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doi:10.22028/D291-40640
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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