sAJID qURESHI - Academia.edu (original) (raw)

Papers by sAJID qURESHI

Indian Journal of Cancer, 2004

Although vascular malformations of the tongue comprise a significant portion of head and neck ang... more Although vascular malformations of the tongue comprise a significant portion of head and neck angiodysplastic lesions, hemangioma of base of tongue is rare. We report a case of hemangioma of base of tongue extending to the supraglottis, which necessitated an extended supraglottic laryngectomy. Patient had an uneventful recovery and at three year, follow-up has a normal speech and no difficulty in swallowing or aspiration. More importantly, there was no recurrence of hemangioma or bleeding. Although hemangiomas may be treated by various conservative methods, occasionally patient may require surgical excision as in the present case due to the repeated bleeding episode and difficult access. A high index of suspicion and radiological investigations should be performed if the clinical presentation is atypical for malignancy, as in our case.

Annals of Surgery, 2020

Background: Overburdened systems and concerns of adverse outcomes have resulted in deferred cance... more Background: Overburdened systems and concerns of adverse outcomes have resulted in deferred cancer surgeries with devastating consequences. In this COVID pandemic, the decision to continue elective cancer surgeries, and their subsequent outcomes, are sparsely reported from hotspots. Methods: A prospective database of the Department of Surgical Oncology was analysed from March 23rd to April 30th, 2020. Findings: Four hundred ninety-four elective surgeries were performed (377 untested and 117 tested for Covid 19 before surgery). Median age was 48 years with 13% (n = 64) above the age of 60 years. Sixty-eight percent patients were American Society of Anaesthesiology (ASA) grade I. As per surgical complexity grading, 71 (14·4%) cases were lower grade (I-III) and 423 (85.6%) were higher grade complex surgeries (IV – VI). Clavien-Dindo ≥ grade III complications were 5.6% (n = 28) and there were no postoperative deaths. Patients >60 years documented 9.3% major complications compared to ...

Cancer Imaging, 2014

To assess the diagnostic accuracy of CT in local staging of Wilms' Tumor.

European Urology Supplements, 2019

Background: Understanding molecular events resulting in testicular germ-cell-tumour (TGCT) pathog... more Background: Understanding molecular events resulting in testicular germ-cell-tumour (TGCT) pathogenesis and progression will facilitate development of new biomarkers and identification of genes/pathways for targeting with novel therapeutic agents. To this end, development of The-Cancer-Genome-Atlas (TCGA), which includes TGCTs from adult patients, has allowed progress [1]. However, TCGA has no normal gonadal control tissue for direct comparison with TGCT data. We sought to integrate two largescale datasets to further extend molecular observations in TGCTs. Methods: RNA-Seq count data downloaded from TCGA website for all tumours including TGCTs (n = 137) and from Genotype-Tissue Expression (GTEx) portal (https://gtexportal.org/) including normal testis samples (n = 225). Attempts to normalise the two datasets were undertaken using approaches including comBat, surrogate-variableanalysis (SVA), linear models (EdgeR & Voom) and count-depletion approaches. Results: The two (TGCT and testis) RNASeq datasets demonstrated major batch effects that were far greater than the gene expression variation within them. This was also true for other cancer datasets (e.g. liver), where internal normal controls were available to validate batch correction. Results were explored using differential gene-expressionanalysis, principal-components-analysis and tSNE to determine if batch effects from sample origin could be successfully modelled into the expression analysis. We conclude that analysis of TCGA data without embedded control samples is challenging and suggest potential bioinformatic approaches to overcome such issues. We believe these batch effects cannot be removed, but can be substantially mitigated. This will be important to maximise the outputs/understanding from such publicly-available resources, as further analyses are being published without proper handling of such effects.

Frontiers in Surgery, 2019

Hepatic resection is the mainstay of treatment for hepatoblastoma. However, the presence of adequ... more Hepatic resection is the mainstay of treatment for hepatoblastoma. However, the presence of adequate future liver remnant (FLR) is essential to prevent postoperative liver failure. Portal vein embolization (PVE) is commonly utilized in adults for promoting hypertrophy of FLR, however, it is sparingly used in children. Secondly, bile leak after liver resections is a well-defined complication. Apart from conservative treatment such as drainage and antibiotic, several management strategies including endoscopic, percutaneous, and surgical approaches have been described for its management. We present an 18-month old child with hepatoblastoma for whom PVE was performed to enhance the FLR so that an extended right hepatectomy could be accomplished. The same patient endured delayed postoperative biliary leak wherein the conservative, and non-operative interventional procedure failed, however, surgery combined with intraoperative interventional radiology procedure was utilized with a favorable outcome.

Pediatric Blood & Cancer, 2019

BackgroundThe availability of robust, equivalent data regarding outcomes for upfront or delayed s... more BackgroundThe availability of robust, equivalent data regarding outcomes for upfront or delayed surgery for renal tumors in children leads to a dilemma in selecting the initial treatment. Imaging criteria associated with the probability of rupture or incomplete resection may provide a more objective assessment for customization for the timing of surgery.ProcedureEighty‐three children with unilateral, nonmetastatic renal tumors were enrolled between January 2012 and April 2018. Upfront nephrectomy was performed in the absence or delayed surgery (after a biopsy and chemotherapy) in the presence of one or more imaging‐based high‐risk features, including perinephric spread or adjacent organ infiltration, tumors crossing the midline, intravascular thrombus, and extensive adenopathy. Post hoc analysis for interobserver concordance for high‐risk imaging features was also performed.ResultsThe upfront surgery group (19) had predominantly stage I or II diseases (89%) and the histological type...

Pediatric Hematology Oncology Journal, 2016

5 (9%) and anaplastic 2 (4%). 19 cases were only reported as medulloblastoma WHO IV. Using immuno... more 5 (9%) and anaplastic 2 (4%). 19 cases were only reported as medulloblastoma WHO IV. Using immunohistochemical marker beta catenin and histology 43 tumours were subdivided into WNT (26), SHH (13), non-WNTnonSHH (4) groups. Conclusion: There was an obvious male predominance in this group. 78% of cases were diagnosed within 3 months of onset of symptoms. 57% of cases had high risk disease.

International Journal of Radiation Oncology*Biology*Physics, 2016

Pediatric Hematology Oncology Journal, 2016

Journal of Postgraduate Medicine

Journal of Clinical Oncology, 2007

A 6-year-old boy presented with 6-month history of intermittent abdominal pain associated with ep... more A 6-year-old boy presented with 6-month history of intermittent abdominal pain associated with episodic vomiting suggestive of subacute intestinal obstruction, which had worsened significantly over the preceding week. Upon physical examination, a 6 ϫ 5 cm mass was palpable in the right iliac fossa extending into the pelvis. A computed tomography (CT) scan revealed a 5.2 ϫ 9.5 ϫ 6.5 cm heterogeneously enhancing mass with ill-defined margins, occupying the right iliac fossa. The mass caused extrinsic compression of ileal loop and abutted the anterior abdominal wall and the iliopsoas muscle with indistinct fat planes between them. There was dilation of small bowel loops and mild ascites (Fig 1). Core biopsy revealed a malignant round cell tumor with rosette-like structures. The tumor cells had an equivocal reaction to desmin and mic2. The clinicopathological features favored a primitive neuroectodermal tumor. Metastatic work-up including bone marrow studies, bone scan, and CT scan of thorax was negative. Combination chemotherapy was initiated as per the institutional protocol for primitive neuroectodermal tumor comprising of a six-drug regimen of vincristine, doxorubicin, cyclophosphamide, dactinomycin, ifosphamide, and etoposide. After the initial 9 weeks of induction therapy, the patient underwent re-evaluation of his disease status. CT scan showed a persistent mass of 5.0 ϫ 8.0 ϫ 6.0 cm with multiple areas of necrosis. There was no change in the extent of the mass, but it appeared well-defined. The proximal small bowel loops were still dilated. Positron emission tomography scan showed central photo deficient area suggestive of necrosis with abnormal tracer uptake at the periphery of the lesion. On exploratory laparotomy, the mass was seen arising from the Meckels diverticulum (Fig 2). No other focus of disease was noted in the abdominal cavity. Resection of ileal loop along

Journal of Cancer Research and Therapeutics, 2005

Oncologist, Sep 5, 2019

Background. Nuclear protein of the testis (NUT) carcinoma is a rare and aggressive malignancy ass... more Background. Nuclear protein of the testis (NUT) carcinoma is a rare and aggressive malignancy associated with rearrangements of the nuclear protein of the testis (NUT) gene on chromosome 15q14. Because of its rarity, this tumor is often underdiagnosed and underreported, and there is limited literature regarding its biology and optimal management. Methods and Results. We report our experience of five patients with pediatric NUT carcinoma, all of whom presented with midline head and neck mass. In spite of aggressive multimodality treatment, only one patient survives. Conclusion. NUT carcinoma has a dismal prognosis in spite of aggressive multimodality management (surgery and adjuvant chemotherapy and/or radiation). Novel strategies are required to improve outcomes of patients with this tumor.

Pediatric Hematology Oncology Journal, 2020

Pediatric Hematology Oncology Journal, 2020

involvement was osseous in 82.4% (n¼61) and extraosseous in 17.6% (n¼13) of patients. Primary oss... more involvement was osseous in 82.4% (n¼61) and extraosseous in 17.6% (n¼13) of patients. Primary osseous site was extremity in 30 patients, pelvis in 10 patients, chest wall in 9 patients, spine in 7 patients and skull in 5 patients. Fifty seven patients (77%) presented with localised disease and 17 patients (23%) with metastatic disease. Main metastatic sites were lung (n¼10), bone (n¼9) and bone marrow (n¼3). Chemotherapy regimen was 3weekly VDC/ IE in 52 patients and VDC in 21 patients. There was no treatment related mortality. Primary local control modality was surgery alone (n¼12), definitive RT (n¼33), surgery + RT (n¼20), palliative RT (n¼4) or none (n¼4). Fourteen patients progressed while on treatment. Recurrence occurred in 22 patients. Time to recurrence ranged from 13 e 57 months (Median 21.5 months). At a median duration of follow up of 64 months (range: 5-91 months), 5 year event free survival was 50.4% and 5 year overall survival was 54.6%. For localized ES, 5 year disease free and overall survivals were 60.6% and 64.2% respectively. For metastatic ES, disease free and overall survivals were 17.6% and 23.5% respectively. D. Conclusion Multimodality treatment seems to confer favorable outcome in localized ES. Intensification of treatment by interval compression may improve outcomes further.

Journal of Gastrointestinal and Abdominal Radiology, 2020

Unlike other pediatric extra cranial solid neoplasms, neuroblastomas have very low incidence of p... more Unlike other pediatric extra cranial solid neoplasms, neuroblastomas have very low incidence of pulmonary metastases. Neuroblastomas also tend to encase rather than infiltrate the major vessels with very low incidence of tumor thrombus. Even in cases with inferior vena cava tumor thrombosis, pulmonary metastases are a rare occurrence. These patients usually show widespread disseminated disease at presentation. We present a rare case of adrenal neuroblastoma with tumor thrombus and bilateral pulmonary metastases at presentation. This presentation can be confused with adrenocortical carcinoma and differentiating between the two is essential for further management.

The Oncologist, 2019

Background Nuclear protein of the testis (NUT) carcinoma is a rare and aggressive malignancy asso... more Background Nuclear protein of the testis (NUT) carcinoma is a rare and aggressive malignancy associated with rearrangements of the nuclear protein of the testis (NUT) gene on chromosome 15q14. Because of its rarity, this tumor is often underdiagnosed and underreported, and there is limited literature regarding its biology and optimal management. Methods and Results We report our experience of five patients with pediatric NUT carcinoma, all of whom presented with midline head and neck mass. In spite of aggressive multimodality treatment, only one patient survives. Conclusion NUT carcinoma has a dismal prognosis in spite of aggressive multimodality management (surgery and adjuvant chemotherapy and/or radiation). Novel strategies are required to improve outcomes of patients with this tumor.

Journal of Gastrointestinal and Abdominal Radiology, 2019

Objectives To evaluate the diagnostic accuracy of multidetector computed tomography (MDCT)–based ... more Objectives To evaluate the diagnostic accuracy of multidetector computed tomography (MDCT)–based staging of Wilms’ tumor (WT) in comparison with surgical-pathological staging (reference standard) and to assess the interobserver agreement in predicting CT stage for WT. Method Retrospective audit of 50 consecutive cases of WT meeting our eligibility criteria was performed, and an electronic database of CT scan findings, intraoperative findings, and final histopathology staging were created. Two radiologists blinded to surgical and histologic findings reviewed the CT scans, using multiplanar reformations to assess various parameters pertaining to tumor extent and assign a possible stage, which was then compared with the final surgical-pathological stage. Interobserver agreement was assessed using κ-coefficient. Results CT scan correctly staged 31 (62%) of 50 WT cases (both observers’ consensus data, all stages combined). CT accuracy was 37.5% in stage I disease, 66% in stage II disease...

The Journal of Pediatrics, 2017

Indian Journal of Cancer, 2004

Although vascular malformations of the tongue comprise a significant portion of head and neck ang... more Although vascular malformations of the tongue comprise a significant portion of head and neck angiodysplastic lesions, hemangioma of base of tongue is rare. We report a case of hemangioma of base of tongue extending to the supraglottis, which necessitated an extended supraglottic laryngectomy. Patient had an uneventful recovery and at three year, follow-up has a normal speech and no difficulty in swallowing or aspiration. More importantly, there was no recurrence of hemangioma or bleeding. Although hemangiomas may be treated by various conservative methods, occasionally patient may require surgical excision as in the present case due to the repeated bleeding episode and difficult access. A high index of suspicion and radiological investigations should be performed if the clinical presentation is atypical for malignancy, as in our case.

Annals of Surgery, 2020

Background: Overburdened systems and concerns of adverse outcomes have resulted in deferred cance... more Background: Overburdened systems and concerns of adverse outcomes have resulted in deferred cancer surgeries with devastating consequences. In this COVID pandemic, the decision to continue elective cancer surgeries, and their subsequent outcomes, are sparsely reported from hotspots. Methods: A prospective database of the Department of Surgical Oncology was analysed from March 23rd to April 30th, 2020. Findings: Four hundred ninety-four elective surgeries were performed (377 untested and 117 tested for Covid 19 before surgery). Median age was 48 years with 13% (n = 64) above the age of 60 years. Sixty-eight percent patients were American Society of Anaesthesiology (ASA) grade I. As per surgical complexity grading, 71 (14·4%) cases were lower grade (I-III) and 423 (85.6%) were higher grade complex surgeries (IV – VI). Clavien-Dindo ≥ grade III complications were 5.6% (n = 28) and there were no postoperative deaths. Patients >60 years documented 9.3% major complications compared to ...

Cancer Imaging, 2014

To assess the diagnostic accuracy of CT in local staging of Wilms' Tumor.

European Urology Supplements, 2019

Background: Understanding molecular events resulting in testicular germ-cell-tumour (TGCT) pathog... more Background: Understanding molecular events resulting in testicular germ-cell-tumour (TGCT) pathogenesis and progression will facilitate development of new biomarkers and identification of genes/pathways for targeting with novel therapeutic agents. To this end, development of The-Cancer-Genome-Atlas (TCGA), which includes TGCTs from adult patients, has allowed progress [1]. However, TCGA has no normal gonadal control tissue for direct comparison with TGCT data. We sought to integrate two largescale datasets to further extend molecular observations in TGCTs. Methods: RNA-Seq count data downloaded from TCGA website for all tumours including TGCTs (n = 137) and from Genotype-Tissue Expression (GTEx) portal (https://gtexportal.org/) including normal testis samples (n = 225). Attempts to normalise the two datasets were undertaken using approaches including comBat, surrogate-variableanalysis (SVA), linear models (EdgeR & Voom) and count-depletion approaches. Results: The two (TGCT and testis) RNASeq datasets demonstrated major batch effects that were far greater than the gene expression variation within them. This was also true for other cancer datasets (e.g. liver), where internal normal controls were available to validate batch correction. Results were explored using differential gene-expressionanalysis, principal-components-analysis and tSNE to determine if batch effects from sample origin could be successfully modelled into the expression analysis. We conclude that analysis of TCGA data without embedded control samples is challenging and suggest potential bioinformatic approaches to overcome such issues. We believe these batch effects cannot be removed, but can be substantially mitigated. This will be important to maximise the outputs/understanding from such publicly-available resources, as further analyses are being published without proper handling of such effects.

Frontiers in Surgery, 2019

Hepatic resection is the mainstay of treatment for hepatoblastoma. However, the presence of adequ... more Hepatic resection is the mainstay of treatment for hepatoblastoma. However, the presence of adequate future liver remnant (FLR) is essential to prevent postoperative liver failure. Portal vein embolization (PVE) is commonly utilized in adults for promoting hypertrophy of FLR, however, it is sparingly used in children. Secondly, bile leak after liver resections is a well-defined complication. Apart from conservative treatment such as drainage and antibiotic, several management strategies including endoscopic, percutaneous, and surgical approaches have been described for its management. We present an 18-month old child with hepatoblastoma for whom PVE was performed to enhance the FLR so that an extended right hepatectomy could be accomplished. The same patient endured delayed postoperative biliary leak wherein the conservative, and non-operative interventional procedure failed, however, surgery combined with intraoperative interventional radiology procedure was utilized with a favorable outcome.

Pediatric Blood & Cancer, 2019

BackgroundThe availability of robust, equivalent data regarding outcomes for upfront or delayed s... more BackgroundThe availability of robust, equivalent data regarding outcomes for upfront or delayed surgery for renal tumors in children leads to a dilemma in selecting the initial treatment. Imaging criteria associated with the probability of rupture or incomplete resection may provide a more objective assessment for customization for the timing of surgery.ProcedureEighty‐three children with unilateral, nonmetastatic renal tumors were enrolled between January 2012 and April 2018. Upfront nephrectomy was performed in the absence or delayed surgery (after a biopsy and chemotherapy) in the presence of one or more imaging‐based high‐risk features, including perinephric spread or adjacent organ infiltration, tumors crossing the midline, intravascular thrombus, and extensive adenopathy. Post hoc analysis for interobserver concordance for high‐risk imaging features was also performed.ResultsThe upfront surgery group (19) had predominantly stage I or II diseases (89%) and the histological type...

Pediatric Hematology Oncology Journal, 2016

5 (9%) and anaplastic 2 (4%). 19 cases were only reported as medulloblastoma WHO IV. Using immuno... more 5 (9%) and anaplastic 2 (4%). 19 cases were only reported as medulloblastoma WHO IV. Using immunohistochemical marker beta catenin and histology 43 tumours were subdivided into WNT (26), SHH (13), non-WNTnonSHH (4) groups. Conclusion: There was an obvious male predominance in this group. 78% of cases were diagnosed within 3 months of onset of symptoms. 57% of cases had high risk disease.

International Journal of Radiation Oncology*Biology*Physics, 2016

Pediatric Hematology Oncology Journal, 2016

Journal of Postgraduate Medicine

Journal of Clinical Oncology, 2007

A 6-year-old boy presented with 6-month history of intermittent abdominal pain associated with ep... more A 6-year-old boy presented with 6-month history of intermittent abdominal pain associated with episodic vomiting suggestive of subacute intestinal obstruction, which had worsened significantly over the preceding week. Upon physical examination, a 6 ϫ 5 cm mass was palpable in the right iliac fossa extending into the pelvis. A computed tomography (CT) scan revealed a 5.2 ϫ 9.5 ϫ 6.5 cm heterogeneously enhancing mass with ill-defined margins, occupying the right iliac fossa. The mass caused extrinsic compression of ileal loop and abutted the anterior abdominal wall and the iliopsoas muscle with indistinct fat planes between them. There was dilation of small bowel loops and mild ascites (Fig 1). Core biopsy revealed a malignant round cell tumor with rosette-like structures. The tumor cells had an equivocal reaction to desmin and mic2. The clinicopathological features favored a primitive neuroectodermal tumor. Metastatic work-up including bone marrow studies, bone scan, and CT scan of thorax was negative. Combination chemotherapy was initiated as per the institutional protocol for primitive neuroectodermal tumor comprising of a six-drug regimen of vincristine, doxorubicin, cyclophosphamide, dactinomycin, ifosphamide, and etoposide. After the initial 9 weeks of induction therapy, the patient underwent re-evaluation of his disease status. CT scan showed a persistent mass of 5.0 ϫ 8.0 ϫ 6.0 cm with multiple areas of necrosis. There was no change in the extent of the mass, but it appeared well-defined. The proximal small bowel loops were still dilated. Positron emission tomography scan showed central photo deficient area suggestive of necrosis with abnormal tracer uptake at the periphery of the lesion. On exploratory laparotomy, the mass was seen arising from the Meckels diverticulum (Fig 2). No other focus of disease was noted in the abdominal cavity. Resection of ileal loop along

Journal of Cancer Research and Therapeutics, 2005

Oncologist, Sep 5, 2019

Background. Nuclear protein of the testis (NUT) carcinoma is a rare and aggressive malignancy ass... more Background. Nuclear protein of the testis (NUT) carcinoma is a rare and aggressive malignancy associated with rearrangements of the nuclear protein of the testis (NUT) gene on chromosome 15q14. Because of its rarity, this tumor is often underdiagnosed and underreported, and there is limited literature regarding its biology and optimal management. Methods and Results. We report our experience of five patients with pediatric NUT carcinoma, all of whom presented with midline head and neck mass. In spite of aggressive multimodality treatment, only one patient survives. Conclusion. NUT carcinoma has a dismal prognosis in spite of aggressive multimodality management (surgery and adjuvant chemotherapy and/or radiation). Novel strategies are required to improve outcomes of patients with this tumor.

Pediatric Hematology Oncology Journal, 2020

Pediatric Hematology Oncology Journal, 2020

involvement was osseous in 82.4% (n¼61) and extraosseous in 17.6% (n¼13) of patients. Primary oss... more involvement was osseous in 82.4% (n¼61) and extraosseous in 17.6% (n¼13) of patients. Primary osseous site was extremity in 30 patients, pelvis in 10 patients, chest wall in 9 patients, spine in 7 patients and skull in 5 patients. Fifty seven patients (77%) presented with localised disease and 17 patients (23%) with metastatic disease. Main metastatic sites were lung (n¼10), bone (n¼9) and bone marrow (n¼3). Chemotherapy regimen was 3weekly VDC/ IE in 52 patients and VDC in 21 patients. There was no treatment related mortality. Primary local control modality was surgery alone (n¼12), definitive RT (n¼33), surgery + RT (n¼20), palliative RT (n¼4) or none (n¼4). Fourteen patients progressed while on treatment. Recurrence occurred in 22 patients. Time to recurrence ranged from 13 e 57 months (Median 21.5 months). At a median duration of follow up of 64 months (range: 5-91 months), 5 year event free survival was 50.4% and 5 year overall survival was 54.6%. For localized ES, 5 year disease free and overall survivals were 60.6% and 64.2% respectively. For metastatic ES, disease free and overall survivals were 17.6% and 23.5% respectively. D. Conclusion Multimodality treatment seems to confer favorable outcome in localized ES. Intensification of treatment by interval compression may improve outcomes further.

Journal of Gastrointestinal and Abdominal Radiology, 2020

Unlike other pediatric extra cranial solid neoplasms, neuroblastomas have very low incidence of p... more Unlike other pediatric extra cranial solid neoplasms, neuroblastomas have very low incidence of pulmonary metastases. Neuroblastomas also tend to encase rather than infiltrate the major vessels with very low incidence of tumor thrombus. Even in cases with inferior vena cava tumor thrombosis, pulmonary metastases are a rare occurrence. These patients usually show widespread disseminated disease at presentation. We present a rare case of adrenal neuroblastoma with tumor thrombus and bilateral pulmonary metastases at presentation. This presentation can be confused with adrenocortical carcinoma and differentiating between the two is essential for further management.

The Oncologist, 2019

Background Nuclear protein of the testis (NUT) carcinoma is a rare and aggressive malignancy asso... more Background Nuclear protein of the testis (NUT) carcinoma is a rare and aggressive malignancy associated with rearrangements of the nuclear protein of the testis (NUT) gene on chromosome 15q14. Because of its rarity, this tumor is often underdiagnosed and underreported, and there is limited literature regarding its biology and optimal management. Methods and Results We report our experience of five patients with pediatric NUT carcinoma, all of whom presented with midline head and neck mass. In spite of aggressive multimodality treatment, only one patient survives. Conclusion NUT carcinoma has a dismal prognosis in spite of aggressive multimodality management (surgery and adjuvant chemotherapy and/or radiation). Novel strategies are required to improve outcomes of patients with this tumor.

Journal of Gastrointestinal and Abdominal Radiology, 2019

Objectives To evaluate the diagnostic accuracy of multidetector computed tomography (MDCT)–based ... more Objectives To evaluate the diagnostic accuracy of multidetector computed tomography (MDCT)–based staging of Wilms’ tumor (WT) in comparison with surgical-pathological staging (reference standard) and to assess the interobserver agreement in predicting CT stage for WT. Method Retrospective audit of 50 consecutive cases of WT meeting our eligibility criteria was performed, and an electronic database of CT scan findings, intraoperative findings, and final histopathology staging were created. Two radiologists blinded to surgical and histologic findings reviewed the CT scans, using multiplanar reformations to assess various parameters pertaining to tumor extent and assign a possible stage, which was then compared with the final surgical-pathological stage. Interobserver agreement was assessed using κ-coefficient. Results CT scan correctly staged 31 (62%) of 50 WT cases (both observers’ consensus data, all stages combined). CT accuracy was 37.5% in stage I disease, 66% in stage II disease...

The Journal of Pediatrics, 2017