Impact of pelvic CT on staging, surveillance, and survival of pediatric patients with wilms tumor and hepatoblastoma

J. Herman Kan, Misun Hwang, Stefanie R. Lowas, Marta Hernanz-Schulman

Research output: Contribution to journalArticle

Abstract

OBJECTIVE. Abdominopelvic CT is often performed in children with Wilms tumor or hepatoblastoma. However, the reported incidence of recurrent disease involving the pelvis is low. This study explores the impact of abdominopelvic CT on children with Wilms tumor or hepatoblastoma. MATERIALS AND METHODS. A text word database search of our radiology information system for the terms "Wilms" and "hepatoblastoma" was performed for the time interval between 1999 and 2009. The study inclusion criterion was performance of abdominopelvic CT. Tumor stage and metastases at presentation, follow-up, and impact on patient care were extracted from the medical records. RESULTS. There were 224 diagnostic and surveillance abdominopelvic CT studies (mean per patient, 6.8; range, 2-20). Among Wilms tumor (n = 17) and hepatoblastoma (n = 16) patients, at presentation 11 (33%) had pelvic extension of the tumor and three (9%) had pulmonary metastases. On follow-up, three (9%) additional patients developed metastatic disease or local recurrence; however, no patient was found to have pelvic metastases or recurrence. One patient with metastatic disease at presentation died. CONCLUSION. In our study population, abdominopelvic CT did not detect pelvic metastases to affect subsequent treatment. Given the low rate of pelvic involvement at relapse in children with Wilms tumor and hepatoblastoma, frequent abdominopelvic CT may not be necessary. Replacing these examinations with abdomen-only CT should be considered to decrease radiation burden to this population.

Original languageEnglish (US)
JournalAmerican Journal of Roentgenology
Volume196
Issue number5
DOIs
StatePublished - May 2011
Externally publishedYes

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Hepatoblastoma
Wilms Tumor
Pediatrics
Survival
Neoplasm Metastasis
Recurrence
Radiology Information Systems
Pelvis
Abdomen
Population
Medical Records
Neoplasms
Patient Care
Databases
Radiation
Lung
Incidence

Keywords

  • CT
  • Hepatoblastoma
  • Pediatric imaging
  • Wilms tumor

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Impact of pelvic CT on staging, surveillance, and survival of pediatric patients with wilms tumor and hepatoblastoma. / Kan, J. Herman; Hwang, Misun; Lowas, Stefanie R.; Hernanz-Schulman, Marta.

In: American Journal of Roentgenology, Vol. 196, No. 5, 05.2011.

Research output: Contribution to journalArticle

Kan, J. Herman ; Hwang, Misun ; Lowas, Stefanie R. ; Hernanz-Schulman, Marta. / Impact of pelvic CT on staging, surveillance, and survival of pediatric patients with wilms tumor and hepatoblastoma. In: American Journal of Roentgenology. 2011 ; Vol. 196, No. 5.
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abstract = "OBJECTIVE. Abdominopelvic CT is often performed in children with Wilms tumor or hepatoblastoma. However, the reported incidence of recurrent disease involving the pelvis is low. This study explores the impact of abdominopelvic CT on children with Wilms tumor or hepatoblastoma. MATERIALS AND METHODS. A text word database search of our radiology information system for the terms {"}Wilms{"} and {"}hepatoblastoma{"} was performed for the time interval between 1999 and 2009. The study inclusion criterion was performance of abdominopelvic CT. Tumor stage and metastases at presentation, follow-up, and impact on patient care were extracted from the medical records. RESULTS. There were 224 diagnostic and surveillance abdominopelvic CT studies (mean per patient, 6.8; range, 2-20). Among Wilms tumor (n = 17) and hepatoblastoma (n = 16) patients, at presentation 11 (33{\%}) had pelvic extension of the tumor and three (9{\%}) had pulmonary metastases. On follow-up, three (9{\%}) additional patients developed metastatic disease or local recurrence; however, no patient was found to have pelvic metastases or recurrence. One patient with metastatic disease at presentation died. CONCLUSION. In our study population, abdominopelvic CT did not detect pelvic metastases to affect subsequent treatment. Given the low rate of pelvic involvement at relapse in children with Wilms tumor and hepatoblastoma, frequent abdominopelvic CT may not be necessary. Replacing these examinations with abdomen-only CT should be considered to decrease radiation burden to this population.",
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N2 - OBJECTIVE. Abdominopelvic CT is often performed in children with Wilms tumor or hepatoblastoma. However, the reported incidence of recurrent disease involving the pelvis is low. This study explores the impact of abdominopelvic CT on children with Wilms tumor or hepatoblastoma. MATERIALS AND METHODS. A text word database search of our radiology information system for the terms "Wilms" and "hepatoblastoma" was performed for the time interval between 1999 and 2009. The study inclusion criterion was performance of abdominopelvic CT. Tumor stage and metastases at presentation, follow-up, and impact on patient care were extracted from the medical records. RESULTS. There were 224 diagnostic and surveillance abdominopelvic CT studies (mean per patient, 6.8; range, 2-20). Among Wilms tumor (n = 17) and hepatoblastoma (n = 16) patients, at presentation 11 (33%) had pelvic extension of the tumor and three (9%) had pulmonary metastases. On follow-up, three (9%) additional patients developed metastatic disease or local recurrence; however, no patient was found to have pelvic metastases or recurrence. One patient with metastatic disease at presentation died. CONCLUSION. In our study population, abdominopelvic CT did not detect pelvic metastases to affect subsequent treatment. Given the low rate of pelvic involvement at relapse in children with Wilms tumor and hepatoblastoma, frequent abdominopelvic CT may not be necessary. Replacing these examinations with abdomen-only CT should be considered to decrease radiation burden to this population.

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