ArticlePediatric blood & cancer2016
Surgical protocol violations in children with renal tumors provides an opportunity to improve pediatric cancer care: a report from the Children's Oncology Group.
Article in Pediatric blood & cancer, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed.
- Treatment of Stage IV Favorable Histology Wilms Tumor With Lung Metastases: A Report From the Children's Oncology Group AREN0533 Study.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2018Trial
- Impact of Pulmonary Tumor Burden in Favorable Histology Wilms Tumor Outcomes: A Report From the Children's Oncology Group Study AREN0533.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025Article
- Updated favourable-histology Wilms tumour risk stratification: rationale for future Children's Oncology Group clinical trials.Nature reviews. Urology · 2025Review
- Essential Knowledge and Skills for the Practice of Pediatric Surgical Oncology: A Modified Delphi Consensus Study by the APSA Cancer Committee.Annals of surgical oncology · 2025Article
- "Complication without context? Rethinking outcome attribution in pediatric oncologic surgery".Pediatric surgery international · 2025Article
- Surgical practices and oncological outcomes of Wilms tumor in a resource limited setting: a risk-adapted approach.Pediatric surgery international · 2025Article
- Meta-analyses: how can we ensure that the hole is not greater than the sum of the parts?Pediatric nephrology (Berlin, Germany) · 2023Article
- Extended Lymph Node Sampling During Surgery for Pediatric Renal Tumors Concerning for Malignancy Does Not Increase Postoperative Complication Rates.The Journal of urology · 2023Article
- Advances in the treatment of pediatric solid tumors: A 50-year perspective.Journal of surgical oncology · 2022Article
- Augmentation of Therapy for Combined Loss of Heterozygosity 1p and 16q in Favorable Histology Wilms Tumor: A Children's Oncology Group AREN0532 and AREN0533 Study Report.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2019Article
- Update on Wilms tumor.Journal of pediatric surgery · 2019Review
- Reply to: Synoptic operative reports for quality improvement in pediatric cancer care: Surgical protocol violations in children with renal tumors provides an opportunity to improve pediatric cancer care: A report from the Children's Oncology Group.Pediatric blood & cancer · 2018Article
- Imaging of renal medullary carcinoma in children and young adults: a report from the Children's Oncology Group.Pediatric radiology · 2017Article
- Reliability of intraoperative frozen section for the diagnosis of renal tumors suspicious for malignancy in children and adolescents.Pediatric blood & cancer · 2017Article
- A 10-Year Study of the Outcome of Wilms' Tumor in Central India and Identifying Practice Gaps.Journal of Indian Association of Pediatric SurgeonsArticle
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Abstract
backgroundThe purpose of this study was to evaluate the frequency and characteristics of surgical protocol violations (SPVs) among children undergoing surgery for renal tumors who were enrolled on the Children's Oncology Group (COG) renal tumor biology and classification study AREN03B2.
methodsAREN03B2 was opened in February 2006, and as on March 31, 2013, there were 3,664 eligible patients. The surgical review forms for 3,536 patients with unilateral disease were centrally reviewed for SPVs. The frequency, type, number of violations, institutional prevalence, and quartiles for SPVs were assessed.
resultsOf the 3,536 patients, there were a total of 505 with at least one SPV (564 total SPVs reported), for an overall incidence of 14.28%. The types of SPVs included a lack of lymph node sampling in 365 (64.7%), avoidable spill in 61 (10.8%), biopsy immediately before nephrectomy in 89 (15.8%), an incorrect abdominal incision in 32 (5.7%), and unnecessary resection of organs in 17 (3.0%). The SPVs occurred in 163 of 215 participating institutions (75.8%). For centers with at least one SPV, the mean number of SPVs reported was 3.10 ± 2.39 (mean ± standard deviation). The incidence of protocol violation per institution ranged from 0 to 67%. Centers with an average of ≤1 case/year had an incidence of SPVs of 12.2 ± 3.8%, those with an average of >1 to <4 cases/year had an incidence of SPVs of 16.4 ± 3.6%, and those with an average of ≥4 cases/year had an incidence of SPVs of 12.6 ± 5.5% (P > 0.05).
conclusionsSPVs that potentially result in additional exposure to chemotherapy and radiation therapy are not uncommon in children undergoing resection of renal malignancies.
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