دورية أكاديمية
أعرض في EDS

Response of bilateral Wilms tumor to chemotherapy suggests histologic subtype and guides treatment.

التفاصيل البيبلوغرافية
العنوان: Response of bilateral Wilms tumor to chemotherapy suggests histologic subtype and guides treatment.
المؤلفون: Duncan C; Departments of Surgery, St Jude Children's Research Hospital, Memphis, TN, USA., Sarvode Mothi S; Departments of Biostatistics, St Jude Children's Research Hospital, Memphis, TN, USA., Santiago TC; Departments of Pathology, St Jude Children's Research Hospital, Memphis, TN, USA., Coggins JA; Departments of Surgery, St Jude Children's Research Hospital, Memphis, TN, USA., Graetz DE; Departments of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA.; Departments of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA., Bishop MW; Departments of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA., Mullen EA; Department of Pediatric Hematology/Oncology, Dana-Farber Cancer Institute, Boston Children's Hospital, Boston, MA, USA., Murphy AJ; Departments of Surgery, St Jude Children's Research Hospital, Memphis, TN, USA., Green DM; Departments of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA., Krasin MJ; Departments of Radiation Oncology, St Jude Children's Research Hospital, Memphis, TN, USA., Davidoff AM; Departments of Surgery, St Jude Children's Research Hospital, Memphis, TN, USA.
المصدر: Journal of the National Cancer Institute [J Natl Cancer Inst] 2024 Aug 01; Vol. 116 (8), pp. 1230-1237.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Oxford University Press Country of Publication: United States NLM ID: 7503089 Publication Model: Print Cited Medium: Internet ISSN: 1460-2105 (Electronic) Linking ISSN: 00278874 NLM ISO Abbreviation: J Natl Cancer Inst Subsets: MEDLINE
أسماء مطبوعة: Publication: <2003-> : Cary, NC : Oxford University Press
Original Publication: Bethesda, Md., U. S. Dept. of Health, Education, and Welfare, Public Health Service, National Institutes of Health; Washington, for sale by the Supt. of Docs., U. S. Govt. Print. Off.
مواضيع طبية MeSH: Wilms Tumor*/pathology , Wilms Tumor*/drug therapy , Wilms Tumor*/surgery , Wilms Tumor*/therapy , Kidney Neoplasms*/pathology , Kidney Neoplasms*/drug therapy , Kidney Neoplasms*/surgery , Neoadjuvant Therapy*, Humans ; Male ; Female ; Retrospective Studies ; Infant ; Child, Preschool ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Nephrectomy ; Treatment Outcome
مستخلص: Background: Patients with bilateral Wilms tumor initially receive neoadjuvant chemotherapy to shrink the tumors and increase the likelihood of successful nephron-sparing surgery. Biopsy of poorly responding tumors is often done to better understand therapy resistance. The purpose of this retrospective, single-institution study was to determine whether initial chemotherapy response is associated with tumor histology, potentially obviating the need for biopsy or change in chemotherapy.
Methods: Patients with synchronous bilateral Wilms tumors who underwent surgery at St Jude Children's Research Hospital from January 2000 to March 2022 were considered for this study. A mixed-effects logistic regression model was used to evaluate the likelihood of the tumor being stromal predominant, as predicted by tumor response to neoadjuvant chemotherapy.
Results: A total of 68 patients were eligible for this study. Tumors that increased in size had an odds ratio of 19.5 (95% confidence interval [CI] = 2.46 to 155.03) for being stromal predominant vs any other histologic subtype. Age at diagnosis was youngest in patients with stromal-predominant tumors, with a mean age of 18.8 (14.1) months compared with all other histologic subtypes (χ2 = 7.05, P = .07). The predictive value of a tumor growing combined with patient aged younger than 18 months for confirming stromal-predominant histology was 85.7% (95% CI = 57.18% to 93.5%).
Conclusions: Tumors that increased in size during neoadjuvant chemotherapy were most frequently stromal-predominant bilateral Wilms tumor, especially in younger patients. Therefore, nephron-sparing surgery, rather than biopsy, or extension or intensification of neoadjuvant chemotherapy, should be considered for bilateral Wilms tumors that increase in volume during neoadjuvant chemotherapy, particularly in patients aged younger than 18 months.
(© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
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معلومات مُعتمدة: P30 CA021765 United States CA NCI NIH HHS; P30 CA21765 Cancer Center Support
تواريخ الأحداث: Date Created: 20240328 Date Completed: 20240808 Latest Revision: 20240810
رمز التحديث: 20240812
مُعرف محوري في PubMed: PMC11308166
DOI: 10.1093/jnci/djae072
PMID: 38539045
قاعدة البيانات: MEDLINE
الوصف
تدمد:1460-2105
DOI:10.1093/jnci/djae072