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Related Experiment Videos

Wilms' tumor after treatment.

M Brisigotti1, C Cozzutto, G Fabbretti

  • 1Department of Pathology, Giannina Gaslini Children's Hospital, Genoa, Italy.

Pediatric Pathology
|May 1, 1992
PubMed
Summary

Preoperative therapy for Wilms tumors (WTs) caused significant changes, including necrosis and muscle cell differentiation. These factors, particularly tumor necrosis and rhabdomyoblast ratio, may indicate prognosis in pediatric cancer patients.

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Area of Science:

  • Pediatric Oncology
  • Surgical Pathology
  • Cancer Research

Background:

  • Wilms tumors (WTs) are the most common pediatric kidney cancer.
  • Preoperative therapy is a standard treatment for WTs, aiming to reduce tumor size before surgical removal.
  • Understanding the morphological changes induced by preoperative therapy is crucial for accurate diagnosis and prognosis.

Purpose of the Study:

  • To investigate the morphological changes in Wilms tumors (WTs) following preoperative therapy.
  • To evaluate the prognostic implications of these treatment-induced changes, such as necrosis and differentiation.
  • To assess the impact of chemotherapy on tumor anaplasia.

Main Methods:

  • Histopathological analysis of 61 Wilms tumors (WTs) from patients treated preoperatively.

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  • Comparison with 27 WTs from a control group that did not receive preoperative treatment.
  • Assessment of necrosis extent, epithelial and rhabdomyoblastic components, and anaplasia.

    • Main Results:

    • Preoperative therapy induced marked and diffuse morphological changes, including extensive necrosis (up to 90%) in treated WTs.
    • Epithelial and rhabdomyoblastic components showed resistance to treatment but underwent differentiation and maturation.
    • Extensive necrosis and a higher rhabdomyoblast/tumor mass ratio post-treatment were associated with better outcomes, though not statistically significant. Chemotherapy did not affect anaplasia.

    Conclusions:

    • Preoperative therapy significantly alters Wilms tumor morphology, with necrosis and differentiation being key changes.
    • The extent of necrosis and the post-treatment rhabdomyoblast ratio appear to hold prognostic value in Wilms tumors.
    • Anaplasia in Wilms tumors is not affected by current chemotherapy regimens.