Intra-Operative Tumor Spill and Outcome of Patients with Stage Ii, Favorable Histology Wilms Tumor. a Report from the National Wilms Tumor Study Group

Publication Type:

Journal Article


Pediatric Blood & Cancer, Volume 60, p.23-23 (2013)




2013, December 2013, Hematology, Oncology, Pediatrics, Public Health Sciences Division


{Purpose/Objective: Intra-operative tumor spill has been reported to increase the risk of local recurrence among children with Wilms tumor. Previous reports were based on institutional acceptance of review tumor stage which may differ from stage based on central review. Materials and Methods: Surgical checklists, operative notes, institutional pathology reports, central pathology review and flow sheets of 602 patients registered between August 1986 and September 1994 on National Wilms Tumor Study * 4 as randomized, followed or switched and coded as Final Stage II/favorable histology (FH) following central pathology review were reviewed by GJD, MHM or AEE. All were reviewed by DMG, who was blinded to the results of the other reviews. Relapse-free (RFS) and overall (OS) survival were estimated using the Kaplan-Meier method. Hazard ratios (HRs) were estimated using the Cox model and tested for statistical significance by the log-rank test. Results: 499 patients were found after review to have stage II/FH Wilms tumor. The eightyear RFS percentages were 85.0% (95% confidence interval (CI) * 81.1%, 88.1%) for those with no spill compared to 75.7% (65.8%, 83.2%) for those with spill. The eight-year OS percentages were 95.6% (93.1%, 97.3%) for those with no spill compared to 90.3% (82.2%, 94.9%) for those with spill. 23 relapses were observed among patients with spill compared to 16.3 expected (HR=1.55 (95%CI * 0.97,2.51)


PT: J; NR: 0; TC: 0; J9: PEDIATR BLOOD CANCER; SU: 3; PG: 1; GA: 222MP