Effect of Wilms tumor histology on response to neoadjuvant chemotherapy

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Taskinen , S , Leskinen , O , Lohi , J , Koskenvuo , M & Taskinen , M 2019 , ' Effect of Wilms tumor histology on response to neoadjuvant chemotherapy ' , Journal of Pediatric Surgery , vol. 54 , no. 4 , pp. 771-774 . https://doi.org/10.1016/j.jpedsurg.2018.05.010

Title: Effect of Wilms tumor histology on response to neoadjuvant chemotherapy
Author: Taskinen, Seppo; Leskinen, Outi; Lohi, Jouko; Koskenvuo, Minna; Taskinen, Mervi
Contributor: University of Helsinki, Lastenkirurgian yksikkö
University of Helsinki, HUS Medical Imaging Center
University of Helsinki, Department of Pathology
University of Helsinki, Children's Hospital
University of Helsinki, Lastentautien yksikkö
Date: 2019-04
Language: eng
Number of pages: 4
Belongs to series: Journal of Pediatric Surgery
ISSN: 0022-3468
URI: http://hdl.handle.net/10138/301857
Abstract: Purpose: To evaluate the association between Wilms tumor histology at diagnosis and the change in Wilms' tumor volume during preoperative chemotherapy. Methods: We included all the 52 patients operated for Wilms tumor at 1988-2015, who had both pathology samples and either CT or MRI-images before and after preoperative chemotherapy, available for reevaluation. Results: The median tumor volume was 586 ml (IQR 323-903) at diagnosis. The median change in tumor volume was -68% (IQR -85 to -40, p <0.001) and the proportion of tumor necrosis 85% (IQR 24-97), after preoperative chemotherapy. There was a correlation between blastemal cell content in prechemotherapy cutting needle biopsy (CNB) sample and the reduction in tumor volume (Rho = -0.452, p = 0.002). High stromal and epithelial cell contents in CNB samples were associated with the lesser change in tumor volume (Rho = 0.279, p = 0.053 and Rho = 0.300, p = 0.038 respectively). Reduction of tumor volume and the proportion of tumor necrosis after chemotherapy were associated (Rho = -0.502, p <0.001). The actual viable tumor volume decreased in median by 97% (IQR 65-100), and the decrease could be seen in all cellular components. In three patients, the tumor volume increased more than 10% during the preoperative chemotherapy. Two of them had anaplastic tumor in the nephrectomy specimen. Conclusion: Wilms tumor total and viable tumor volumes were reduced by 68% and 97% with preoperative chemotherapy, respectively. High proportion of blastemal cells in CNB was associated with greatest decrease in Wilms tumor volume. Increase in tumor volume during preoperative chemotherapy may indicate anaplastic tumor and prolonging of preoperative therapy should be avoided. Type of study: Retrospective review. (C) 2018 Elsevier Inc. All rights reserved.
Subject: 3126 Surgery, anesthesiology, intensive care, radiology
Wilms' tumor
Chemotherapy
Tumor volume
Histology
IMMEDIATE NEPHRECTOMY
MANAGEMENT
BIOPSY
VOLUME
TRIAL
SURGICAL COMPLICATIONS
PREOPERATIVE CHEMOTHERAPY
PREDICT
UKW3
NEPHROBLASTOMA
3123 Gynaecology and paediatrics
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