CT Image Parameters for Predicting Surgical Risk and Outcome in Wilms Tumor.

Objective: This study determined preoperative image parameters for predicting surgical risk and outcome in Wilms tumor (WT).

Methods: A total of 55 patients with WT were enrolled and classified into surgically low-risk (SLR) and surgically high-risk (SHR) groups. The relationship between imaging findings and surgical risk factors was analyzed, and a survival analysis was performed.

Results: The number of patients in the SLR and SHR groups was 35 and 20, respectively. The abdominal aorta encasement, adrenal involvement, and tumor spillage of the computed tomography (CT) image parameters showed a statistically significant difference between the two groups (-value = 0.021, 0.02, and < 0.01, respectively). Multivariable Cox regression analysis demonstrated that those three CT parameters significantly increased surgical risks (OR = 10.11 -value = 0.043, OR = 7.61 -value = 0.031, and OR = 55.57 -value = < 0.001, respectively). The one-, two-, and five-year disease-free survival (DFS) rates were 83%, 78.2%, and 72.6%, respectively. The radiological parameters associated with poor survival were adrenal involvement and tumor spillage.

Conclusion: The abdominal aorta encasement, adrenal involvement, and tumor spillage in the preoperative CT image were strong evidence for predicting surgical risk and outcome in WT. These parameters could be beneficial for the surgeon in preoperative preparation and during the procedure.