The impact of surveillance imaging on overall survival in patients with recurrent Wilms tumor: A report from the Children’s Oncology Group.

9536 Background: Surveillance imaging during and after therapy is employed to detect relapse in patients with Wilms tumor (WT). The use of more sensitive imaging modalities such as CT and MRI scans to supplement chest x-rays (CXR) and abdominal ultrasounds (US) may lead to early detection of relapse and improved survival. Concerns about the risk of cumulative exposure to radiation prompted us to assess whether the method of detection of relapse correlates with survival in patients with recurrent WT. Methods: Records were reviewed for 344 patients with recurrent unilateral WT who were enrolled on National Wilms Tumor Study-5 between 1995 and 2002. The reason for imaging (sign/symptoms versus routine surveillance), type of imaging, timing of relapse, site, maximum size and number of lesions, and interval from the last normal scan were recorded. These variables were analyzed with respect to 5-year overall survival (OS). Results: The estimated 5-yr OS from recurrence for all patients was 57%. 70% of relapses ...