838 IMAGE-BASED FEASIBILITY OF RENAL SPARING SURGERY FOR LOW VOLUME UNILATERAL WILMS TUMORS
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Résumé
You have accessJournal of UrologyPediatrics: Stones/Tumors1 Apr 2012838 IMAGE-BASED FEASIBILITY OF RENAL SPARING SURGERY FOR LOW VOLUME UNILATERAL WILMS TUMORS Fernando Ferrer, Rosen Nancy, Fernandez Conrad, Katherine Herbst, Geetika Khanna, Jeffrey dome, Robert Shamberger, Michael Ritchey, and Peter Ehrlich Fernando FerrerFernando Ferrer Hartford, CT More articles by this author , Rosen NancyRosen Nancy New York, NY More articles by this author , Fernandez ConradFernandez Conrad Halifax, Canada More articles by this author , Katherine HerbstKatherine Herbst Hartford, CT More articles by this author , Geetika KhannaGeetika Khanna St Louis, MO More articles by this author , Jeffrey domeJeffrey dome Washington DC, DC More articles by this author , Robert ShambergerRobert Shamberger Boston, MA More articles by this author , Michael RitcheyMichael Ritchey Phoenix, AZ More articles by this author , and Peter EhrlichPeter Ehrlich Ann Arbor, MI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.929AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Partial nephrectomy is performed infrequently in children with unilateral Wilms tumor. Our objective was to assess the theoretical feasibility, as predicted by preoperative imaging, of performing renal sparing surgery in patients with very low risk, stage 1 disease enrolled in COG study AREN03B2. We hypothesized that this group of patients would be most amenable to a renal sparing approach because of the smaller tumor size. METHODS 60 consecutive patients enrolled on ARENO3B2 met our study inclusion criteria (age < 2 years, tumor < 550 gms and Stage I). Preoperative CT scans were reviewed simultaneously by a COG Renal Tumor Committee surgeon experienced in partial nephrectomy and, a COG Renal Tumor Committee radiologist. Parameters evaluated were: tumor dimension, tumor weight, location of tumor, vascular involvement, feasibility of partial nephrectomy and percentage of kidney spared, if partial was possible. Specific criteria determining feasibility of renal salvage included: ability to perform procedure in-situ, absence of tumor involving/directly abutting the renal hilar vessels, ability to obtain an adequate margin (> 1 cm) while preserving at least 1/3 of the renal unit. RESULTS The mean patient age was 10.6 months, 48% were females-52% males. 55% tumors were left side, 45% right. Mean tumor weight was 315gms at nephrectomy. Tumor locations are shown in the figure 1. In 32% of tumors the vasculature was engulfed by tumor preventing PN. Partial nephrectomy was deemed not feasible in 91% of cases. In 9% (5 pts) of cases, partial nephrectomy was considered theoretically feasible. 75 % or greater of the kidney could have been preserved in 1 child (a polar lesion), 50% in 4 patients (polar lesions involving the central zone). CONCLUSIONS In this cohort of very low risk patients, 9% would theoretically have been candidates for PN based on preoperative imaging. Utilizing the current COG approach of upfront surgery, a minority of very low risk unilateral Wilms tumor patients are candidates for renal sparing procedures. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e342 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Fernando Ferrer Hartford, CT More articles by this author Rosen Nancy New York, NY More articles by this author Fernandez Conrad Halifax, Canada More articles by this author Katherine Herbst Hartford, CT More articles by this author Geetika Khanna St Louis, MO More articles by this author Jeffrey dome Washington DC, DC More articles by this author Robert Shamberger Boston, MA More articles by this author Michael Ritchey Phoenix, AZ More articles by this author Peter Ehrlich Ann Arbor, MI More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,033 | 0,003 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».