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Wilms tümöründe tedavi sonuçları

Yıl 2019, Cilt 44, Sayı 3, 840 - 844, 30.09.2019
https://doi.org/10.17826/cumj.493064

Öz

Amaç: Bu çalişmanın amacı Wilms tümörlü (WT) hastaların tedavi sonuçlarını değerlendirmektir.

Gereç ve Yöntem: 2012-2017 yılları arasında WT tanılı 21 hastanın klinik kayıtları geriye dönük olarak incelendi. Yaş, uyruk, semptomlar, teşhis ve cerrahi methotlar, cerrahi komplikasyonlar, hastalığın evresi, neoadjuvan kemoterapi durumu, radyoterapi durumu, rekürren hastalığın varlığı, tümörün histopatolojik özellikleri ve hastaların sonuçları analiz edildi. 

Bulgular: Kız/erkek oranı 2/1olup, ortalama yaş 4.21±2.26 yıldı. En sık saptanan fizik muayene bulgusu abdominal kitle idi. Hastaların %90,5’ine radyolojik bulgular ve klinik muayene ile tanı konuldu. Hastaların tamamına total nefroüreterektomi uygulandı. Hastaların %81’inde saptanan histopatolojik alt grup klasik Wilms tümörü idi. Hastaların %6,8’inde tanı anında uzak metastaz olup en sık uzak metastaz yeri akciğerdi. Hastaların genel sağkalımı (OS) %85,7 idi ve ortalama sağkalım süresi 36 aydı(2 ay-62 ay). Tanı anında ileri ever hastalık olması, uzak metastaz varlığı ve difüz anaplastik histoloji ile sağkalım oranları belirgin olarak etkilenmekteydi.

Sonuç: Literatürdeki verilere benzer şekilde, çalışmamızın bulguları Wilms tümöründe ileri evre, uzak metastaz ve yaygın anaplastik histolojinin sağkalım üzerindeki olumsuz etkilerini doğrulamıştır. Uygun tedaviye karar vermek ve prognozu daha kesin olarak belirleyebilmek için tümörün moleküler özelliklerini araştıran büyük ölçekli çalışmalara ihtiyaç vardır.


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.
  • 11. Irtan S, Ehrlich PF, Pritchard-Jones K. Wilms Tumor “state-of-the-art” update 2016. Semin Pediatr Surg. 2016;25:250-6.
  • 12. Geller, JI. Current standards of care and future directions for “high-risk” pediatric renal tumors: anaplastic Wilms tumor and rhabdoid tumor. Urol Oncol. 2016;34:50–6. 13. Dome JS, Cotton CA, Perlman E. Treatment of anaplastic histology Wilms tumor: results from the fifth National Wilms Tumor Study. J Clin Oncol. 2006;24:2352-8.
  • 14. Njuguna F, Martij HA, Kuremu RT, Saula P, Kirtika P, Olbara G. Wilms tumor treatment outcomes: perspectives from a low-income setting. J Glob Oncol. 2016;3:555-62.
  • 15. Beckwith JB. New development in the pathology of Wilms tumor. Cancer Invest. 1997;15:153-62.
  • 16. Nakayama DK1, Bonasso PC. The history of multimodal treatment of Wilms' tumor. Am Surg. 2016;82:487-92.
  • 17. Cone EB, Dalton SS, Van Noord M, Tracy ET, Rice HE, Routh JC. Biomarkers for Wilms tumor: a systematic review. Urol. 2016;196:1530–5.
  • 18. Grundy PE, Telzerow PE, Breslow. Loss of heterozygosity for chromosomes 16q and 1p in Wilms' tumors predicts an adverse outcome. Cancer Res. 1994;54:2331-3.

Treatment results of Wilms tumour

Yıl 2019, Cilt 44, Sayı 3, 840 - 844, 30.09.2019
https://doi.org/10.17826/cumj.493064

Öz

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.


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.
  • 11. Irtan S, Ehrlich PF, Pritchard-Jones K. Wilms Tumor “state-of-the-art” update 2016. Semin Pediatr Surg. 2016;25:250-6.
  • 12. Geller, JI. Current standards of care and future directions for “high-risk” pediatric renal tumors: anaplastic Wilms tumor and rhabdoid tumor. Urol Oncol. 2016;34:50–6. 13. Dome JS, Cotton CA, Perlman E. Treatment of anaplastic histology Wilms tumor: results from the fifth National Wilms Tumor Study. J Clin Oncol. 2006;24:2352-8.
  • 14. Njuguna F, Martij HA, Kuremu RT, Saula P, Kirtika P, Olbara G. Wilms tumor treatment outcomes: perspectives from a low-income setting. J Glob Oncol. 2016;3:555-62.
  • 15. Beckwith JB. New development in the pathology of Wilms tumor. Cancer Invest. 1997;15:153-62.
  • 16. Nakayama DK1, Bonasso PC. The history of multimodal treatment of Wilms' tumor. Am Surg. 2016;82:487-92.
  • 17. Cone EB, Dalton SS, Van Noord M, Tracy ET, Rice HE, Routh JC. Biomarkers for Wilms tumor: a systematic review. Urol. 2016;196:1530–5.
  • 18. Grundy PE, Telzerow PE, Breslow. Loss of heterozygosity for chromosomes 16q and 1p in Wilms' tumors predicts an adverse outcome. Cancer Res. 1994;54:2331-3.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Araştırma
Yazarlar

İlknur BANLI CESUR
0000-0001-5263-5786
Türkiye


Begül YAĞCI KÜPELİ
SAĞLIK BİLİMLERİ ÜNİVERSİTESİ
0000-0001-2345-6789


Zerrin ÖZÇELİK Bu kişi benim
SAĞLIK BİLİMLERİ ÜNİVERSİTESİ
0000-0003-3728-0846

Yayımlanma Tarihi 30 Eylül 2019
Yayınlandığı Sayı Yıl 2019, Cilt 44, Sayı 3

Kaynak Göster

MLA Banlı Cesur, İ. , Yağcı Küpeli, B. , Özçelik, Z. "Treatment results of Wilms tumour" . Cukurova Medical Journal 44 (2019 ): 840-844 <https://dergipark.org.tr/tr/pub/cumj/issue/42406/493064>