Predictive factor for intraoperative tumor rupture of Wilms tumor

Hiroaki Fukuzawa, Yuko Shiima, Yasuhiko Mishima, Sachi Sekine, Shizu Miura, Kiyoaki Yabe, Satoshi Yamaki, Keiichi Morita, Yuichi Okata, Chieko Hisamatsu, Makoto Nakao, Akiko Yokoi, Kosaku Maeda, Yoshiyuki Kosaka

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


Purpose: For Wilms tumor, intraoperative tumor rupture with wide tumor spillage during surgical manipulation raises the classification to stage 3. Then, postoperative chemotherapy must be more intensive, and abdominal radiotherapy is added. Therefore, intraoperative tumor rupture should be avoided if possible. However, predictive factors for intraoperative tumor rupture have not been sufficiently described. Here we examined the risk factors for intraoperative tumor rupture. Methods: Patients with Wilms tumor who underwent treatment according to the National Wilms Tumor Study or the Japanese Wilms Tumor Study protocol at our institution were reviewed retrospectively. Collected cases were categorized into two groups: the ruptured group and the non-ruptured group. Risk factors for intraoperative tumor rupture, including the ratio of the tumor area to the abdominal area in a preoperative single horizontal computed tomography slice (T/A ratio), were investigated in both groups. Results: The two groups were not different in age, body weight, tumor laterality, sex, or histological distribution. The T/A ratio in the ruptured group was significantly higher than that in the non-ruptured group. Receiver operating characteristic curve analysis identified a discriminative value for a T/A ratio >0.5. Conclusion: The T/A ratio can be a predictive factor for intraoperative tumor rupture of Wilms tumor.

Original languageEnglish
Pages (from-to)91-95
Number of pages5
JournalPediatric Surgery International
Issue number1
Publication statusPublished - 2017 Jan 1
Externally publishedYes


  • Nephroblastoma
  • Risk factor
  • Rupture
  • Wilms tumor

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery


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