IS POSTMORTEM EXAMINATION USEFUL IN PEDIATRIC ONCOLOGY

Clinicians are often reluctant to request an autopsy for patients who have been extensively investigated during life, because they may belie ve that little additional information will be obtained. To examine whe ther this is the case, the autopsy records of pediatric oncology patie nts at the Adelaide Children's Hospital were reviewed. A total of 63 o ncology patients died in the hospital during the period 1982-1991, 28 of wham underwent postmortem examination. Class I findings (those that would have altered management if they had been known during life) wer e found in 7 cases (25 %). Major pathological findings that would not have altered management (class II) were found in 14.3 % of cases. The most common class I findings were fungal infections with organisms suc h as Aspergillus or Candida species. Postmortem examination also revea led treatment-related complications in five patients, and in one case the diagnosis was made only at autopsy. This study confirms that postm ortem examination can provide valuable new information even for patien ts who had been widely investigated in life and in whom the cause of d eath may appear obvious.