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Sentinel Lymph Node Mapping and Biopsy for Endometrial Cancer at Early Stage with Laparoscopy

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Nephroblastoma: does the decrease in tumor volume under preoperative chemotherapy predict the lymph nodes status at

Jan Godzinski¹, Harm van Tinteren, Jan de Kraker

¹Marciniak Hospital, Pediatric Surgery, Wroclaw and Technical University of Opole, Institut of Physiotherapy, Opole, Poland. jgodzin@wp.pl

Pediatric Blood & Cancer

|May 4, 2011

Summary

This summary is machine-generated.

Tumor volume decrease during chemotherapy does not predict lymph node status in nephroblastoma. Larger initial tumor size increases lymph node invasion risk, making volume change an unreliable indicator for nephron-sparing surgery safety.

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Published on: September 8, 2021

Area of Science:

Pediatric Oncology
Surgical Oncology
Medical Imaging

Background:

Nephron-sparing surgery (NSS) offers functional benefits for unilateral nephroblastoma.
Regional lymph node (LN) involvement can negate NSS benefits due to radiotherapy.
Assessing LN status preoperatively is crucial for treatment planning.

Purpose of the Study:

To determine if a decrease in tumor volume after preoperative chemotherapy predicts lymph node (LN) clearance.
To evaluate the relationship between tumor volume changes and LN status in nephroblastoma patients.

Main Methods:

Retrospective review of 1,360 localized nephroblastoma patients from the SIOP 9301 trial (1993-2001).
Analysis of tumor volume changes before and after neoadjuvant chemotherapy.
Comparison of LN status at surgery based on initial tumor volume and volume reduction.

Main Results:

5.5% of patients had tumor-positive lymph nodes (LN(+)) at surgery.
Tumor volume decreased by 67% in the LN(+) group and 62% in the LN(-) group during chemotherapy (not statistically significant).
Initial tumor volume was significantly larger in LN(+) patients, and smaller initial tumors (<318 ml) were associated with less frequent LN involvement.

Conclusions:

Tumor volume reduction during preoperative chemotherapy is not a reliable predictor of lymph node status in nephroblastoma.
Initial tumor volume is a significant factor associated with lymph node invasion risk.
The low incidence of lymph node positivity (5.5%) suggests a low overall risk for NSS safety concerns.