|Table of Contents|

Analysis of clinicopathological characteristics and prognostic influencing factors of pediatric nephroblastoma

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 17
Page:
3327-3332
Research Field:
Publishing date:

Info

Title:
Analysis of clinicopathological characteristics and prognostic influencing factors of pediatric nephroblastoma
Author(s):
CHEN Chunni; WANG Caihong; GENG Yuanyuan; YANG Jun
Department of Pathology,the Second Affiliated Hospital of Xi'an Jiaotong University (Northwest Hospital)，Shaanxi Xi′an 710004，China.
Keywords:
nephroblastoma; clinicopathological characteristics; prognostic
PACS:
R737.11
DOI:
10.3969/j.issn.1672-4992.2024.17.026
Abstract:
Objective:To investigate the clinicopathological features and prognosis of children with nephroblastoma.Methods:A total of 34 nephroblastoma patients who received treatment at the scond Affiliated Hospital of Xi'an Jiaotong University from 2017 to 2022 were selected for retropectived analysis and Kaplan-Meier method was used to calculate the survival rate and create survival curve.Univariate (Kaplan-Meier test and log-rank test) and multivariate(COX regression) survival analysis were perfored for the factors related to the prognosis of pediatric nephroblastoma,such as age,gender,site of onset,clinical manifestations,clinical stages,pathological classificatim,tumor size,lymph node metastasis vascular embolus,distant metastasis,peroperative chemotherapy.Results:Among the 34 patients,sixteen were males and eighteen were females,and age ranged from five months to ten years(mean 2 years).71%（24/34） had abdominal mass as the first sysptom,32%（11/34） had distant metastasis and lung metastasis was the most common.Tumor size ranged from 4.5 cm to 20 cm(mean 10.1 cm),the cut surface of most tumors was solid and grayish with clear border.Microscopy consisted of four main histologic types:13 cases of mixed,3 cases of epithelial,14 cases of blastemal,and 4 cases of stromal.Clinical stage and metastasis were significantly affected the prognosis of children with nephroblastoma(P＜0.05).But it was not significantly affected by gender,age,site of onset,clinical manifestations,pathological classification,tumor size,lymph node metastasis,vascular cancer embolus,preoperative chemotherapy treatment and surgical approach(P>0.05).Multivariate COX proportional hazards regression analysis showed that metastasis was an independent risk factor for prognosis of nephroblastoma(P＜0.05).Conclusion:Nephroblastoma is a highly curable malignant tumor in children.Early detection,early diagnosis,and early clarification of clinical stage can better assist the clinic in choosing the appropriate treatment plan.For children with high clinical stage and distant metastases,preoperative chemotherapy is beneficial to improve the prognosis of children.

References:

［1］ XIE W,WEI L,GUO J,et al.Physiological functions of wilms' tumor 1-associating protein and its role in tumourigenesis［J］.J Cell Biochem,2019,120(7):10884-10892.
［2］ GRATIAS EJ,DOME JS,JENNINGS LJ,et al.Association of chromosome 1q gain with Inferior survival in favorable-histology wilms tumor:a report from the children's oncology group［J］.J Clin Oncol,2016,34(26):3189-3194.
［3］ DOME JS,GRAF N,GELLER JI,et al.Advances in wilms tumor treatment and biology:progress through international collaboration［J］.J Clin Oncol,2015,33(27):2999-3007.
［4］杨文萍,武海燕,张文,等.儿童肾母细胞瘤病理诊断共识［J］.中华病理学杂志,2017,046(003):149-154. YANG WP,WU HY,ZHANG W,et al.Expert consensus on pediatric nephroblastoma［J］.Chinese Journal of Pathology,2017,046(003):149-154.
［5］廖玮玮,何志旭,冉立.1147例儿童实体瘤临床特征分析［J］.贵州医科大学学报,2017,42(10):1227-1232. LIAO WW,HE ZX,RAN L.Clinical analysis of 1147 solid tumor in children［J］.Journal of Guizhou Medecine University,2017,42(10):1227-1232.
［6］ 中华医学会小儿外科学分会泌尿外科学组.儿童肾母细胞瘤诊疗专家共识［J］.中华小儿外科杂志,2020,41(07):585-590. Group of Urological Surgery,Branch of Pediatric Surgery,Chinese Medical Association.Expert Consensus on Pediatric Nephroblastoma［J］.Chinese Journal of Pediatric Surgery,2020,41(07):585-590.
［7］ SALTZMAN AF,COST NG,ROMAO RLP.Wilms tumor［J］.Urol Clin North Am,2023,50(3):455-464.
［8］ 何丽,徐松,张眉,等.腹膜后畸胎瘤样肾母细胞瘤1例［J］.实用放射学杂志,2021,37(8):1401-1402. HE L,XU S,ZHANG M,et al.One case:retroperitoneal teratoid wilms tumor［J］.J Pract Radiol,2021,37(8):1401-1402.
［9］李艳华,蒋莎义,廖雪莲,等.16例儿童横纹肌样瘤的临床特点及其诊治分析［J］.山东医药,2020,60(16):72-74. LI YH,JIANG SY,LIAO XL,et al.Analysis of clinical characteristics and their diagnosis and treatment of 16 cases malignant rhabdomyosarcoma in childhood［J］.Shandong Medical Journal,2020,60(16):72-74.
［10］ 金汝佳,王青杰,马怡晖.儿童恶性横纹肌样瘤9例临床病理分析［J］.临床与实验病理学杂志,2020,36(10):1209-1211. JIN RJ,WANG QJ,MA YH.Clinicopathologic analysis of 9 cases malignant rhabdomyosarcoma in childhood［J］.J Clin Exp pathol,2020,36(10):1209-1211.
［11］ 王亚楠,田亚明,许艳平,等.儿童肾母细胞瘤的临床病理特征及预后影响因素分析［J］.实用癌症杂志,2022,37(4):653-655. WANG YN,TIAN YM,XU YP,et al.Analysis of clinicopathological characteristics and prognostic influencing factors of pediatric nephroblastoma［J］.The Practical Journal of Cancer,2022,37(4):653-655.
［12］储婧.儿童肾母细胞瘤临床病理资料与预后的影响因素分析［J］.临床泌尿外科杂志,2023,38(4):260-264. CHU J.Analysis of clinicopathological characteristics and prognostic influencing factors of pediatric nephroblastoma［J］.Journal of Clinical Urology,2023,38(4):260-264.
［13］赵利敏.儿童肾母细胞瘤预后的危险因素分析［J］.罕少疾病杂志,2023,30(4):67-68. ZHAO LM.Analysis of the risk factors for the prognosis of pediatric nephroblastoma［J］.Journal of Rare and Uncommon Diseases,2023,30(4):67-68.
［14］洪博,董瑞.肾母细胞瘤治疗研究进展［J］.临床小儿外科杂志,2021,20(6):569-575. HONG B,DONG R.Recent advances in the treatment of wilms tumor［J］.J Clin Ped Sur,2021,20(6):569-575.
［15］ KUMAR SAS.Is pre-operative chemotherapy desirable in all patients of wilms' tumor［J］.Indian Journal of Pediatrics,2017,84(9):709-714.
［16］ 张伟令,胡慧敏,黄东生,等.儿童肾母细胞瘤39例临床分析［J］.中国医学前沿杂志（电子版）,2019,11(11):46-49. ZHANG WL,HU HM,HUANG DS,et al.Clinical analysis of 39 children with nephroblastoma［J］.Chinese Journal of the Frontiers of Medical Science(Electronic Version),2019,11(11):46-49.
［17］ ALDRINK JH,HEATON TE,DASGUPTA R,et al.Update on wilms tumor［J］.J Pediatr Surg,2019,54(3):390-397.
［18］ DOME JS,PERLMAN EJ,GRAF N.Risk stratification for wilms tumor:current approach and future directions［J］.American Society of Clinical Oncology Educational Book,2014,34(1):215-223.
［19］CONTE B,SHEN C,THOMPSON,et al.Long-term outcomes after abdominal radiation for wilms tumor:A 20-year experience［J］.American Journal of Clinical Oncology,2024,47(3):128-131.
［20］ WU XW,ZHOU PP,DONG Q.Survival assessment of nephron-sparing surgery or radical nephrectomy in children with unilateral wilms tumor receiving adjuvant chemotherapy:a retrospective cross-sectional study［J］.European Review for Medical and Pharmacological Sciences,2024,28(3):1095-1102.
［21］ IRTAN S,EHRICH PF,Pritchard JK.Wilms tumor:"state-of-the-art" update［J］.Semin Pediatr Surg,2016,25(5):250-256.

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Last Update: 2024-07-31