renowned expertise and a multidisciplinary, patient-centered approach to offer each patient the best experience, and the best possible outcome. 


Conditions We Treat

Wilms tumor is the most common kidney tumor in children, while renal cell carcinoma (RCC) is more common in adolescent patients. Other rarer tumors of the kidney including malignant rhabdoid tumor, clear cell sarcoma of the kidney (CCSK) and renal medullary tumor. Surgical excision of the tumor is the first step for most children and adolescents with kidney tumors. In some cases, your team may advise initial treatment with chemotherapy to shrink the tumor prior to surgery.

Lurie Children’s surgeons have expertise in the surgical care of these diagnoses.  Pediatric surgical oncologist Dr. Timothy Lautz has extensive experience in the surgical care of children with Wilms tumor and other kidney masses. In addition, Dr. Lautz and urologic oncologist Dr. Edward Gong work in close collaboration for the care of older patients with renal cell carcinoma, including offering minimally invasive robotic surgical options for select patients. The surgical team also works closely with colleagues in medical oncology and radiation oncology to provide comprehensive, multi-disciplinary care.   

Neuroblastoma is the most common solid tumor in children.  It is a tumor which arises from nerve tissue in the body.  It most commonly arises from one of the adrenal glands in the upper abdomen but can also occur along the spine in the neck, chest or abdomen, or elsewhere in the body. These tumors run the spectrum from completely benign (ganglioneuroma), to more aggressive tumors. In some select cases, no therapy is needed, and the tumor can just be observed. When treatment is needed, surgery is an important part of the overall therapy. Sometimes, surgical resection is the only treatment needed, while in other cases surgery it one part of a comprehensive multi-modal treatment plan.   

Lurie Children’s Surgeons, including pediatric surgical oncologist, Dr. Timothy Lautz, work in close collaborations with colleagues from pediatric oncology to determine the optimal treatment plan for each child with neuroblastoma.   

Hepatoblastoma is the most common liver tumor in children, while hepatocellular carcinoma (HCC) also occurs in older children and teenagers. Complete surgical resection is a key component of therapy for any liver tumor. Sometimes surgery is recommended soon after diagnoses, but often the recommendation is to initially shrink the tumor with chemotherapy prior to surgery.   

The Comprehensive Hepatobiliary Surgical Program is led by world-renowned transplant and hepatobiliary surgeon Dr. Riccardo Superina. Lurie Children’s has one of the world’s largest experiences in resecting liver tumors that other surgeons might consider “unresectable.” We also have a comprehensive transplant center, offering the option for liver transplant for tumors that truly cannot be resected without removing the entire liver.

The hepatobiliary surgery team works in close collaboration with the Fluorescent-guided Surgery Program. Fluorescence visualization using indocyanine green (ICG) can help to define the tumor margins and help ensure complete tumor removal. ICG fluorescence can also help to visualize even very small metastatic nodules in the lung, helping Lurie Children’s surgeons to find and remove all areas where tumor has spread. 

The most common bone tumors in children are osteosarcoma and Ewing sarcoma. These tumors are more common in older children and teenagers. Most patients require a combination of chemotherapy and surgical resection of the tumor.  For some patients with Ewing sarcoma, radiation therapy may be used instead of, or in addition to surgery.  

Drs. Terrence Peabody and Samer Attar from orthopedic oncology provide expertise in resection of bone tumors, including options for limb salvage and preservation of limb function. They take a patient-centric approach, working with each family to determine the surgical approach optimizing both oncologic outcome and quality of life. 

Dr. Timothy Lautz from pediatric surgical oncology has extensive expertise in pulmonary metastasectomy (removal of tumor nodules which have spread to the lung). Dr Lautz is the vice-chair of an international randomized trial comparison surgical techniques for removal lung metastases in osteosarcoma (AOST2031). 

Lurie Children’s is also affiliated with the Shirley Ryan Ability Lab, the nation’s No.1 rehabilitation hospital with unmatched expertise in post-surgical rehab.

Soft tissue sarcomas are tumors arising from the muscle or connective tissue of the body. The most common soft tissue sarcoma in children is rhabdomyosarcoma. Other “non-rhabdomyosarcoma soft tissue sarcomas (NRSTS)” are more common in teenagers and young adults. These tumors are treated with a combination of chemotherapy, surgery and/or radiation.    

Because these tumors can arise anywhere in the body, surgical care is provided by physicians from multiple different specialties, all working in close collaboration.  Members of the orthopedic oncology team, including Dr. Terrence Peabody and Dr. Samer Attar, care for children with tumors arising in the extremities (arms and legs) and pelvis. The otolaryngology, head and neck surgery team, including Drs. Jeff Rastatter, Douglas Johnston and John Maddalozzo care for children with tumors arising in the head and neck region. For those with tumors involving the bladder, prostate or testicular region, the urologic oncology team, led by Dr. Edward Gong provide expert care. Finally, Dr. Timothy Lautz, and the pediatric surgical oncology team care for children with tumors arising from the chest and abdominal region, as well gynecologic organs.  They also offer procedures for selective lymph node sampling and excision of pulmonary metastases.   

Desmoplastic small round cell tumor (DSRCT) is a unique and rare form of soft tissue sarcoma which often presents with widespread dissemination throughout the abdomen in teenage patients. This tumor requires an extensive, meticulous operation to remove all sites of tumor. Lurie Children’s (and Dr. Lautz) is one of few hospitals offering this type of surgery, as well as Heated Intraperitoneal Chemotherapy (HIPEC).   

Dr. Lautz is a member of the soft tissue sarcoma committee in the Children’s Oncology Group where he is a study member for multiple ongoing and recently completed clinical trials.   

Germ cells are a type of cell that forms as a fetus develops. These cells later become sperm or eggs in the testicle of ovary. Germ cells can also develop outside of the gonads. Tumors developing from these germ cells can be benign or malignant. In addition to the testicle or ovary (“gonadal”) then can also occur in the region near the tailbone, in the back of the abdomen, or in the chest near the heart (“extra-gonadal”). While treatment varies depending on the location of the tumor, most patients require surgical excision, and those with malignant tumors require chemotherapy.   

Besides germ cell tumors, there are a number of other benign and malignant tumors that can occur in the ovary or testicle of a child. These include Sertoli-Leydig Tumors and Juvenile Granulosa Cell Tumor.   

Surgeons in the division of urology provide expert care for boys with testicular tumors, including malignant germ cell tumors such as yolk-sac tumor, seminoma and choriocarcinoma. Surgeons in the division of pediatric surgery likewise provide outstanding care for girls with ovarian tumors, as well as tumors arising from other sites in the chest, abdomen and pelvis. This includes sacrococcygeal teratomas (SCTs) – tumors arising near the tailbone. In some cases, SCTs are even diagnosed in utero (prior to birth) and surgeons from the Chicago Institute of Fetal Health provide comprehensive care before, during and after delivery.   

Lurie Children’s has comprehensive, multidisciplinary clinics dedicated to the care of Thyroid tumors and Melanoma. The pediatric surgical oncology team also treats a wide variety of more-rare tumors, including, adrenal tumors (pheochromocytoma, adrenocortical carcinoma), colon cancer, pancreatic tumors (pancreaticoblastoma, solid and cystic pseudopapillary tumors), gastric cancer and pleuropulmonary blastoma, among others. 

The Lurie Children’s Difference

Each member on our team of pediatric specialists has specialized training in treating and managing solid tumors in children. Our program also works in collaboration with the following unique programs and offerings at Lurie Children’s: 

  • While treatments for cancer and other diseases continue to improve, some of those treatments can also impact future fertility and hormone function for patients. The Fertility and Hormone Preservation and Restoration Program is dedicated to working with families to guide them in deciding if fertility preservation is appropriate, and if so, which option is best for their child or adolescent. Lurie Children’s is the only hospital in Illinois to offer this service for pediatric patients. 
  • Lurie Children’s is one of the only pediatric hospitals in the world with a comprehensive Robotic Surgery Program for pediatric general and thoracic surgery.  This expertise allows for a minimally invasive approach for resection of some tumors that would otherwise require a large incision. 
  • Lurie Children’s is among the only children’s hospitals in the U.S. with a comprehensive Fluorescence-Guided Surgery Program. This unique approach to surgery involves injecting an FDA-approved dye called indocyanine green (or ICG) through an IV into a patient’s body. Then, surgeons use special cameras to see the dye glow inside the body, helping them to be even more comprehensive and precise in operations including tumor removal.  Specifically, this approach can help the surgeon visualize and remove tumor which has spread to the lung or identify lymph nodes most likely to have tumor involvement.   
  • Flexible Options: Patients come to us from all over the country and the world for second opinions. For patients outside of the Chicago area, we are happy to arrange for initial phone consultation and remote (virtual) review of studies and results.
    In many cases, when patients come to us for a second opinion, we can create a treatment plan that allows them to receive most of their care closer to home. For instance, specialized services such as surgery for tumor resection or fertility preservation are performed at Lurie Children’s while chemotherapy is administered closer to home. 
  • Multidisciplinary Team: The Surgical Oncology Program team includes a variety of pediatric specialists from both Lurie Children’s and Northwestern Memorial Hospital. This team meets weekly to review all cases and communicates constantly to ensure that each patient’s care is timely and well-coordinated. 

Our Specialists

Dr. Timothy Lautz, is an attending physician in the Division of Pediatric Surgery and associate professor of Surgery at Northwestern Feinberg School of Medicine, is the director of pediatric surgical oncology at Lurie Children’s. In this role, he coordinates care across multiple medical and surgical specialties for each pediatric patient.

Dr. Lautz is a nationally renowned expert in the surgical treatment of pediatric solid tumors. In addition to clinical practice, he leads research in the treatment of solid tumors in kids, specifically soft tissue sarcomas and addressing tumors that have metastasized to the lung. Dr. Lautz is a member of the International Society of Pediatric Surgical Oncology, advancing research with other surgeons around the world who specialize in the surgical care of children with cancer. 

Members of the Surgical Oncology Program team are leaders in their individual specialties. The team includes: 

Pediatric Surgical Oncology 

Urologic Oncology 

Transplant and Advanced Hepatobiliary Surgery 

Orthopedic Oncology 

Radiation Oncology 

Otorhinolaryngology, Head and Neck Surgery 

What to Expect

The Pediatric Surgical Oncology Program team does everything possible to see new patients quickly – usually within one week. It is often possible for patients to see members of the team from multiple specialties on the same day, or even during the same office visit. 

When you call to make an appointment, you will speak with an advanced practice nurse who will begin the coordination of care between oncology, surgery and other services. The initial consultation appointment can be scheduled by calling 312.227.4769. The nurse practitioner will also help to arrange rapid review of any other studies or procedures already performed at another institution, such as CT scans, MRIs, biopsy results, etc. 

After your visit, members of the team from all different specialties will meet to discuss the findings about your child and to formulate a group recommendation. This recommendation is always created and implemented with close collaboration from the patient and their family. 

In addition to our medical specialists, the comprehensive program also includes social work, child life, psychology, and art and music therapy services to help make your child’s care as comfortable as possible. 

Resources

The following websites may offer helpful information or resources for families: 

Research

The Surgical Oncology Program team includes leadership in international and national research groups focused on finding better treatment options for children’s cancers. 

Dr. Timothy Lautz, the surgical director of the program, is involved with the Children’s Oncology Group where he is a member of committees related to soft tissue sarcoma and bone tumors. He is currently the vice chair of a randomized clinical trial comparing different surgical techniques for removing lung nodules in kids with osteosarcoma. He also co-leads the Pediatric Surgical Oncology Research Collaborative, a consortium of pediatric surgical oncologists from more than 40 institutions around the world working to advance the surgical care of kids with cancer. 

See Dr. Lautz’s academic publications