Surveillance for Wilms tumour in at-risk children: pragmatic recommendations for best practice.
Arch Dis Child
; 91(12): 995-9, 2006 Dec.
Article
en En
| MEDLINE
| ID: mdl-16857697
ABSTRACT
BACKGROUND:
Most Wilms tumours occur in otherwise healthy children, but a small proportion occur in children with genetic syndromes associated with increased risks of Wilms tumour. Surveillance for Wilms tumour has become widespread, despite a lack of clarity about which children are at increased risk of these tumours and limited evidence of the efficacy of screening or guidance as to how screening should be implemented.METHODS:
The available literature was reviewed.RESULTS:
The potential risks and benefits of Wilms tumour surveillance are finely balanced and there is no clear evidence that screening reduces mortality or morbidity. Prospective evidence-based data on the efficacy of Wilms tumour screening would be difficult and costly to generate and are unlikely to become available in the foreseeable future.CONCLUSIONS:
The following pragmatic recommendations have been formulated for Wilms tumour surveillance in children at risk, based on our review (1) Surveillance should be offered to children at >5% risk of Wilms tumour. (2) Surveillance should only be offered after review by a clinical geneticist. (3) Surveillance should be carried out by renal ultrasonography every 3-4 months. (4) Surveillance should continue until 5 years of age in all conditions except Beckwith-Wiedemann syndrome, Simpson-Golabi-Behmel syndrome and some familial Wilms tumour pedigrees where it should continue until 7 years. (5) Surveillance can be undertaken at a local centre, but should be carried out by someone with experience in paediatric ultrasonography. (6) Screen-detected lesions should be managed at a specialist centre.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Tumor de Wilms
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Screening_studies
Límite:
Humans
Idioma:
En
Revista:
Arch Dis Child
Año:
2006
Tipo del documento:
Article
País de afiliación:
Reino Unido