Surgical management, staging, and outcomes of Wilms tumours with intravascular extension: Results of the IMPORT study
| Autor: | Minou Oostveen, Tanzina Chowdhury, Imran Mushtaq, Øystein E. Olsen, Suzanne Tugnait, Tom A. Watson, Mark Powis, Sabine Irtan, Kristina Dzhuma, Naima Smeulders, Richard A Williams, Gordan M. Vujanic, Jesper Brok, Reem Al-Saadi, Kathy Pritchard-Jones, Susan C. Shelmerdine |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Tumour thrombus business.industry Thrombosis Wilms' tumor General Medicine medicine.disease Wilms Tumor Tumour stage Kidney Neoplasms Progression-Free Survival Resection Pediatrics Perinatology and Child Health medicine Humans Surgery Level ii Radiology Neoplasm Recurrence Local Stage (cooking) Thrombus Renal vein Child business Neoplasm Staging |
| Zdroj: | Journal of Pediatric Surgery. 57:572-578 |
| ISSN: | 0022-3468 |
| Popis: | To review surgical management, tumour stage and clinical outcomes in children with intravascular extension of Wilms tumour (WT) registered in a national clinical study (2012-19).WTs with presence/suspicion of tumour thrombus in the renal vein (RV) or beyond on radiology, surgery or pathology case report forms were identified. Only cases where thrombus was confirmed by surgeon and/or reference pathologist were included. Surgical management, disease stage, overall (OS) and event free survival (EFS) were investigated.69/583 (11.8%) patients met the inclusion criteria. Forty-six (67%) had abdominal stage III due to thrombus-related reasons: 11 had macroscopically incomplete resection, including 8 cases where cavotomy was not performed; 20 had piecemeal complete resection of thrombus; 15 had microscopically positive resection margins at the RV. 66% of tumour thrombi contained viable tumour. There were eight relapses and five deaths. EFS, but not OS, was significantly associated with completeness of surgical resection (P0.05). OS and EFS were also significantly associated with histological risk group (P0.05) but not with viability of tumour thrombus (P=0.19; P=0.59).WTs with intravascular extension have a high risk of local stage III due to thrombus-related reasons. Controlled complete removal of the thrombus should be the aim of surgery.Level II. |
| Databáze: | OpenAIRE |
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