National reevaluation of staging in Wilms tumor

In order to evaluate if incorrect staging of Wilms tumor resulted in inadequate treatment a retrospective reevaluation was performed. During 1982-1990 153 patients were treated in Sweden. The review revealed that 6 cases were not Wilms tumor and 25 cases had incomplete information. The remaining material consisted of 122 cases. The survey of the charges revealed that the initial distribution was stage I 58, stage II 17, 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 the stage were thick needle puncture preoperatively in 4, capsule histologically not intact 4, tumor not radically excised 2, tumor rupture peroperatively 1 and lymph node malignancy 1. The staging procedure cannot be safely performed by a single doctor. It is dependent on cooperation in a pediatric oncologic team including the pediatric surgeon.