Wilm’s tumor is one of the most common pediatric abdominal cancers. With the advent of multi-modal therapy there is an excellent survival rate. Therapy generally involves a combination of surgery chemotherapy and sometimes radiation. The children’s oncology group (COG) has developed clear criteria for an adequate resection of a Wilm’s tumor.
It is known that about 15 percent of patients in the COG had a surgical protocol violation, the majority of these violations were due to the lack of lymph node sampling. This is a significant risk because if the lymph nodes are not sampled and are positive, the child would be undertreated for the stage of their disease and risk tumor recurrence.
Cincinnati Children’s cancer committee has been auditing the procedures performed at Cincinnati Children’s to ensure quality surgical procedures and adherence to the protocol. Operative and pathologic data were examined for all patients undergoing Wilm’s tumor resection over the past 10 years. It was noted that in all cases proper surgical protocols were followed and lymph nodes were sampled. It is imperative to do intermittent assessment of surgical quality to ensure that patients are receiving the best care possible.