- Use of CT scans for routine surveillance does not improve survival in patients with recurrent unilateral favorable-histology Wilms tumor vs surveillance with chest X-ray or abdominal ultrasound (CXR/US).
Why this matters
- Eliminating CT scans from surveillance will reduce radiation exposure and healthcare costs without affecting survival.
- 281 patients with recurrent unilateral favorable-histology Wilms tumor from fifth National Wilms Tumor Study.
- Funding: NIH; others.
- The recurrences were detected with signs/symptoms (25%), surveillance imaging with CT (26.5%), or CXR/US (48.5%).
- 5-year OS was similar in patients whose recurrences were detected with signs/symptoms vs surveillance imaging (59% vs 70%; P=.23).
- 5-year OS rate in patients in whom recurrences were detected by CXR/US vs CT was statistically similar (73% vs 65%; P=.20):
- patients with stages I or II favorable-histology Wilms tumor (79% vs 85%; P=.53),
- patients with initial stages III and IV disease (66% vs 52%; P=.11),
- patients with stage IV disease (64% vs 48%; P=.17), and
- patients with lung-only relapse (73% vs 73%; P=.91).
- 5-year OS rate was significantly higher in patients with recurrence at other sites detected by CXR/US vs CT (72% vs 48%; P=.02).
- Retrospective design.