Treatment results of Wilms tumour
Abstract
Purpose: The purpose of this study was to evaluate the treatment results of the patients with Wilms tumour (WT).
Materials and Methods: The clinical records of 21 children with WT treated between 2012 and 2017 were retrospectively reviewed. Age, nationality, symptoms, diagnostic and surgical methods, surgical complications, the stage of the disease, the status of neoadjuvant chemotherapy, radiotherapy status, presence of recurrent disease and histopathological characteristics of the tumour and outcome of the patients were analyzed.
Results: The female/male ratio was 2/1 and the mean age was 4.21±2.26 years. The most common physical examination finding was abdominal mass. The diagnosis was made with clinical examination and radiological investigation in 90.5% of the patients. Total nephroureterectomy was performed in all patients. The most common histopathological subgroup was classical Wilms Tumour that was detected in 81 % of the patients. 6.8 % of the patients had distant metastasis at the time of the diagnosis. The most common distant metastasis site was lungs. Overall survival (OS) of the patients was 85.7% and mean survival time was 36 months (2 months - 62 months). Advanced stage at diagnosis, presence of distant metastasis and diffuse anaplastic histology were associated with worse OS rates.
Conclusion: Similar to existing knowledge on outcome of patients with Wilms tumor, our results confirmed the negative effect of advanced stage, distant metastasis and diffuse anaplastic histology on survival. Further large-scale studies investigating molecular features of the tumor are needed to decide for proper treatment and to better predict outcome.
Keywords
Kaynakça
- 1. Gurney JG, Bondy ML. Epidemiology of chilhood cancer. In Principles and Practice of Pediatric Oncology, 5th edition (Eds PA Pizzo, DG Poplack):1-13. Philadelphia, Lippincott Williams&Wilkins. 2006.
- 2. Kramer S, Meadows AT, Jarret P. Racial variation in incidence of Wilms’ tumor relationship to congenital anomalies. Med Pediatr Oncol. 1984;12:401-5.
- 3. Terenziani M, Spreafico F, Collini P, Piva L, Perotti D, Podda M et al. Adult Wilms’ tumor: a monoinstitutional experience and review of the literature. Cancer. 2004;101:289-93.
- 4. Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF et al. SEER Cancer Statistics Review, 1975-2011. Bethesda, MD, National Cancer Institute, 2014.
- 5. Ehrlich PF. Wilms tumor: progress and considerations for the surgeon. Surg Oncol. 2007;16:157-71.
- 6. Akyüz C, Yalçın B, Yıldız I, Hazar V, Yörük A, Tokuç G et al. Treatment of Wilms tumor:a report from the Turkish Pediatric Oncology Group(TPOG). Pediatr Hematol Oncol. 2010;27:161-78.
- 7. Israels T, Pidini D, Borgstein E, Bailey S, Tump C, Chagaluka G et al. Survival of children with a Wilms tumor in Blantyre, Malawi. Pediatr Hematol Oncol. 2018;35:196-202.
- 8. Green DM. The diagnosis and management of Wilms' tumor. Pediatr Clin North Am. 1985;32:735-54.
- 9. Lall A, Pritchard-Jones, K, Walker J. Wilms’ tumor With intracaval thrombus in the UK Children’s Cancer Study Group UKW3 Trial. J Pediatric Surg. 2006;41:382-7.
- 10. Dome JS, Graf N, Geller JI et al. Advances in Wilms tumor treatment and biology: Progress through ınternational collaboration. J Clin Oncol. 2015;33:2999-3007.
