Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
A 23-year experience with malignant renal tumors in infancy and childhood
Autore:
Trobs, RB; Hansel, M; Friedrich, T; Bennek, J;
Indirizzi:
Univ Leipzig, Klin & Poliklin Kinderchirurg, D-04129 Leipzig, Germany UnivLeipzig Leipzig Germany D-04129 erchirurg, D-04129 Leipzig, Germany Univ Leipzig, Inst Pathol, D-04129 Leipzig, Germany Univ Leipzig LeipzigGermany D-04129 st Pathol, D-04129 Leipzig, Germany
Titolo Testata:
EUROPEAN JOURNAL OF PEDIATRIC SURGERY
fascicolo: 2, volume: 11, anno: 2001,
pagine: 92 - 98
SICI:
0939-7248(200104)11:2<92:A2EWMR>2.0.ZU;2-C
Fonte:
ISI
Lingua:
ENG
Soggetto:
NATIONAL-WILMS-TUMOR; PREOPERATIVE CHEMOTHERAPY; STAGE-I; PARTIAL NEPHRECTOMY; CELL CARCINOMA; CHILDREN; NEPHROBLASTOMA; HISTOLOGY; SURGERY;
Keywords:
Wilms' tumor; nephroblastoma; renal-cell carcinoma; preoperative chemotherapy; prognosis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Trobs, RB Univ Leipzig, Klin & Poliklin Kinderchirurg, Oststr 21-25, D-04129 Leipzig, Germany Univ Leipzig Oststr 21-25 Leipzig Germany D-04129 pzig, Germany
Citazione:
R.B. Trobs et al., "A 23-year experience with malignant renal tumors in infancy and childhood", EUR J PED S, 11(2), 2001, pp. 92-98

Abstract

A retrospective analysis of 77 children treated between 1974 and 1996 was undertaken to evaluate morbidity and the evolution of therapy. A Wilms' tumor (WT) was present in 73 children. 74% of patients (pats.) with WT survived (54 of 73 pats.). Histological specimens of 67 patients were re-evaluated, including 4 children with non-WT histology. Among patients with Wilms' tumors (WT), nephroblastoma (NB) of intermediate risk predominated (73 %; 46 of 63 pats.). Low-risk tumors occurred in 5 of 63 children (8%; mesoblasticnephroma 3, cystic partially diff. NE 1, completely necrotic NE ?). High-risk WT were diagnosed in 12 of 63 patients (19%) (NB with anaplasia 10, clear cell sarcoma 1, malignant rhabdoid tumor 1). Nephrogenic rests were present in 14 cases. We observed 3 children of school age with renal carcinoma and one patient with an intrarenal neuroblastoma. WT histology was the mostimportant factor determining prognosis (p=0.018). The risk for relapses was 2.6-fold higher in patients with high-risk WT compared to the standard risk group. Stages were re-evaluated according to SIOP 93-01. Comparing relapse-free survival of stages I, II and iii, respectively, there was a reducedsurvival rate for stage III (p=0.019). According to the SIOP/GPOH protocolin 1989, the regimen was switched from primary surgery to preoperative chemotherapy without biopsy in 1989 (If pats.). Compared to earlier years, survival improved (n.s.). In 3 patients preoperative diagnosis by means of imaging failed. During preoperative chemotherapy a venous occlusive disease ofthe liver occurred in 2 patients. Preoperative chemotherapy led to an impressive tumor shrinkage in the majority of patients, 2 patients of the preoperative group died (focal anaplastic MB). Long-term morbidity was analysed in 49 patients and included radiation-induced scoliosis (35), chest-wall deformity (3), congestive cardiomyopathy after relapse (1) and arterial hypertension (2). Over the years there was a trend to reduce frequency and dose of irradiation. Prognosis of WT is excellent but unfavorable histology thigh risk) predicts a poor prognosis. in our experience, reduction of tumor volume due to preoperative chemotherapy facilitates tumor removal by surgery and may preventtumor spillage and the deleterious effects of radiation in young children. Surgery without delay is necessary if the diagnosis is unclear or the tumor fails to respond to preoperative chemotherapy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/07/20 alle ore 19:11:41