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[Wilms' tumor. Its multidisciplinary management]
Insights
Wilms tumor prognosis depends on clinical stage and histology. Early stages with favorable histology have an 82% survival rate, suggesting chemotherapy over radiotherapy.
Area of Science:
- Pediatric Oncology
- Cancer Research
- Clinical Pathology
Context:
- Wilms tumor is a common pediatric kidney cancer.
- Accurate staging and histopathological subtyping are crucial for treatment planning.
Purpose:
- To identify prognostic factors in pediatric Wilms tumor.
- To evaluate treatment strategies based on stage and histology.
- To determine survival rates in a cohort of affected children.
Summary:
- This study analyzed 115 children with Wilms tumor, with Stage II being predominant. Prognostic factors included clinical stage and histology. Patients in Stages I and II with favorable histology benefited from chemotherapy over radiotherapy, achieving an 82% five-year survival rate.
- Unfavorable histology correlated with advanced stages (II and IV) and poorer outcomes.
- Statistical significance was observed in disease-free survival between early (I-II) and advanced (III-IV) stages (p=0.01), and between unfavorable and favorable histology (p=0.01).
Impact:
- Findings support tailored treatment protocols for Wilms tumor, optimizing chemotherapy and radiotherapy use.
- Highlights the importance of multidisciplinary management for improving pediatric cancer outcomes.
- Provides valuable data for refining prognostic models and treatment guidelines in pediatric nephroblastoma.
Abstract:
A total of 115 children with a histopathological diagnosis of Wilms' tumor were studied. The average age was three years. An abdominal tumor was the most frequent clinical manifestations, with a predominating clinicopathological stage II. The most important prognostic factors were the clinical stage and histological subvariety. A five year disease free period during the early stages was very favorable. On the other hand, advances stages and unfavorable histopathology established a poor prognosis. In our experience, stages I and II and favorable histology should not receive radiotherapy but instead brief chemotherapy. The global five year survival was 82%. All the patients with an unfavorable histology occupied stages II and IV. a comparison of disease free survival between stages I and II against III and IV showed statistical significance (p 0.01). Statistical significance also appeared upon comparison between unfavorable versus favorable (p 0.01) histology. Emphasis is placed upon multidisciplinary management of this type of malignant neoplasias.