NATIONAL REEVALUATION OF STAGING IN WILMS-TUMOR

In order to evaluate if incorrect staging of Wilms tumor resulted in i nadequate treatment a retrospective reevaluation was performed. During 1982-1990 153 patients were treated in Sweden The review revealed tha t 6 cases were not Wilms tumor and 25 cases had incomplete information . The remaining material consisted of 122 cases. The survey of the cha rges revealed that the initial distribution was stage I 58, stage II 1 7, stage III 21, stage IV 15 and stage V 11. The stage was changed in 12 cases, mainly in the initial stage I. The causes for changing of th e stage were thick needle puncture preoperatively in 4, capsule histol ogically not intact 4, tumor not radically excised 2, tumor rupture pe roperatively 1 and lymph node malignancg 1. The staging procedure cann ot be safely performed by a single doctor. It is dependent on cooperat ion in a pediatric oncologic team including the pediatric surgeon.