Wilms'tumor : a rational use of preoperative imaging.
To determine whether a preoperative imaging protocol relying predominantly on a chest X-ray film (CXR) and ultrasound in patients with Wilms'tumor is adequate for patient management and to determine the frequency more sophisticated imaging, in particular, computed tomography (CT), is required.
Design and setting
Historical cohort study at a tertiary pediatric hospital.
Subjects - 60 consecutive patients with Wilms'tumor treated at our institution between 1980 and 1990.
Main outcome measure
The preoperative imaging was recorded and 2-and 4-year survival were compared with the National Wilms'Tumor Study.
100% of patients had a preoperative CXR, 95% abdominal ultrasound, 5% abdominal CT, 13% chest CT, 47% abdominal X-ray, 2% aortography, 5% cavography, and 35% intravenous urography.
The overall 2-and 4-year survivals of 92% and 90%, respectively, did not statistically differ from the National Wilms'Tumor Study 2-and 4-year survivals of 94% and 91%. Conclusions - A preoperative imaging protocol relying predominantly on a CXR and abdominal ultrasound does not reduce survival.
Other more sophisticated imaging, in particular, CT, is not required in the majority of cases and is warranted only when a CXR or ultrasound is unable to resolve relevant management problems.
Mots-clés Pascal : Tumeur Wilms, Préopératoire, Tomodensitométrie, Exploration ultrason, Etude cohorte, Radiographie RX, Analyse coût efficacité, Economie santé, Australie, Océanie, Enfant, Homme, Appareil urinaire pathologie, Rein pathologie, Tumeur maligne, Radiodiagnostic
Mots-clés Pascal anglais : Wilms tumor, Preoperative, Computerized axial tomography, Sonography, Cohort study, X ray radiography, Cost efficiency analysis, Health economy, Australia, Oceania, Child, Human, Urinary system disease, Renal disease, Malignant tumor, Radiodiagnosis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0269258
Code Inist : 002B14D01. Création : 01/03/1996.