Original Research
Post-treatment surveillance abdominopelvic computed tomography in children with Wilms tumour: Is it worth the risk?
Submitted: 02 February 2015 | Published: 05 August 2015
About the author(s)
Jacobus H. Otto, Department of Clinical Imaging Sciences, University of the Free State, South AfricaJacques Janse van Rensburg, Department of Clinical Imaging Sciences, University of the Free State, South Africa
David K. Stones, Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, University of the Free State, South Africa
Abstract
Objective: To critically evaluate the routine use of post-treatment abdominopelvic CT by determining the detection rate of disease recurrence and associated clinical outcomes.
Methods: Sixty-four patients in remission following initial treatment for Wilms tumour were included in this retrospective study. Variables obtained from patient records included gender, age, histological grading and tumour stage at presentation, number of abdominopelvic CT scans, site(s) of relapse, method of recurrence detection and confirmation, time to recurrence and clinical outcome.
Results: The patients received a total of 334 surveillance abdominopelvic CT scans. Nine (14%) patients developed disease recurrence during the follow-up period. In three cases, the initial detection method was abdominopelvic CT. All three of these patients subsequently died despite salvage therapy (22 months median survival). Five false-positive diagnoses of recurrence occurred, with two being made on abdominopelvic CT.
Conclusion: Routine post-treatment abdominopelvic CT showed a low detection rate of disease recurrence in children treated for Wilms tumour, while subjecting patients to a large radiation burden. The recommendation is that current practice be changed in line with the ultrasound-based Société Internationale d’Oncologie Pédiatrique (SIOP) imaging guidelines.
Keywords
Metrics
Total abstract views: 4346Total article views: 6446