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Wilms tumor presenting with abdominal pain: a special subgroup of patients.

Abstract：

BACKGROUND:Although significant progress has been made in the management of children with Wilms tumor, two major controversies still exist: the extent of radiographic evaluation necessary before surgery and the role of preoperative chemotherapy. This study sought to determine whether patients with Wilms tumor who presented with abdominal pain defined a special subset of patients who might require a more extensive preoperative work-up and neoadjuvant chemotherapy. METHODS:From 1970 to 1995, 250 children were treated for Wilms tumor at a single pediatric institution. A retrospective chart review determined presenting signs and symptoms for each patient. RESULTS:Thirty-four (14%) patients (mean age 5.5 years) sought medical attention with a chief complaint of abdominal pain. The stage distribution for these patients tended to be higher and was significantly different (P <.001, chi(2)-analysis) from those presenting without pain. Four (14%) of 29 patients with tumor available for analysis were found to have anaplastic histology. CONCLUSION:These data suggest that patients with Wilms tumor who present with abdominal pain represent a special subgroup that tends to be older and has an increased incidence of tumor rupture, anaplasia, and higher stage. These patients may benefit from a more extensive preoperative evaluation and consideration of neoadjuvant chemotherapy.

journal_name

Ann Surg Oncol

journal_title

Annals of surgical oncology

authors

Davidoff AM,Soutter AD,Shochat SJ

doi

10.1007/BF02303774

subject

Has Abstract

pub_date

1998-04-01 00:00:00

pages

213-5

issue

3

eissn

1068-9265

issn

1534-4681

journal_volume

5

pub_type

杂志文章

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