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The following is a summary of “Correlation of CT Scan Response to Necrosis and Volume Changes With Histopathology in Children With Wilms’ Tumor,” published in the February 2024 issue of Pediatrics by Nilave et al.
Wilms’ tumor stands as the predominant renal tumor affecting children, prompting a critical need for effective diagnostic and prognostic measures. In this prospective study conducted from January 2020 to December 2022, the researchers aimed to elucidate the correlation between preoperative Contrast Enhanced Computed Tomography (CECT) findings and post-operative histopathological outcomes in pediatric patients diagnosed with unilateral localized Wilms’ tumor (WT), encompassing stages I, II, and III, and managed per the SIOP UMBRELLA protocol 2016. Excluded from the analysis were cases of bilateral, syndromic, and stage IV WT. Leveraging CECT scans, the study group quantified the percentage of necrosis and tracked tumor volume changes pre and post-chemotherapy, subsequently comparing these radiological findings with histopathological data obtained post-operatively.
Among the cohort of 33 patients, 15 met the inclusion criteria, allowing for a comprehensive analysis. Their results unveiled a compelling positive correlation between radiological response, particularly the extent of necrosis identified on preoperative CECT images, and post-operative histopathological findings, as confirmed by Pearson correlation analysis. Furthermore, a significant positive correlation was also observed between tumor volume changes measured on pre and post-chemotherapy CECT scans and histological parameters, as determined by Spearman correlation analysis.
The findings underscore the pivotal role of preoperative radiological evaluation in prognosticating Wilms’ tumor outcomes, with histologically confirmed necrosis serving as a robust indicator of tumor response. These observations highlight the potential utility of CECT imaging in guiding therapeutic decisions and optimizing patient management strategies. As the investigators continue to refine their understanding of the interplay between radiological findings and histopathological outcomes in Wilms’ tumor, their study underscores the importance of comprehensive multidisciplinary approaches in pediatric oncology to ensure optimal patient care and outcomes.
Source: sciencedirect.com/science/article/abs/pii/S0022346824001088
