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Titel: Management and outcome of pediatric Wilms tumor with malignant inferior Vena cava thrombus: largest cohort of single-center experience
VerfasserIn: Elayadi, Moatasem
Hammad, Mahmoud
Sallam, Kareem
Ahmed, Gehad
Ahmed, Soha
Ibrahim, Ahmed
Refaat, Amal
Elkinaai, Naglaa
Younes, Alaa
Graf, Norbert
Zekri, Wael
Sprache: Englisch
Titel: International Journal of Clinical Oncology
Bandnummer: 25
Heft: 7
Seiten: 1425-1431
Verlag/Plattform: Springer Nature
Erscheinungsjahr: 2020
Freie Schlagwörter: Wilms tumor
Nephroblastoma
Thrombus
IVC
Pediatric oncology
Outcome
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: Background Wilms tumor (WT) with an inferior Vena cava (IVC) malignant thrombus comprises 4–10% of all WT cases. Methods This retrospective analysis included 51 pediatric patients presenting at Children Cancer Hospital Egypt-57357 from July 2007 to December 2016 with the diagnosis of WT with malignant IVC thrombus. Results Median age at presentation=4.4 years and 28 cases (55%) were females. Twenty-fve patients (49%) were metastatic and 4 patients (7.8%) had bilateral disease. Forty-seven cases (92.2%) had favorable histology with no evidence of anaplasia. Level of thrombus extension at presentation was classifed as infra-hepatic, retro-hepatic, supra-hepatic and intra-cardiac in 33, 9, 6 and 3 patients, respectively. Fifty patients started neoadjuvant chemotherapy (CTH) with 16 patients showing complete resolution of thrombus after 6 weeks of CTH. None of the patients developed thrombus progression after neoadjuvant CTH; one patient had stationary intra-cardiac thrombus, while remaining patients showed partial regression of their thrombus and had nephrectomy with en-bloc thrombectomy. The mean cranio-caudal dimension of IVC thrombi at initial presentation was 6.5 cm, and 3.6 cm post 6th week of CTH. The 5-year OS and EFS were 75.9% and 71.1%, respectively. There was no signifcant correlation of initial levels of thrombus extension with survival. Conclusion Neoadjuvant chemotherapy followed by radical nephrectomy with en-bloc thrombectomy and radiotherapy seems a successful approach for management of patients with WT and IVC tumor thrombus. Measurement of the cranio-caudal dimension of thrombus and its response to treatment should be considered in the surgical planning.
DOI der Erstveröffentlichung: 10.1007/s10147-020-01667-0
URL der Erstveröffentlichung: https://doi.org/10.1007/s10147-020-01667-0
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-406405
hdl:20.500.11880/36512
http://dx.doi.org/10.22028/D291-40640
ISSN: 1437-7772
1341-9625
Datum des Eintrags: 28-Sep-2023
Bezeichnung des in Beziehung stehenden Objekts: Electronic supplementary material
In Beziehung stehendes Objekt: https://static-content.springer.com/esm/art%3A10.1007%2Fs10147-020-01667-0/MediaObjects/10147_2020_1667_MOESM1_ESM.docx
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Pädiatrie
Professur: M - Prof. Dr. Norbert Graf
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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