Surgical treatment of invasive fungal infection in pediatric oncology.

Autor: Federica F; Pediatric Surgery, Department of Woman and Child's Health, University Hospital of Padua, Padua, Italy., Elisa Z; Pediatric Surgery, Department of Woman and Child's Health, University Hospital of Padua, Padua, Italy.; Department of Pediatric Surgery, Pediatric Hospital Regina Margherita, Turin, Italy., Maria Grazia P; Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Women's and Child's Health, University of Padua, Padua, Italy., Calogero V; Pediatric Surgery, Department of Woman and Child's Health, University Hospital of Padua, Padua, Italy., Patrizia DI; Division of Pediatric Surgery, Department of Emergencies and Organ Transplantation, Bari University, Bari, Italy., Maria Caterina P; Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Women's and Child's Health, University of Padua, Padua, Italy., Marica P; Division of Pediatric Infectious Diseases, Department of Women's and Children's Health, University of Padua, Padua, Italy., Piergiorgio G; Pediatric Surgery, Department of Woman and Child's Health, University Hospital of Padua, Padua, Italy., DeCorti F; Pediatric Surgery, Department of Woman and Child's Health, University Hospital of Padua, Padua, Italy.
Jazyk: angličtina
Zdroj: European journal of haematology [Eur J Haematol] 2024 Jul; Vol. 113 (1), pp. 90-98. Date of Electronic Publication: 2024 Apr 01.
DOI: 10.1111/ejh.14205
Abstrakt: Background: Invasive fungal disease (IFD) is typically aggressive and related with high mortality in children with a hematological malignancy. The association of medical and surgical treatment may ameliorate the outcome. The aim of this study was to analyze the surgical treatment of fungal infections in pediatric oncological populations.
Methods: Retrospective study (2000-2022) of a single-center experience. We reviewed the medical record of all patients with hematologic malignancies and IFD, analyzing the outcome.
Results: From the 70 pediatric cases of hematologic malignancies with the diagnosis IFD over 22 years, we included in the present study 44 cases who required surgical approaches for either diagnosis or treatment. Twenty-one patients were males and the mean age was 11 (range 1-23) years. The main indications for surgery were lack of improvement following medical treatment and/or progression of fungal infection (80%) and diagnosis confirmation (20%). Only five patients needed an emergency operation for rapid worsening of symptoms. The most common site of infection was the lung (80%) and the most frequently identified pathogen was Aspergillus (75%). The most common surgical procedures were lobectomy (performed in 17 patients) and atypical lung resection (10). Complications of surgery were mostly treated by medical approach. The mean time of resumption of oncological treatment was 40 (range 0-150) days.
Conclusions: Surgery is an important step in the multimodal treatment of invasive fungal infection with excellent resolution rate. Overall mortality depends on the underlying malignancy.
(© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
Externí odkaz: