Relapse of unilateral favorable histology Wilms¡¯ tumor: Significant clinicopathological factors

详细信息    查看全文

• 作者：Takeshi Aoba^a ; ^b ; ^{t2aoba@marianna-u.ac.jp} ; Naoto Urushihara^a ; Koji Fukumoto^a ; Shigeyuki Furuta^b ; Hiroaki Fukuzawa^a ; Maki Mitsunaga^a ; Kentaro Watanabe^a ; Masaya Yamoto^a ; Hiromu Miyake^a ; Mariko Koyama^b ; Hideto Iwabuchi^c ; Junki Koike^d ; Shinobu Tatsunami^e ; Munechika Wakisaka^b ; Hiroaki Kitagawa^b ; ¹
• 关键词：Wilms&rsquo ; tumor ; Favorable Histology ; Blastemal predominant type ; Relapse factor ; Prognosis
• 刊名：Journal of Pediatric Surgery
• 出版年：2012
• 出版时间：December, 2012
• 年：2012
• 卷：47
• 期：12
• 页码：2210-2215
• 全文大小：303 K

文摘

Purpose

To evaluate the clinicopathological features that indicate relapse and suggest a new risk based therapeutic strategy for unilateral Favorable Histology Wilms Tumor (FH-WT).

Materials & Methods

Thirty-three patients with unilateral WT were treated in two institutions between 1986 and 2010. Twenty-eight patients with FH-WT received primary nephrectomy according to the National Wilms¡¯ Tumor Study (NWTS) or the Japanese Wilms¡¯ Tumor Study (JWiTS) protocol. Retrospective analyses of the non-relapsed group (n = 23) and the relapsed group (n = 5) compared age, gender, tumor laterality, tumor weight, initial tumor stage, known histological subtype, chemotherapy (2 or 3 drugs), and any irradiation delivered. Stages and histological subtypes of the tumors were re-evaluated according to the Japanese staging system.

Results

Five of the twenty-eight tumors relapsed, and one patient died. The initial staging (P = 0.029) and the histological subtype (P = 0.003) were the only factors indicating relapse. Nine of the twenty-three tumors were histologically classified as blastemal predominant subtype (BPT-WT). Five relapsed.

Conclusion

According to the basic Japanese therapeutic strategy, all patients underwent a primary nephrectomy before chemotherapy. This study suggests that the histological subtype pre-treatment ¡°BPT-WT¡± should be included as a strong indicator of poor prognosis. Such patients should be treated as a high-risk group.