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Five Years Experience In Surgical Treatment of Wilms Tumor

Year 2014, Volume: 39 Issue: 3, 546 - 549, 22.07.2014
https://doi.org/10.17826/cutf.02032

Abstract

Purpose: To evaluate the treatment results of the patients operated with diagnosis of Wilms" tumor . Materials and Methods: The records of patients operated for Wilms" tumor in 2008-2012 were evaluated retrospectively. Sex, age, additional anomalies, tumor stages, preoperative biopsy and chemotherapy history, histopathological features, preoperative tumor rupture, complications and survival rates were reviewed Results: Male/Female ratio of total 31 patients operated due to Wilms" tumor was 0.7 and mean age was 3.1 years (6 months - 11 years). Five of the patients had additional congenital anomalies. Thirteen patients had stage I tumor, 6 had stage II, 6 had stage III, 3 had stage IV and 3 had stage V. Eleven of the patients underwent immediate nephrouretectomy as a first intervention, eleven patients went through delayed nephrouretectomy after neoadjuvant chemotherapy without biopsy, eight patients were diagnosed via biopsy and underwent delayed nephrectomy after neoadjuvant chemotherapy. One of the patients went through immediate nephrouretectomy with biopsy. The histopathologic examination of 68,9% of the patients reported as triphasic Wilms" tumor. Three patients had positive surgical margins. Peroperative spillage was experienced in two patients. Two patients had postoperative complications (pneumonia and meningitis) and three patients had tumor relapses. Mean follow-up period was 2.9 years (1-6 years) and no mortality was observed. Conclusion: Increased surgical experience, development of radiologic imaging techniques and chemotherapeutic reduction of tumor size make treatment of Wilms" tumor easier and increase the survival rate.

References

  • Grundy PE, Green DM, Coppes MJ, Breslow NE, Ritchey ML, Perlman EJ, et al. Renal tumors. Principles and Practice of Pediatric Oncology. Philadelphia, Lippincott Williams & Wilkins. 2002.
  • Gurney JG, Severson RK, Davis S, Robison LL. Incidence of cancer in children in the United States. Sex race and 1 year age specific rates by histologic type. Cancer. 1995;75:2186-95.
  • Kalapurakal JA, Dome JS, Perlman EJ, Malogolowkin M, Haase GM, Grundy P, et al. Management of Wilms' tumour: current practice and future goals. Lancet Oncol. 2004;5:37-46.
  • Ehrlich PF. Wilms tumor: progress and considerations for the surgeon. Surg Oncol. 2007;16:157-71.
  • Ritchey ML, Green DM, Breslow NB, Moksness J, Norkool P. Accuracy of current imaging modalities in the diagnosis of synchronous bilateral Wilms' tumor. A report from the National Wilms Tumor Study Group. Cancer. 1995;75:600-4.
  • Ritchey ML, Shamberger RC, Hamilton T, Haase G, Argani P, Peterson S. Fate of bilateral renal lesions missed on preoperative imaging: a report from the National Wilms Tumor Study Group. J Urol. 2005;174:1519-21.
  • Tournade MF, Com-Nougue C, de Kraker J, Ludwig R, Rey A, Burgers JM, et al. Optimal duration of preoperative therapy in unilateral and nonmetastatic Wilms' tumor in children older than 6 months: results of the Ninth International Society of Pediatric Oncology Wilms' Tumor Trial and Study. J Clin Oncol. 2001;19:488-500.
  • Mitchell C, Pritchard-Jones K, Shannon R, Hutton C, Stevens S, Machin D, et al. Immediate nephrectomy versus preoperative chemotherapy in the management of non-metastatic Wilms' tumour: results of a randomised trial (UKW3) by the UK Children's Cancer Study Group. Eur J Cancer. 2006;42:2554-62.
  • Tournade MF, Com-Nougue C, Voute PA, Lemerle J, de Kraker J, Delemarre JF, et al. Results of the Sixth International Society of Pediatric Oncology Wilms' Tumor Trial and Study: a risk-adapted therapeutic approach in Wilms' tumor. J Clin Oncol. 1993;11:1014-23.
  • Kembhavi SA, Qureshi S, Vora T, Chinnaswamy G, Laskar S, Ramadwar M, et al. Understanding the principles in management of Wilms' tumour: can imaging assist in patient selection? Clin Radiol. 2013;68:646-53.
  • Shamberger RC. Pediatric renal tumors. Semin Surg Oncol. 1999;16:105-20.
  • Yazışma Adresi / Address for Correspondence: Dr. Önder Özen Çukurova Üniversitesi Tıp Fakültesi Çocuk Cerrahisi Anabilim Dalı Email: onder24@hotmail.com G eliş tarihi/Received on: 22.01.2014
  • Kabul tarihi/Accepted on:24.02.2014

Wilms Tümöründe Beş Yıllık Cerrahi Deneyim

Year 2014, Volume: 39 Issue: 3, 546 - 549, 22.07.2014
https://doi.org/10.17826/cutf.02032

Abstract

Amaç: Wilms tümörü tanısı konulan ve cerrahi tedavi uygulanan hastaların tedavi sonuçlarını değerlendirmek. Materyal ve Metod: 2008-2012 tarihleri arasında Wilms tümörü tanısıyla izlenen ve cerrahi tedavi uygulanan hastaların dosyaları retrospektif olarak incelendi. Cinsiyet, yaş, ek anomali birlikteliği, hastalığın evresi, ameliyat öncesi biyopsi alınıp alınmadığı, ameliyatın kemoterapi öncesi veya sonrası yapıldığı, histopatolojik özellikler, komplikasyonlar, ameliyat sırasında tümör rüptürü olup olmadığı ve sağkalım oranları irdelendi. Bulgular: Wilms tümörü tanısı ile ameliyat edilen toplam 31 hasta için Erkek/Kız oranı 0,7, ortalama yaş 3,1 yıldı (6 ay-11 yaş). Beş hastada konjenital ek anomali vardı. Tümör 13 hastada evre I, altışar hastada evre II ve III, üçer hastada evre IV ve V idi. Hastaların 11"ine ilk girişim olarak nefroüreterektomi, 11"ine biyopsi alınmadan neoadjuvan kemoterapi verildikten sonra nefroüreterektomi yapıldı. Sekiz hastada biyopsi ile tanı konuldu, kemoterapi verildi ve sonra nefroüreterektomi yapıldı. Bir hastada biyopsi alındıktan sonra tedavi verilmeden nefroüreterektomi uygulandı. Ameliyat sırasında iki hastada tümör rüptürü görüldü. Üç hastada cerrahi sınır pozitifti. Hastaların %68,9"unun histopatolojik tanısı trifazik Wilms tümörüydü. İki hastada postoperatif komplikasyon (menenjit ve pnömoni) gelişti. Üç hastada yineleme oldu. Ameliyat sonrası takip süresi ortalama 2,9 yıldı (1-6 yıl). Mortalite görülmedi. Sonuç: Cerrahi deneyimin artması, radyolojik görüntüleme tekniklerinin gelişmesi ve kemoterapi ile kitlelerin küçülmesi Wilms tümöründe tedaviyi kolaylaştırmakta ve sağkalım oranını arttırmaktadır.

References

  • Grundy PE, Green DM, Coppes MJ, Breslow NE, Ritchey ML, Perlman EJ, et al. Renal tumors. Principles and Practice of Pediatric Oncology. Philadelphia, Lippincott Williams & Wilkins. 2002.
  • Gurney JG, Severson RK, Davis S, Robison LL. Incidence of cancer in children in the United States. Sex race and 1 year age specific rates by histologic type. Cancer. 1995;75:2186-95.
  • Kalapurakal JA, Dome JS, Perlman EJ, Malogolowkin M, Haase GM, Grundy P, et al. Management of Wilms' tumour: current practice and future goals. Lancet Oncol. 2004;5:37-46.
  • Ehrlich PF. Wilms tumor: progress and considerations for the surgeon. Surg Oncol. 2007;16:157-71.
  • Ritchey ML, Green DM, Breslow NB, Moksness J, Norkool P. Accuracy of current imaging modalities in the diagnosis of synchronous bilateral Wilms' tumor. A report from the National Wilms Tumor Study Group. Cancer. 1995;75:600-4.
  • Ritchey ML, Shamberger RC, Hamilton T, Haase G, Argani P, Peterson S. Fate of bilateral renal lesions missed on preoperative imaging: a report from the National Wilms Tumor Study Group. J Urol. 2005;174:1519-21.
  • Tournade MF, Com-Nougue C, de Kraker J, Ludwig R, Rey A, Burgers JM, et al. Optimal duration of preoperative therapy in unilateral and nonmetastatic Wilms' tumor in children older than 6 months: results of the Ninth International Society of Pediatric Oncology Wilms' Tumor Trial and Study. J Clin Oncol. 2001;19:488-500.
  • Mitchell C, Pritchard-Jones K, Shannon R, Hutton C, Stevens S, Machin D, et al. Immediate nephrectomy versus preoperative chemotherapy in the management of non-metastatic Wilms' tumour: results of a randomised trial (UKW3) by the UK Children's Cancer Study Group. Eur J Cancer. 2006;42:2554-62.
  • Tournade MF, Com-Nougue C, Voute PA, Lemerle J, de Kraker J, Delemarre JF, et al. Results of the Sixth International Society of Pediatric Oncology Wilms' Tumor Trial and Study: a risk-adapted therapeutic approach in Wilms' tumor. J Clin Oncol. 1993;11:1014-23.
  • Kembhavi SA, Qureshi S, Vora T, Chinnaswamy G, Laskar S, Ramadwar M, et al. Understanding the principles in management of Wilms' tumour: can imaging assist in patient selection? Clin Radiol. 2013;68:646-53.
  • Shamberger RC. Pediatric renal tumors. Semin Surg Oncol. 1999;16:105-20.
  • Yazışma Adresi / Address for Correspondence: Dr. Önder Özen Çukurova Üniversitesi Tıp Fakültesi Çocuk Cerrahisi Anabilim Dalı Email: onder24@hotmail.com G eliş tarihi/Received on: 22.01.2014
  • Kabul tarihi/Accepted on:24.02.2014
There are 13 citations in total.

Details

Primary Language Turkish
Journal Section Research
Authors

Önder Özden This is me

Ender Fakıoğlu This is me

Murat Alkan This is me

Hilmi Serdar İskit This is me

Recep Tuncer This is me

Hasan Okur This is me

Serhan Küpeli This is me

Şeyda Erdoğan This is me

Süreyya Soyupak This is me

Ünal Zorludemir This is me

Publication Date July 22, 2014
Published in Issue Year 2014 Volume: 39 Issue: 3

Cite

MLA Özden, Önder et al. “Wilms Tümöründe Beş Yıllık Cerrahi Deneyim”. Cukurova Medical Journal, vol. 39, no. 3, 2014, pp. 546-9, doi:10.17826/cutf.02032.