Evaluation of effect of preoperative chemotherapy on Wilms' tumor histopathology

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Taskinen , S , Lohi , J , Koskenvuo , M & Taskinen , M 2018 , ' Evaluation of effect of preoperative chemotherapy on Wilms' tumor histopathology ' , Journal of Pediatric Surgery , vol. 53 , no. 8 , pp. 1611-1614 . https://doi.org/10.1016/j.jpedsurg.2017.10.002

Title: Evaluation of effect of preoperative chemotherapy on Wilms' tumor histopathology
Author: Taskinen, Seppo; Lohi, Jouko; Koskenvuo, Minna; Taskinen, Mervi
Contributor organization: Lastenkirurgian yksikkö
Children's Hospital
Clinicum
Medicum
Department of Pathology
Hematologian yksikkö
Lastentautien yksikkö
HUS Children and Adolescents
HUS Comprehensive Cancer Center
Date: 2018-08
Language: eng
Number of pages: 4
Belongs to series: Journal of Pediatric Surgery
ISSN: 0022-3468
DOI: https://doi.org/10.1016/j.jpedsurg.2017.10.002
URI: http://hdl.handle.net/10138/304164
Abstract: Purpose: To evaluate usefulness of cutting needle biopsy (CNB) to recognize pediatric renal tumors and to predict the evolution of histology during preoperative chemotherapy of Wilms tumors. Methods: Ninety pediatric patients were operated for renal tumors at our institution in 1988-2015. We included all 64 patients who had undergone CNB at diagnosis and whose CNB and nephrectomy samples were available for re-evaluation. Results: The CNB was diagnostic in all 59 Wilms tumors but only in two out of live non-Wilms tumors. Anaplasia was missed by CNB in one of three with diffuse anaplasia in nephrectomy specimens. In Wilms tumors the proportions of the blastemal, stromal and epithelial components were 55% (IQR 25-85), 28% (IQR 10-58) and 2% (IQR 0-10) in CNB samples and 5% (IQR 0-64), 15% (IQR 0-50) and 15% (IQR 0-44) in the nephrectomy specimens (p-values 0.002,0.599 and 0.005 respectively). The degree of tumor necrosis was in median 80% (IQR 21-97), after preoperative chemotherapy. The degree of tumor necrosis after chemotherapy had a positive correlation with the proportion of blastemal component (p = 0.008) and a negative correlation with proportion of epithelial component in pre-chemotherapy CNB samples (p <0.001). Conclusions: Wilms tumors are usually recognizable unlike non-Wilms tumors in CNB at diagnosis. In Wilms tumors, high blastemal cell content is associated with significant tumor necrosis during pre-operative chemotherapy. Our results do not support routine use of CNB in diagnosis of renal tumors. Type of study: Retrospective review. (C) 2017 Elsevier Inc. All rights reserved.
Subject: Wilms tumor
Pathology
Kidney
Children
Chemotherapy
RENAL TUMORS
INTERNATIONAL SOCIETY
PERCUTANEOUS BIOPSY
NEPHROBLASTOMA
TRIAL
NEPHRECTOMY
MANAGEMENT
CHILDHOOD
CHILDREN
3123 Gynaecology and paediatrics
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: publishedVersion


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