Please use this identifier to cite or link to this item: doi:10.22028/D291-41910
Title: How to improve initial diagnostic accuracy of kidney tumours in childhood?-A non-invasive approach
Author(s): Welter, Nils
Metternich, Gregor
Furtwängler, Rhoikos
Bayoumi, Ahmed
Mergen, Marvin
Kager, Leo
Vokuhl, Christian
Warmann, Steven W.
Fuchs, Jörg
Meier, Clemens-Magnus
Melchior, Patrick
Gessler, Manfred
Wagenpfeil, Stefan
Schenk, Jens-Peter
Graf, Norbert
Language: English
Title: International Journal of Cancer
Volume: 154
Issue: 11
Pages: 1955-1966
Publisher/Platform: Wiley
Year of Publication: 2024
Free key words: biopsy
kidney neoplasms in childhood
neoadjuvant therapy
radiology
Wilms tumour
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: Non-invasive differentiation of paediatric kidney tumours is particularly important in the SIOP-RTSG protocols, which recommend pre-operative chemotherapy without histological confirmation. The identification of clinical and tumour-related parameters may enhance diagnostic accuracy. Age, metastases, and tumour volume (TV) were retrospectively analysed in 3306 patients enrolled in SIOP/GPOH 9, 93-01, and 2001 including Wilms tumour (WT), congenital mesoblastic nephroma (CMN), clear cell sarcoma (CCSK), malignant rhabdoid tumour of the kidney (MRTK), and renal cell carcinoma (RCC). WT was diagnosed in 2927 (88.5%) patients followed by CMN 138 (4.2%), CCSK 126 (3.8%), MRTK 58 (1.8%) and RCC 57 (1.7%). CMN, the most common localized tumour (71.6%) in patients younger than 3 months of age, was diagnosed earliest and RCC the latest (median age [months]: 0 and 154, respectively) both associated with significantly smaller TV (median TV [mL]: 67.2 and 45.0, respectively). RCC occurred in >14% of patients older than 120 months or older than 84 months with TV <100 mL. Receiver operating characteristic analyses discriminated WT from CMN, RCC and MRTK regarding age (AUC = 0.976, 0.929 and 0.791) and TV (AUC = 0.768, 0.813 and 0.622). MRTK had the highest risk of metastasis (37.9%) despite young age, whereas the risk of metastasis increased significantly with age in WT. Age and TV at diagnosis can differentiate WT from CMN and RCC. MRTK must be considered for metastatic tumours at young age. Identification of CCSK without histology remains challenging. Combined with MRI-characteristics, including diffusion-weighted imaging, and radiomics and liquid biopsies in the future, our approach allows optimization of biopsy recommendations and prevention of misdiagnosis-based neoadjuvant treatment.
DOI of the first publication: 10.1002/ijc.34870
URL of the first publication: https://doi.org/10.1002/ijc.34870
Link to this record: urn:nbn:de:bsz:291--ds-419107
hdl:20.500.11880/37491
http://dx.doi.org/10.22028/D291-41910
ISSN: 1097-0215
0020-7136
Date of registration: 16-Apr-2024
Description of the related object: Supporting Information
Related object: https://onlinelibrary.wiley.com/action/downloadSupplement?doi=10.1002%2Fijc.34870&file=ijc34870-sup-0001-Supinfo.pdf
Faculty: M - Medizinische Fakultät
Department: M - Medizinische Biometrie, Epidemiologie und medizinische Informatik
M - Pädiatrie
M - Radiologie
Professorship: M - Prof. Dr. Norbert Graf
M - Prof. Dr. Stefan Wagenpfeil
M - Keiner Professur zugeordnet
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes



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