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Higher incidence of surgery‐related complications in Wilms tumor nephrectomy from clinical records analysis compared with central database registration
Author(s) -
Poll Daan,
Wilde Jim,
de Ven Kees,
Asimakidou Maria,
Heij Hugo,
Wijnen Marc
Publication year - 2019
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.27502
Subject(s) - medicine , database , nephrectomy , incidence (geometry) , medical record , wilms' tumor , surgery , kidney , physics , computer science , optics
Background/Objectives Central database registrations are widely used tools for assessment of clinical results, but their reliability is subject to debate. The aim of this study is to evaluate the reliability of central database registration for Wilms tumor (WT) nephrectomy‐related complications. Design/Methods All Dutch patients undergoing WT nephrectomy according to the International Society of Paediatric Oncology (SIOP) 2001 protocol between 2001 and 2013 were evaluated. Results from the central database were analyzed and compared with data found via individual medical records analysis (gold standard). Results A total of 179 patients were included. Fourteen (7.8%) patients with a total of 17 complications were identified in the central database. The medical records revealed that 33 (18.4%) of patients had undergone a total of 41 complications ( P < 0.001). Operative complications were similar between the groups ( P = 0.157). Eleven short‐term complications were noted in the central database versus 27 in the medical records ( P = 0.059). Significantly more long‐term complications, namely, adhesive small‐bowel obstruction, were noted from the medical records compared with the central database (7 vs 1, respectively, P < 0.001). Postoperative chemotherapy was significantly delayed by on average 6 days ( P < 0.0001) in patients with complications. No significant effect of complications on event‐free survival, overall survival, or the relapse rate was recorded. Conclusion Central database registrations underestimate the incidence of surgery‐related complications after WT nephrectomy and need to be regarded with caution.