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Pediatric Surgery International
Published in: Pediatric Surgery International 1/2018

01-01-2018 | Original Article

Image-based surgical risk factors for Wilms tumor

Authors: Takaharu Oue, Akihiro Yoneda, Noriaki Usui, Takashi Sasaki, Masahiro Zenitani, Natsumi Tanaka, Shuichiro Uehara, Soji Ibuka, Yuichi Takama, Hiroomi Okuyama

Published in: Pediatric Surgery International | Issue 1/2018

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Abstract

Purpose

The standard treatment for Wilms tumor (WT) is primary resection. However, in cases with unresectable tumor or tumor spillage, which are considered to have high surgical risks, more intensive chemotherapy and radiotherapy are required. In the present study, we retrospectively analyzed preoperative image parameters to identify factors associated with surgical risks.

Methods

Twenty-nine patients with WT were enrolled in this study. Data on various preoperative image parameters, such as tumor size, tumor volume, displacement of great vessels, and contralateral extension of the tumor were collected, and their relationship with surgical factors, including operative time, hemorrhage, tumor spillage, and unresectability were analyzed.

Results

Patients with unresectable tumor or with tumor spillage (surgical high-risk group) more frequently demonstrated displacement of great vessels and contralateral tumor extension. Operative time and blood loss were also significantly related to tumor size, area, volume, displacement of great vessels and contralateral extension.

Conclusion

Besides tumor size, displacement of great vessels and contralateral extension were significantly associated with surgical risks. These factors are easily determined using CT images and are, therefore, useful to decide whether preoperative chemotherapy should be started instead of primary tumor resection for large localized WTs.
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Metadata
Title
Image-based surgical risk factors for Wilms tumor
Authors
Takaharu Oue
Akihiro Yoneda
Noriaki Usui
Takashi Sasaki
Masahiro Zenitani
Natsumi Tanaka
Shuichiro Uehara
Soji Ibuka
Yuichi Takama
Hiroomi Okuyama
Publication date
01-01-2018
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 1/2018
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-017-4210-4

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