Long-Term Follow-Up of Surgical Outcomes for Patients With Wilms Tumor and Neuroblastoma
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- 14% of Wilms tumor and neuroblastoma survivors required repeat laparotomy, most commonly for small bowel obstruction or tumor recurrence.
- Timing of obstruction differs: Wilms tumor patients typically within first year, neuroblastoma often >10 years post-op.
- Scoliosis occurs in 10-13% of survivors, higher than general population, due to surgery and possibly radiation exposure.
- Hypertension after nephrectomy was not increased compared to population norms in this 27-year follow-up cohort.
- Long-term surveillance is essential: surgical complications can emerge decades after initial oncologic resection.
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You just surgically treated your patient with Wilms tumor or neuroblastoma. Now what? Hi, I'm Doctor Sophia Skerhorn from Cincinnati Children's, and this study examines long-term surgical outcomes in survivors of Wilms tumor and neuroblastoma. This single institution cohort followed survivors for a mean of 27 years, offering rare insight into late surgical sequelae after open oncologic resection. 14% of patients. Required a repeat laparotomy, most commonly for small bowel obstruction or tumor recurrence. In Wilm's tumor, obstruction typically occurred within the first year. However, neuroblastoma, it often developed more than a decade later, well beyond routine follow-up. Radiation dose was not associated with this re-operation risk. Additionally, secondary malignancy was uncommon in this cohort, and hypertension after nephrectomy was. Not increased compared to the population norms. Finally, scoliosis occurred in roughly 10 to 13% of patients, higher than the general population, with multi-factorial contributors including surgery and possibly radiation. The takeaway is that surgical care does not end at resection. Even decades after treatment, these patients remain at risk for late complications that warrant long-term counseling and follow-up.