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Poppe MM, Tai A, Li XA, Miften M, Olch A, Marks LB, Qureshi BM, Spunt SL, Shnorhavorian M, Nelson G, Ronckers C, Kalapurakal J, Marples B, Constine LS, Liu AK. Kidney Disease in Childhood Cancer Survivors Treated With Radiation Therapy: A PENTEC Comprehensive Review. Int J Radiat Oncol Biol Phys 2024; 119:560-574. [PMID: 37452796 DOI: 10.1016/j.ijrobp.2023.02.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 02/11/2023] [Accepted: 02/16/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE Kidney injury is a known late and potentially devastating complication of abdominal radiation therapy (RT) in pediatric patients. A comprehensive Pediatric Normal Tissue Effects in the Clinic review by the Genitourinary (GU) Task Force aimed to describe RT dose-volume relationships for GU dysfunction, including kidney, bladder, and hypertension, for pediatric malignancies. The effect of chemotherapy was also considered. METHODS AND MATERIALS We conducted a comprehensive PubMed search of peer-reviewed manuscripts published from 1990 to 2017 for investigations on RT-associated GU toxicities in children treated for cancer. We retrieved 3271 articles with 100 fulfilling criteria for full review, 24 with RT dose data and 13 adequate for modeling. Endpoints were heterogenous and grouped according to National Kidney Foundation: grade ≥1, grade ≥2, and grade ≥3. We modeled whole kidney exposure from total body irradiation (TBI) for hematopoietic stem cell transplant and whole abdominal irradiation (WAI) for patients with Wilms tumor. Partial kidney tolerance was modeled from a single publication from 2021 after the comprehensive review revealed no usable partial kidney data. Inadequate data existed for analysis of bladder RT-associated toxicities. RESULTS The 13 reports with long-term GU outcomes suitable for modeling included 4 on WAI for Wilms tumor, 8 on TBI, and 1 for partial renal RT exposure. These reports evaluated a total of 1191 pediatric patients, including: WAI 86, TBI 666, and 439 partial kidney. The age range at the time of RT was 1 month to 18 years with medians of 2 to 11 years in the various reports. In our whole kidney analysis we were unable to include chemotherapy because of the heterogeneity of regimens and paucity of data. Age-specific toxicity data were also unavailable. Wilms studies occurred from 1968 to 2011 with mean follow-ups 8 to 15 years. TBI studies occurred from 1969 to 2004 with mean follow-ups of 4 months to 16 years. We modeled risk of dysfunction by RT dose and grade of toxicity. Normal tissue complication rates ≥5%, expressed as equivalent doses, 2 Gy/fx for whole kidney exposures occurred at 8.5, 10.2, and 14.5 Gy for National Kidney Foundation grades ≥1, ≥2, and ≥3, respectively. Conventional Wilms WAI of 10.5 Gy in 6 fx had risks of ≥grade 2 toxicity 4% and ≥grade 3 toxicity 1%. For fractionated 12 Gy TBI, those risks were 8% and <3%, respectively. Data did not support whole kidney modeling with chemotherapy. Partial kidney modeling from 439 survivors who received RT (median age, 7.3 years) demonstrated 5 or 10 Gy to 100% kidney gave a <5% risk of grades 3 to 5 toxicity with 1500 mg/m2 carboplatin or no chemo. With 480 mg/m2 cisplatin, a 3% risk of ≥grade 3 toxicity occurred without RT and a 5% risk when 26% kidney received ≥10 Gy. With 63 g/m2 of ifosfamide, a 5% risk of ≥grade 3 toxicity occurred with no RT, and a 10% toxicity risk occurred when 42% kidney received ≥10 Gy. CONCLUSIONS In patients with Wilms tumor, the risk of toxicity from 10.5 Gy of WAI is low. For 12 Gy fractionated TBI with various mixtures of chemotherapy, the risk of severe toxicity is low, but low-grade toxicity is not uncommon. Partial kidney data are limited and toxicity is associated heavily with the use of nephrotoxic chemotherapeutic agents. Our efforts demonstrate the need for improved data gathering, systematic follow-up, and reporting in future clinical studies. Current radiation dose used for Wilms tumor and TBI appear to be safe; however, efforts in effective kidney-sparing TBI and WAI regimens may reduce the risks of renal injury without compromising cure.
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Affiliation(s)
- Matthew M Poppe
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.
| | - An Tai
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - X Allen Li
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Moyed Miften
- Department of Radiation Oncology, University of Colorado School of Medicine, Denver, Colorado
| | - Arthur Olch
- Department of Radiation Oncology, Keck School of Medicine, University of Southern California, and Children's Hospital Los Angeles, Los Angeles, California
| | - Lawrence B Marks
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina
| | - Bilal Mazhar Qureshi
- Radiation Oncology Section, Department of Oncology, Aga Khan University, Karachi, Pakistan
| | - Sheri L Spunt
- Stanford University School of Medicine, Department of Pediatrics, Stanford, California
| | - Margarett Shnorhavorian
- Department of Urology, Seattle Children's Hospital, University of Washington, Seattle, Washington
| | - Geoff Nelson
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Cecile Ronckers
- Princess Máxima Center for Paediatric Oncology, Utrecht, Netherlands; Division of Organisational Health Care Research, Departement of Health Care Research, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - John Kalapurakal
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Brian Marples
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York
| | - Louis S Constine
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York
| | - Arthur K Liu
- UC Health - Poudre Valley Hospital, Radiation Oncology, Fort Collins, Colorado
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2
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Russell BE, Kianmahd RR, Munster C, Yu A, Ahad L, Tan WH. Clinical findings in 39 individuals with Bohring-Opitz syndrome from a global patient-driven registry with implications for tumor surveillance and recurrence risk. Am J Med Genet A 2023; 191:1050-1058. [PMID: 36751885 DOI: 10.1002/ajmg.a.63125] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/01/2022] [Accepted: 01/04/2023] [Indexed: 02/09/2023]
Abstract
Bohring-Opitz syndrome (BOS) is a rare genetic condition caused by pathogenic variants in ASXL1, which is a gene involved in chromatin regulation. BOS is characterized by severe intellectual disabilities, distinctive facial features, hypertrichosis, facial nevus simplex, severe myopia, a typical posture in infancy, variable anomalies, and feeding issues. Wilms tumor has also been reported in two individuals. We report survey data from the largest known cohort of individuals with BOS with 34 participants from the ASXL Patient-Driven Registry and data on five additional individuals with notable findings. Important or novel findings include hepatoblastoma (n = 1), an additional individual with Wilms tumor, two families with a parent who is mosaic including a pair of siblings, birth weights within the normal range for the majority of participants, as well as presence of craniosynostosis and hernias. Data also include characterization of communication, motor skills, and care level including hospitalization frequency and surgical interventions. No phenotype-genotype correlation could be identified. The ASXL Registry is also presented as a crucial tool for furthering ASXL research and to support the ASXL community.
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Affiliation(s)
- Bianca E Russell
- Department of Pediatrics, Division of Genetics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA.,Department of Pediatrics, Division of Human Genetics, Cincinnati Children's Hospital, Cincinnati, Ohio, USA
| | - Rebecca R Kianmahd
- Department of Pediatrics, Division of Genetics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
| | - Chelsea Munster
- Department of Pediatrics, Division of Human Genetics, Cincinnati Children's Hospital, Cincinnati, Ohio, USA.,Department of Medicine, California University of Science and Medicine, Colton, California, USA
| | - Anna Yu
- Department of Pediatrics, Division of Genetics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
| | - Leena Ahad
- Department of Pediatrics, Division of Human Genetics, Cincinnati Children's Hospital, Cincinnati, Ohio, USA.,Department of Biological Sciences, Department of Neuroscience, University of Cincinnati College of Arts & Sciences, Cincinnati, Ohio, USA
| | - Wen-Hann Tan
- Division of Genetics and Genomics, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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Hemrom A, Arora G, Damle NA, Bal C. Comparative Role of 18F-DOPA PET/CT and 131I-MIBG Scintigraphy in Neuroblastoma and Application of Curie and SIOPEN Scoring Systems in 18F-DOPA PET/CT. Nucl Med Mol Imaging 2022; 56:236-244. [PMID: 36310834 PMCID: PMC9508302 DOI: 10.1007/s13139-022-00762-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 06/15/2022] [Accepted: 06/30/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose Neuroblastoma (NB) is childhood's most common extracranial solid malignancy. We have compared two imaging modalities, 131I-MIBG and 18F-DOPA PET/CT, to evaluate NB. Also, feasibility of the application of standardised scoring systems, SIOPEN and Curie scoring systems, in 18F-DOPA PET/CT was explored. Methods Patients with histopathology-proven NB underwent 131I-MIBG (planar and SPECT/CT) and 18F-DOPA PET/CT scans, as per standard imaging protocols. Duration between scans ranged from 1 to 30 days (median = 8 days). Number of lesions in Curie and SIOPEN scoring systems applied on both modalities was compared. Results Forty-six patients were included (M:F = 29:17) with a median age of 36 months. Both 131I-MIBG and 18F-DOPA scans were positive in 39 patients and negative in four patients. 18F-DOPA PET/CT was positive in additional three patients, in which 131I-MIBG was negative (p = 0.25). Overall, 18F-DOPA identified significantly greater number of lesions than 131I-MIBG, especially metastatic skeletal lesions (p < 0.05). Significant difference was observed between Curie scores in the two modalities, unlike SIOPEN scores. However, when the cut-off age of 18 months was taken, no significant difference was seen in either of the scoring systems in both the scans (p > 0.05). CS and SIOPEN scores were significantly higher in bone marrow-positive patients. Conclusion 18F-DOPA PET/CT detected more lesions than 131I-MIBG but had little impact on staging of the disease. For evaluation of NB, both scans can be used interchangeably as per the availability. Furthermore, both SIOPEN and Curie scoring systems, standardised for MIBG, can also be used to semi-quantify disease extent in 18F-DOPA PET/CT. Supplementary Information The online version contains supplementary material available at 10.1007/s13139-022-00762-6.
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Affiliation(s)
- Angel Hemrom
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Geetanjali Arora
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Nishikant Avinash Damle
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Chandrasekhar Bal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, 110029 India
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Moon JK, Hwang R, Balis FM, Mattei P. An enhanced recovery after surgery protocol in children who undergo nephrectomy for Wilms tumor safely shortens hospital stay. J Pediatr Surg 2022; 57:259-265. [PMID: 35768311 DOI: 10.1016/j.jpedsurg.2022.05.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 05/19/2022] [Accepted: 05/24/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Pediatric unilateral renal tumors in the US are treated with upfront nephrectomy and surgical staging. We applied enhanced recovery after surgery (ERAS) principles in care of children after Wilms nephrectomy. METHODS We reviewed records of pediatric unilateral nephrectomies for Wilms tumors, and analyzed tumor stage, surgical approach, length of operation, use of anesthesia adjuncts and catheters, diet advancement, hospital length of stay (LOS), and complications. Our ERAS protocol includes: parental education regarding discharge criteria and anticipated LOS, avoiding thoraco abdominal incisions, avoiding routine nasogastric tubes, clear liquids starting day of surgery, minimizing opiates, routine IV ketorolac use, and avoiding routine ICU stay. We examined the effects of our protocol on postoperative hospital LOS and complication rates. RESULTS Sixty six children (31 boys, mean age 3.8y, range 0-11.9) underwent unilateral total nephrectomy for Wilms tumor. Mean nephrectomy duration was 2.7 h. Post operatively, seven (11%) had temporary gastric tubes and 24 (36%) had epidural catheters. Ten (15%) recovered in the ICU. Patients were given regular diets mean of 1.9 days post op. Mean LOS was 3.7 days, with 56% of patients being discharged within 2-3 days. Presence of tumor thrombus, longer epidural catheter duration, delayed diet advancement, and total IV narcotic usage were associated with longer LOS. Routine use of IV ketorolac was associated with shorter LOS. CONCLUSIONS Use of an ERAS protocol in children undergoing nephrectomy for Wilms tumor is safe, resulting in rapid return to regular diet and compared to the published literature, shorter postoperative LOS without an increase in complications or return to ED/OR. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- James K Moon
- Division of General, Thoracic and Fetal Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Department of General Surgery, Mount Sinai Hospital, New York, NY, USA.
| | - Rosa Hwang
- Division of General, Thoracic and Fetal Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Frank M Balis
- Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Peter Mattei
- Division of General, Thoracic and Fetal Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
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5
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Bhambhvani HP, Peterson DJ, Sheth KR. Sociodemographic factors associated with Wilms tumor treatment and survival: a population-based study. Int Urol Nephrol 2022; 54:3055-3062. [PMID: 36069962 DOI: 10.1007/s11255-022-03343-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/17/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Though Wilms tumor (WT) is one of the most common malignancies in children, there is a paucity of epidemiologic studies exploring sociodemographic disparities in treatment and survival. Here, we leveraged a national cancer registry to examine sociodemographic factors associated with receipt of adjuvant therapy, either chemotherapy or radiation, as well as overall survival among pediatric patients with WT. MATERIALS AND METHODS Within the Surveillance Epidemiology and End Results database (2000-2016), we identified 2043 patients (≤ 20 years of age) with unilateral WT. Multivariable logistic regression and Cox proportional hazard models were constructed to examine the association of sociodemographic factors with, respectively, adjuvant chemotherapy/radiotherapy and overall survival (OS). RESULTS Patients in the lowest SES quintile (OR 0.56, 95% CI 0.33-0.93, p = 0.03) were less likely to receive chemotherapy as compared to those in the highest SES quintile, though this association did not persist in sensitivity analyses including only patients at least 2 years of age and patients with regional/distant disease. In addition, female patients were more likely to receive chemotherapy (OR 1.46, 95% CI 1.08-1.97, p = 0.02) than male patients. Age, race, year of diagnosis, insurance status, and tumor laterality were not associated with receipt of chemotherapy. No sociodemographic variables were associated with receipt of radiotherapy. Lastly, as compared to Non-Hispanic-White patients, Hispanic patients had worse OS (HR 1.59, 95% CI 1.08-2.35, p = 0.02); no other sociodemographic variables were associated with OS. CONCLUSIONS This study suggests multilevel sociodemographic disparities involving ethnicity and SES in WT treatment and survival.
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Affiliation(s)
- Hriday P Bhambhvani
- Department of Urology, Stanford University Medical Center, Stanford, CA, USA.
- Department of Urology, New York-Presbyterian Hospital, Weill Cornell Medical College, 525 East 68th Street, Starr 9, New York, NY, 10065, USA.
| | - Dylan J Peterson
- Department of Urology, Stanford University Medical Center, Stanford, CA, USA
| | - Kunj R Sheth
- Department of Urology, Stanford University Medical Center, Stanford, CA, USA
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Lin NY, Chen ST, Chang HL, Lu MY, Yang YL, Chou SW, Lin DT, Lin KH, Jou ST, Hsu WM, Huang MC, Chang HH. C1GALT1 expression predicts a favorable prognosis and suppresses malignant phenotypes via TrkA signaling in neuroblastoma. Oncogenesis 2022; 11:8. [PMID: 35169131 PMCID: PMC8847342 DOI: 10.1038/s41389-022-00383-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 01/29/2022] [Accepted: 02/02/2022] [Indexed: 11/09/2022] Open
Abstract
Neuroblastoma (NB) is a childhood tumor derived from the sympathoadrenal lineage of the neural crest progenitor cells. Core 1 β1,3-galactosyltransferase (C1GALT1) controls the crucial step of GalNAc-type O-glycosylation, and its altered expression affects cancer behaviors. However, the role of C1GALT1 in NB tumors remains unclear. Our data showed that C1GALT1 expression was significantly associated with differentiated tumor histology, correlated with TrkA expression, and predicted good prognosis independently in NB. Downregulation of C1GALT1 promotes malignant behaviors of NB cells in vitro and in vivo. Mechanistic investigation showed that knockdown of C1GALT1 in NB cells increased TrkA pulled down through Vicia villosa agglutinin beads, indicating the modulation of O-glycans on TrkA by C1GALT1, and silencing C1GALT1 suppressed the TrkA expression on the NB cell surface. Overexpression of C1GALT1 increased the protein levels of TrkA and promoted the differentiation of NB cells, whereas knockdown of TrkA inhibited C1GALT1-induced neuronal differentiation. Moreover, the inhibitory effects of migration and invasion in C1GALT1-overexpressing NB cells were blocked by TrkA downregulation. C1GALT1 knockdown enhanced AKT phosphorylation but attenuated ERK phosphorylation, and these properties were consistent in C1GALT1-overexpressing NB cells with TrkA knockdown. Taken together, our data provided the first evidence for the existence of GalNAc-type O-glycans on TrkA and altered O-glycan structures by C1GALT1 can regulate TrkA signaling in NB cells. This study sheds light on the novel prognostic role of C1GALT1 in NB and provides new information of C1GALT1 and TrkA on the pathogenesis of NB.
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Affiliation(s)
- Neng-Yu Lin
- Graduate Institute of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Syue-Ting Chen
- Graduate Institute of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Anatomy, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Neurosurgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hsiu-Ling Chang
- Graduate Institute of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Meng-Yao Lu
- Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yung-Li Yang
- Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.,Departments of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shu-Wei Chou
- Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Dong-Tsamn Lin
- Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.,Departments of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Kai-Hsin Lin
- Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shiann-Tarng Jou
- Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wen-Ming Hsu
- Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Min-Chuan Huang
- Graduate Institute of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hsiu-Hao Chang
- Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
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Cooke-Barber J, Scorletti F, Rymeski B, Eshelman-Kent D, Nagarajan R, Burns K, Jenkins T, Dasgupta R. Long-term follow-up of surgical outcomes for patients with Wilms tumor and neuroblastoma. Cancer 2021; 127:3232-3238. [PMID: 34043819 DOI: 10.1002/cncr.33581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND There are minimal data on long-term surgical outcomes of patients who have undergone resection for Wilms tumor (WT) and neuroblastoma (NB). METHODS A retrospective review of patients in a long-term survivor clinic between the years 1967 and 2016 in a pediatric tertiary care hospital (>5 years posttreatment) was performed. RESULTS Eighty-six survivors of WT and 86 survivors of NB who had ongoing follow-up in the survivors' clinic were identified. The median age at diagnosis was 2.5 years (range, 0.4-15.7 years) with a mean follow-up of 22.3 years (±10.4 years) for WT. The median age at diagnosis for patients with NB was 0.9 years (range, 0.1-8.6 months); mean follow-up of 21.7 years (±7.9 years). Twelve patients with WT (14.0%) had at least 1 repeat laparotomy, 11.1% for bowel obstruction, at a median of 3 months from initial surgery. Twelve patients (14.0%) with NB required laparotomy and 8.1% for bowel obstruction, at a median of 12 years after initial surgery. The incidence of hypertension in patients with WT who had undergone nephrectomy was not outside of population norms. Patients who underwent thoracotomy for a NB have a higher incidence of scoliosis and Horner syndrome. CONCLUSIONS Small bowel obstruction requiring laparotomy is significantly higher than the literature norms for both tumor patient populations and typically occurs in the early postoperative period for patients with WT and remotely in patients with NB. The long-term surgical complications of patients who underwent resection for NB and WT clearly merit follow-up and patient education within multidisciplinary long-term survivorship clinics.
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Affiliation(s)
- Jo Cooke-Barber
- Division of General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Federico Scorletti
- Division of General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Beth Rymeski
- Division of General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Debra Eshelman-Kent
- Center for Cancer and Blood Diseases Institute, Division of Oncology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Rajaram Nagarajan
- Center for Cancer and Blood Diseases Institute, Division of Oncology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Karen Burns
- Center for Cancer and Blood Diseases Institute, Division of Oncology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Todd Jenkins
- Division of General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Roshni Dasgupta
- Division of General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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8
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Dhakal R, Moeller BJ, Prabhu RS, Frenkel CH, Carrizosa DR, Sumrall AL, Milas ZL, Brickman DS, Ward MC. Pattern of distant metastasis in oropharyngeal carcinoma - Do they differ by HPV status? Oral Oncol 2021; 120:105286. [PMID: 33883078 DOI: 10.1016/j.oraloncology.2021.105286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 03/27/2021] [Accepted: 03/31/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Reshika Dhakal
- Levine Cancer Institute, Atrium Health, Charlotte, NC, USA.
| | - Benjamin J Moeller
- Levine Cancer Institute, Atrium Health, Charlotte, NC, USA; Southeast Radiation Oncology (SERO), Charlotte, NC, USA
| | - Roshan S Prabhu
- Levine Cancer Institute, Atrium Health, Charlotte, NC, USA; Southeast Radiation Oncology (SERO), Charlotte, NC, USA
| | | | | | | | | | | | - Matthew C Ward
- Levine Cancer Institute, Atrium Health, Charlotte, NC, USA; Southeast Radiation Oncology (SERO), Charlotte, NC, USA.
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9
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Bates T, Kao E, Alderete J, Lybeck D. Synovial Sarcoma: A Series of Small Tumors in Active Duty Service Members. Mil Med 2021; 185:e1864-e1868. [PMID: 32196117 DOI: 10.1093/milmed/usaa048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 02/18/2020] [Accepted: 02/25/2020] [Indexed: 11/12/2022] Open
Abstract
Synovial Sarcoma is a soft tissue sarcoma with a propensity to imitate a benign neoplasm. It is most common in males 15-40 years old, typically presents as a slow growing painful mass, and often arises insidiously without alarm to the patient. Three patients with synovial sarcomas who had each undergone an index procedure to treat a small presumedly benign mass that was later identified as synovial sarcoma were reviewed. All three patients required re-excision of the tumor and tumor bed and are currently undergoing routine surveillance. All patients exhibited the classic translocation t(X;18) (p11.2; q11.2) and all were of the monophasic type. All lesions were less than 35 mm in greatest longitudinal dimension on MRI. None have experienced recurrences of synovial sarcoma to date. Healthcare providers should be aware of the synovial sarcoma's propensity to masquerade as a benign disease and the characteristic clinical and radiological findings. We advocate for a low threshold to obtain advanced imaging and consideration of a tissue diagnosis prior to excision. A referral to an orthopedic oncologist should be considered and biopsy should only be performed where the definitive treatment will take place if malignancy is identified.
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Affiliation(s)
- Taylor Bates
- Department of Orthopaedic Surgery, San Antonio Military Medical Center, JBSA-Fort Sam Houston, San Antonio Military Medical Center, 3551 Roger Brooke Drive, Ft. Sam Houston TX, 78219
| | - Erica Kao
- Department of Pathology, San Antonio Military Medical Center, Fort Sam Houston, TX
| | - Joseph Alderete
- Department of Orthopaedic Surgery, San Antonio Military Medical Center, JBSA-Fort Sam Houston, San Antonio Military Medical Center, 3551 Roger Brooke Drive, Ft. Sam Houston TX, 78219
| | - Dustin Lybeck
- Department of Orthopaedic Surgery, San Antonio Military Medical Center, JBSA-Fort Sam Houston, San Antonio Military Medical Center, 3551 Roger Brooke Drive, Ft. Sam Houston TX, 78219
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Leimanis Laurens M, Snyder K, Davis AT, Fitzgerald RK, Hackbarth R, Rajasekaran S. Racial/Ethnic Minority Children With Cancer Experience Higher Mortality on Admission to the ICU in the United States. Pediatr Crit Care Med 2020; 21:859-868. [PMID: 33017127 DOI: 10.1097/pcc.0000000000002375] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We investigated whether differences in survival exist between children of various racial/ethnic groups with cancer admitted to the PICU. DESIGN A retrospective multicenter analysis was conducted using Virtual Pediatric Systems data from reporting centers. Demographic information, Pediatric Risk for Mortality III score, and outcome variables were analyzed using mixed-effects logistic regression modeling to assess for differences in mortality. SETTING One hundred thirty-five PICUs in the United States. PATIENTS Pediatric patients with cancer admitted to PICUs in the United States. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS This study details the analysis of 23,128 PICU admissions of 12,232 unique oncology patients representing 3% of all PICU admissions with 1,610 deaths (7.0% case fatality). African American (8.5%) and Hispanic children (8.1%) had significantly higher mortality (p < 0.05) compared with Caucasian children (6.3%). Regional analysis showed Hispanic patients to have higher mortality in the West in the United States, whereas African American patients in the South in the United States had higher mortality. A pulmonary disease diagnosis in Hispanics increased odds of mortality (odds ratio, 1.39; 95% CI, 1.13-1.70), whereas a diagnosis of shock/sepsis increased risk for mortality in African Americans (odds ratio, 1.56; 95% CI, 1.11-2.20) compared with Caucasians. There were no differences between races/ethnic groups in the rates of limitations of care. After controlling for Pediatric Risk of Mortality III, PICU length of stay, stem cell transplant status, readmissions, cancer type (solid, brain, hematologic), mechanical ventilation days, and sex, Hispanic (odds ratio, 1.24; 95% CI, 1.05-1.47) and African Americans (odds ratio, 1.37; 95% CI, 1.14-1.66) had significantly higher odds of mortality compared with Caucasians. CONCLUSIONS The results show that after controlling for severity and cancer type, a child's race, ethnicity, and region of presentation influence mortality in the PICU. This suggests that additional investigation is warranted along with a need to rethink our approach to the evaluation and treatment of critically ill African American and Hispanic children with cancer.
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Affiliation(s)
- Mara Leimanis Laurens
- Pediatric Intensive Care Unit, Helen DeVos Children's Hospital, Grand Rapids, MI.,Department of Pediatric and Human Development, College of Human Medicine, Michigan State University, East Lansing, MI
| | - Kristen Snyder
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Alan T Davis
- Spectrum Health, Office of Research and Education, Grand Rapids, MI.,Department of Surgery, College of Human Medicine, Michigan State University, East Lansing, MI
| | - Robert K Fitzgerald
- Pediatric Intensive Care Unit, Helen DeVos Children's Hospital, Grand Rapids, MI.,Department of Pediatric and Human Development, College of Human Medicine, Michigan State University, East Lansing, MI
| | - Richard Hackbarth
- Pediatric Intensive Care Unit, Helen DeVos Children's Hospital, Grand Rapids, MI.,Department of Pediatric and Human Development, College of Human Medicine, Michigan State University, East Lansing, MI
| | - Surender Rajasekaran
- Pediatric Intensive Care Unit, Helen DeVos Children's Hospital, Grand Rapids, MI.,Department of Pediatric and Human Development, College of Human Medicine, Michigan State University, East Lansing, MI
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11
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GEÇKALAN SOYSAL D, YAZICI N, ERBAY A. Malign tümör tanısı alan çocuk hastaların epidemiyolojik özellikleri ve sağkalımları. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.685250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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12
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Wang Z, Cheng H, Qi L, Sui D. Comprehensive analysis of long non‑coding RNA using an associated competitive endogenous RNA network in Wilms tumor. Mol Med Rep 2020; 22:105-116. [PMID: 32377711 PMCID: PMC7252721 DOI: 10.3892/mmr.2020.11124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 02/26/2020] [Indexed: 12/27/2022] Open
Abstract
Wilms tumor (WT) is the most common malignant renal neoplasm in children; however, the underlying molecular mechanisms are not well understood. According to the competing endogenous RNA (ceRNA) theory, long non-coding RNAs (lncRNAs) can regulate the expression of target genes by adsorbing microRNAs (miRNAs/miRs). However, the role of lncRNAs in WT has not been fully elucidated. The aim of the present study was to construct a ceRNA network to identify the potential lncRNAs involved in WT. The expression profiles of lncRNAs, miRNAs and mRNAs in 120 WT and six normal tissues were obtained from the Therapeutically Applicable Research to Generate Effective Treatments database. A total of 442 lncRNAs, 214 miRNAs and 4,912 mRNAs were identified as differentially expressed in WT and were enriched in 472 Gene Ontology terms (355 biological processes, 89 cellular components and 29 molecular functions) and 18 Kyoto Encyclopedia of Genes and Genomes pathways. A lncRNA-miRNA-mRNA ceRNA network of WT consisting of with 32 lncRNAs, 14 miRNAs and 158 mRNAs was constructed, based on the bioinformatics analysis of the miR target prediction database and the miRNAcode, miRTarBase and TargetScan databases. Subsequently, three lncRNAs, three miRNAs and 17 mRNAs, which had a significant effect on the overall survival rate of patients with WT, were identified based on the survival analysis. The three lncRNAs were also differentially expressed in the late and early stages of WT and were validated using the GSE66405 dataset obtained from the Gene Expression Omnibus database. In conclusion, the present study generated a specific lncRNA-related ceRNA network of WT, which may provide a novel perspective on the molecular mechanisms underlying the progression and prognosis of the disease.
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Affiliation(s)
- Zhichao Wang
- Department of Pharmacology, School of Pharmaceutical Sciences, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Huiyan Cheng
- Department of Gynecology, First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Lingli Qi
- Department of Pediatric Gastroenterology, First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Dayun Sui
- Department of Pharmacology, School of Pharmaceutical Sciences, Jilin University, Changchun, Jilin 130021, P.R. China
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13
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MYCN RNA levels determined by quantitative in situ hybridization is better than MYCN gene dosages in predicting the prognosis of neuroblastoma patients. Mod Pathol 2020; 33:531-540. [PMID: 31695155 DOI: 10.1038/s41379-019-0410-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 10/21/2019] [Accepted: 10/21/2019] [Indexed: 02/07/2023]
Abstract
The aim of this study was to investigate the prognostic role of MYCN RNA expression by quantitative RNA in situ hybridization and its association with MYCN amplification in neuroblastoma. MYCN RNA expression in 69 neuroblastoma tumors was evaluated by an ultrasensitive quantitative RNA in situ hybridization technique, RNAscope. The correlations between MYCN RNA expression, MYCN amplification, and other clinicopathologic variables of neuroblastoma were analyzed. High expression levels of MYCN RNA were detected 30 of 69 (43%) of neuroblastomas, mainly in those with undifferentiated or poorly differentiated histology. High expression of MYCN RNA was significantly associated with MYCN amplification (P < 0.001) and other adversely prognostic factors, including older age at diagnosis (>18 months, P = 0.017), advanced clinical stage (International Neuroblastoma Staging System stage 3, 4, P = 0.002), unfavorable International Neuroblastoma Pathology Classification tumor histology (P < 0.001), and high-risk Children's Oncology Group risk group (P = 0.001). In Kaplan-Meier analysis, MYCN RNA levels determined by quantitative in situ hybridization were better than MYCN gene dosages determined by chromogenic in situ hybridization in discriminating good and poor prognostic groups of neuroblastoma patients. In multivariate analysis, we further confirmed that high expression of MYCN RNA was an independent adverse prognostic factor for event-free and overall survival. Furthermore, high expression of MYCN RNA predicted unfavorable survival outcomes for neuroblastoma patients with MYCN non-amplification or high-risk Children's Oncology Group risk group. In conclusion, our study is the first report to show the application of MYCN RNA in situ hybridization in neuroblastoma and established that high expression of MYCN RNA could be a better biomarker than MYCN amplification for predicting poor prognosis of neuroblastoma patients.
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14
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Isack A, Santana VM, Russo C, Klosky JL, Fasciano K, Block SD, Mack JW. Communication Regarding Therapeutic Clinical Trial Enrollment Between Oncologists and Adolescents and Young Adults with Cancer. J Adolesc Young Adult Oncol 2020; 9:608-612. [PMID: 32101064 DOI: 10.1089/jayao.2019.0107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Adolescent and young adult (AYA) cancer patients enroll in therapeutic clinical trials at low rates. Prior study has focused on trial availability; this research attempts to elucidate the role of communication in individual decision-making. We surveyed 193 AYA patients and reviewed medical records of informed consent discussions. Twenty percent (38/193) of patients were offered trials, 58% (22/38) enrolled. Many were unable to correctly identify whether they were offered trials or enrolled, including 27% (6/22) of patients on clinical trials who believed that they were not. Efforts to improve communication have potential to enhance informed decision-making in this vulnerable population.
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Affiliation(s)
- Asisa Isack
- The Division of Population Sciences' Center for Outcomes and Policy Research, Boston, Massachusetts, USA
| | - Victor M Santana
- Departments of Oncology and Clinical Trials Administration, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Carolyn Russo
- Departments of Oncology and Clinical Trials Administration, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - James L Klosky
- Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Karen Fasciano
- Department of Psychosocial Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Susan D Block
- Department of Psychosocial Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Jennifer W Mack
- The Division of Population Sciences' Center for Outcomes and Policy Research, Boston, Massachusetts, USA.,Division of Pediatric Hematology/Oncology, Children's Hospital Boston, Massachusetts, USA.,Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
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15
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Nerli RB, Sharma M, Ghagane S, Nutalapati S, Hiremath M, Dixit N. Oncological and renal function outcome in children with unilateral wilms' tumors treated with nephron sparing surgery or ablative nephrectomy. JOURNAL OF CANCER RESEARCH AND PRACTICE 2020. [DOI: 10.4103/jcrp.jcrp_12_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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Chang HH, Lu MY, Yang YL, Chou SW, Lin DT, Lin KH, Hsu WM, Jeng YM, Jou ST. The prognostic roles of and correlation between ALK and MYCN protein expression in neuroblastoma. J Clin Pathol 2019; 73:154-161. [DOI: 10.1136/jclinpath-2019-206063] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/02/2019] [Accepted: 09/13/2019] [Indexed: 11/04/2022]
Abstract
AimsTo investigate the relations between anaplastic lymphoma kinase (ALK) and v-myc myelocytomatosis viral related oncogene neuroblastoma derived homolog (MYCN) protein expression and their prognostic roles in neuroblastoma tumours.MethodsSixty-one neuroblastoma tumours obtained at diagnosis were stained with anti-MYCN and anti-ALK antibodies by immunohistochemical staining. The correlations between protein expression of MYCN, ALK and clinicopathological and biological variables of neuroblastoma tumours were analysed.ResultsHigh expression of ALK protein could be detected in 25 (41%) and high expression of MYCN protein could be detected in 24 (39.3%) of the 61 neuroblastoma tumours, respectively. The majority of neuroblastoma tumours with evident of ALK or MYCN protein high expression exhibited undifferentiated or poorly differentiated histology (30/35, 85.7%). ALK or MYCN protein high expression in neuroblastoma tumours was associated with adverse clinical prognostic factors and ALK protein high expression was significantly associated with MYCN protein high expression. In addition, either ALK or MYCN protein high expression in neuroblastoma tumours was the independent adverse prognostic factor and also predicted worse survival outcomes for neuroblastoma patients with MYCN non-amplified status or non-high-risk Children’s Oncology Group grouping.ConclusionsOur study showed a novel coordinately prognostic role of ALK and MYCN protein expression in neuroblastoma and is the first report to demonstrate the correlation between ALK and MYCN protein expression in primary neuroblastoma tumours.
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17
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Su H, Wang X, Song J, Wang Y, Zhao Y, Meng J. MicroRNA-539 inhibits the progression of Wilms' Tumor through downregulation of JAG1 and Notch1/3. Cancer Biomark 2019; 24:125-133. [PMID: 30530967 PMCID: PMC6398546 DOI: 10.3233/cbm-181972] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Previous studies demonstrated that miR-539 play an important role in the carcinogenesis of some cancers. The aim of the present study was to determine the role of miR-539 in the pathogenesis of Wilms' Tumor (WT). METHODS The expression level of miR-539 was measured by qRT-PCR in 42 WT tissues and SK-NEP-1 cell line. Protein expression of genes (E-cadherin, N-cadherin, Vimentin, Notch 1, Notch 3 and JAG1) was assessed by Western blot. The function of miR-539 was investigated in SK-NEP-1 cells by MTT and Transwell assays. The relationship between miR-539 and JAG1 was verified by a dual luciferase assay in SK-NEP-1 cells. RESULTS The expression level of miR-539 was significantly decreased in WT tissues. Downregulation of miR-539 was closely related to NWTS-5 stage, lymph node metastasis and histological type of WT patients. Furthermore, low miR-539 expression was associated with a shorter overall survival rate in WT patients. In vitro, overexpression of miR-539 suppressed proliferation, migration and invasion of SK-NEP-1 cells. In addition, JAG1 was a direct target of miR-539. MiR-539 inhibited the development of WT by inhibiting JAG1-Notch1/3 expressing and blocking EMT. CONCLUSION MiR-539 inhibited the progression of WT through downregulation of JAG1 and Notch1/3.
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Affiliation(s)
- Hailong Su
- Department of Pediatric Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China.,Department of Pediatric Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Xuebo Wang
- Department of Clinical Laboratory, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China.,Department of Pediatric Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Jingjing Song
- Department of Clinical Laboratory, People's Hospital of Rizhao, Rizhao, Shandong, China
| | - Yongjiao Wang
- Department of Internal Medicine, Community Health Service Center, Zao Yuan Street Office of Zhangqiu District, Jinan, Shandong, China
| | - Yingchun Zhao
- Department of Pediatrics, The People's Hospital of Zhangqiu Area, Jinan, Shandong, China
| | - Juan Meng
- Department of Blood Transfusion, Yankuang New Journey General Hospital, Zoucheng, Shandong, China
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18
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Liu K, He B, Xu J, Li Y, Guo C, Cai Q, Wang S. miR-483-5p Targets MKNK1 to Suppress Wilms' Tumor Cell Proliferation and Apoptosis In Vitro and In Vivo. Med Sci Monit 2019; 25:1459-1468. [PMID: 30798328 PMCID: PMC6398281 DOI: 10.12659/msm.913005] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Background Wilms’ tumor (WT) is the most common type of renal tumor in children and it has high mortality rates. MicroRNAs (miRNAs) are important regulators of cellular differentiation processes that have been discovered to contribute to the development of various kinds of tumors. Material/Methods The Wilms’ tumor tissues and adjacent tissues were obtained from 28 patients to quantity miR-483-5p expression level. The miR-483-5p mimics and scrambles were transfected into the human kidney WT cell line GHINK-1 to evaluate the effect of miR-483-5p on Wilms’ tumor cell proliferation and apoptosis in vitro. A total of 18 female BALB/c nu/nu mice were used to further confirm how miR-483-5p affects Wilms’ tumor in vivo. Results In the present study, miR-483-5p was identified to be downregulated in Wilms’ tumor tissues compared with the normal adjacent tissues. Additionally, low expression of mir-483-5p was significantly correlated with unfavorable histology subtypes, lymphatic metastasis, and late clinical stage (stage III and IV). Overexpression of miR-483-5p inhibited the proliferation and colony formation of GHINK-1 (Wilms’ tumor) cells compared with the control group due to enhanced cell apoptosis. Furthermore, miR-483-5p upregulated the protein expression level of caspase-3. Finally, MAP kinase-interacting serine/threonine-protein kinase 1 was identified as a direct target of miR-483-5p, which was confirmed by luciferase reporter assay and Western blotting. Conclusions MiR-483-5p suppressed WT cell proliferation via inducing apoptosis through targeting MKNK1. This may provide novel insights into the mechanisms underlying WT and a potential therapeutic candidate for the treatment of WT in the future.
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Affiliation(s)
- Kai Liu
- Department of Pediatrics, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China (mainland)
| | - Bingsen He
- Department of Pediatrics, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China (mainland)
| | - Jiang Xu
- Department of Pediatrics, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China (mainland)
| | - Yang Li
- Department of Pediatrics, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China (mainland)
| | - Cheng Guo
- Department of Pediatrics, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China (mainland)
| | - Qinhui Cai
- Department of Pediatrics, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China (mainland)
| | - Shuya Wang
- Department of Rheumatology and Immune Disease, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China (mainland)
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The utility of magnetic resonance imaging in the diagnosis and management of pediatric benign ovarian lesions. J Pediatr Surg 2018; 53:2013-2018. [PMID: 29433795 DOI: 10.1016/j.jpedsurg.2017.12.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 12/27/2017] [Accepted: 12/29/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND The utility of magnetic resonance imaging (MRI) in the diagnosis and management of pediatric ovarian lesions has not been well defined. METHODS A retrospective review of all girls who underwent MRI evaluation of ovarian masses during the period 2009-2015 was performed. The accuracy of MRI was evaluated by comparing results with surgical findings, pathology reports, and subsequent imaging. The influence of the MRI on the treatment plan was specifically explored. RESULTS Eighteen girls, 12-17years of age, underwent 27 MRIs, subsequent to ultrasound identification of ovarian lesions. Of 9 neoplastic lesions diagnosed on MRI, 8 (89%) were confirmed by surgical and pathological findings. Of 18 functional lesions, 17 (94.4%) were confirmed pathologically or by resolution on subsequent imaging. Twenty MRI exams (74%) directly influenced the treatment plan, by leading to appropriate operative intervention in 9 and appropriate observation in 11. The extent of ovarian resection was guided by MRI findings in 8 of 9 (89%) neoplastic lesions. For characterizing lesions as neoplastic, the sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of MRI were 89%, 94%, 94%, 89%, and 93% respectively. CONCLUSIONS MRI can differentiate functional from neoplastic pediatric ovarian masses, and guide ovarian resection in appropriate cases. LEVEL OF STUDY II.
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20
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Bozlu G, Çıtak EÇ. Evaluation of renal tumors in children. Turk J Urol 2018; 44:268-273. [PMID: 29733801 DOI: 10.5152/tud.2018.70120] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 04/03/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Renal tumors are not uncommon in children. In this study, we aimed to evaluate the clinical and pathological features of renal tumors in children. MATERIAL AND METHODS Between January 2008 and December 2017, the records of children with renal tumors in our institution were retrospectively analyzed. Data collected were composed of demographic and clinical characteristics including gender, age at time of diagnosis, symptoms, laterality of the tumor and pathological evaluation. RESULTS A total of 48 children with renal tumor (28 males and 20 females) were included in the study. They were diagnosed at mean age of 53.26±46.64 months (range: 1-192) and the mean follow-up period was 73.45±48.92 months (range: 6-120). The most common symptom was a lump or mass in the area of the kidneys (45.8%), abdominal pain and hematuria (14.6%). Four patients (8.3%) were diagnosed at antenatal period. 68.8% of the children had Wilms tumor and the major histological groups of non-Wilms renal tumors were renal cell carcinoma (12.5%), congenital mesoblastic nephroma (10.4%) and angiomyolipoma (4.2%). 10.4% of the children had bilateral tumors and one patients had Wilms tumor with horseshoe kidney. 87.5% of the children were treated with surgery and of those 7 (14.5%) underwent nephron-sparing surgery. The patients had chemotherapy and radiotherapy (83.3% and 41.7%, respectively). Seven patients (14.6%) died during follow-up. CONCLUSION Wilms tumor is the most common pediatric renal neoplasm. On the other hand, we showed that considerable number of children with renal tumors had non-Wilms tumors including renal cell carcinoma, congenital mesoblastic nephroma and angiomyolipoma.
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Affiliation(s)
- Gülçin Bozlu
- Departments of Pediatrics, Mersin University, Mersin, Turkey
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21
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Richards MK, Goldin AB, Ehrlich PF, Beierle EA, Doski JJ, Goldfarb M, Langer M, Nuchtern JG, Vasudevan S, Gow KW. Partial Nephrectomy for Nephroblastoma: A National Cancer Data Base Review. Am Surg 2018. [DOI: 10.1177/000313481808400315] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Standard of care for unilateral nephroblastoma includes total nephrectomy (TN) with nodal sampling. We sought to compare the outcomes of TN and partial nephrectomy (PN). We performed a retrospective cohort study of TN and PN for nephroblastoma using the National Cancer Data Base. The outcomes included nodal sampling frequency, margin status, and survival. Categorical and continuous data were evaluated with χ2 and t tests, respectively ( P < 0.05). Generalized linear models evaluated nodal sampling and margin status. Cox regression compared survival. In total, 235 patients underwent PN and 3572 had TN. TN patients were 50 per cent more likely to undergo nodal sampling (RR: 1.47, 95% CI 1.30–1.66). There was no difference in margin status (RR: 0.91, 95% CI 0.65–1.28) or overall survival (HR 1.57; 95% CI 0.78–3.19). This study reports the largest review of patients with PN for unilateral nephroblastoma. PN patients had less nodal sampling but similar margin involvement and overall survival.
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Affiliation(s)
- Morgan K. Richards
- Department of Surgery, University of Washington, Seattle, Washington
- Department of General and Thoracic Surgery, Seattle Children's Hospital, Seattle, Washingon
| | - Adam B. Goldin
- Department of General and Thoracic Surgery, Seattle Children's Hospital, Seattle, Washingon
| | | | | | - John J. Doski
- Methodist Children's Hospital of South Texas, San Antonio, Texas
| | | | | | | | | | - Kenneth W. Gow
- Department of General and Thoracic Surgery, Seattle Children's Hospital, Seattle, Washingon
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Chang HH, Liu YL, Lu MY, Jou ST, Yang YL, Lin DT, Lin KH, Tzen KY, Yen RF, Lu CC, Liu CJ, Peng SSF, Jeng YM, Huang SF, Lee H, Juan HF, Huang MC, Liao YF, Lee YL, Hsu WM. A multidisciplinary team care approach improves outcomes in high-risk pediatric neuroblastoma patients. Oncotarget 2018; 8:4360-4372. [PMID: 27966455 PMCID: PMC5354838 DOI: 10.18632/oncotarget.13874] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 12/01/2016] [Indexed: 11/25/2022] Open
Abstract
We assessed the impact of a multidisciplinary team care program on treatment outcomes in neuroblastoma patients. Newly diagnosed neuroblastoma patients received treatment under the Taiwan Pediatric Oncology Group (TPOG) N2002 protocol at the National Taiwan University Hospital beginning in 2002. A multidisciplinary team care approach that included nurse-led case management for patients treated under this protocol began in January 2010. Fifty-eight neuroblastoma patients, including 29 treated between 2002 and 2009 (Group 1) and 29 treated between 2010 and 2014 (Group 2), were enrolled in the study. The 5-year overall survival (OS) and event-free survival (EFS) rates for all 58 patients were 59% and 54.7%, respectively. Group 2 patients, who were treated after implementation of the multidisciplinary team care program, had better 3-year EFS (P = 0.046), but not OS (P = 0.16), rates than Group 1 patients. In a multivariate analysis, implementation of the multidisciplinary team approach was the only significant independent prognostic factor for neuroblastoma patients. In further subgroup analyses, the multidisciplinary team approach improved EFS, but not OS, in patients with stage 4 disease, those in the high-risk group, and those with non-MYCN amplified tumors. These data indicate a multidisciplinary team care approach improved survival outcomes in high-risk neuroblastoma patients. However, further investigation will be required to evaluate the long-term effects of this approach over longer follow-up periods.
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Affiliation(s)
- Hsiu-Hao Chang
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yen-Lin Liu
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Pediatrics, Taipei Medical University Hospital, Taipei, Taiwan
| | - Meng-Yao Lu
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shiann-Tarng Jou
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yung-Li Yang
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Laboratory Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Dong-Tsamn Lin
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Laboratory Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Kai-Hsin Lin
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Kai-Yuan Tzen
- Department of Nuclear Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ruoh-Fang Yen
- Department of Nuclear Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ching-Chu Lu
- Department of Nuclear Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chia-Ju Liu
- Department of Nuclear Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Steven Shinn-Forng Peng
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yung-Ming Jeng
- Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shiu-Feng Huang
- Division of Molecular and Genomic Medicine, National Health Research Institutes, Miaoli County, Taiwan
| | - Hsinyu Lee
- Department of Life Science, National Taiwan University, Taipei, Taiwan.,Institutes of Zoology, National Taiwan University, Taipei, Taiwan
| | - Hsueh-Fen Juan
- Department of Life Science, National Taiwan University, Taipei, Taiwan.,Institutes of Molecular and Cellular Biology, National Taiwan University, Taipei, Taiwan
| | - Min-Chuan Huang
- Graduate Institute of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yung-Feng Liao
- Institute of Cellular and Organismic Biology, Academia Sinica, Taipei, Taiwan
| | - Ya-Ling Lee
- Department of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Wen-Ming Hsu
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Abstract
Introduction Wilms’ tumor (WT), the most common childhood tumor, occurs in sporadic or familial forms. Recent findings reported that abnormal expression in microRNA (miRNA) suggests an important role of miRNAs during WT progress. MiRNAs are endogenous short-chain noncoding RNAs, which have been reported as key biomarkers for detecting tumor onset and progression. However, the functional role of miR-1180 in WT has remained unknown. Materials and methods MTT and clonogenic survival assays were used to detect WT cell proliferation. Flow cytometry Annexin V-FITC was used to measure apoptosis. In addition, proteins expressions in the cells were determined by Western blotting. Results In the present study, we demonstrated that miR-1180 is upregulated in WT when compared with adjacent tissues by quantitative reverse-transcription polymerase chain reaction. In addition, the inhibition of miR-1180 induced apoptosis in SK-NEP-1 cell line in vitro. Moreover, luciferase reporter assay showed that p73 protein was the target of miR-1180, which was confirmed by the results of Western blotting. Finally, in vivo data indicated that the tumor growth in mice was significantly inhibited by miR-1180 inhibitor. Conclusion Our results indicate that miR-1180 might serve as a therapeutic target for future WT therapy.
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Affiliation(s)
- Xiuyun Jiang
- Neonatal Intensive Care Unit, Zhoukou Central Hospital, Zhoukou
| | - Huaicheng Li
- Department of Internal Medicine, The People's Hospital of Zhoukou, Zhoukou, People's Republic of China
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24
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Mishra A, Beniwal M, Nandeesh BN, Srinivas D, Somanna S. Primary Pediatric Intracranial Neuroblastoma: A Report of Two Cases. J Pediatr Neurosci 2018; 13:366-370. [PMID: 30271478 PMCID: PMC6144601 DOI: 10.4103/jpn.jpn_68_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Neuroblastoma is the most common pediatric extracranial solid malignancy. It has a high propensity for spread, especially to the bones and lymph nodes. The involvement of central nervous system is uncommon and most of the cases are restricted to the spine. Primary intracranial neuroblastoma is extremely rare and very few cases have been described in the available literature. We report two cases of primary intracranial neuroblastoma in pediatric age group.
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Affiliation(s)
- Ajit Mishra
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Manish Beniwal
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Bevinahalli N Nandeesh
- Department of Neuropathology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Dwarakanath Srinivas
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Sampath Somanna
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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25
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Wade G, Revels J, Hartman L, Brown W. Pediatric mandibular metastasis: A rare finding of neuroblastoma. Radiol Case Rep 2017; 13:289-294. [PMID: 29552266 PMCID: PMC5851114 DOI: 10.1016/j.radcr.2017.10.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/10/2017] [Accepted: 10/12/2017] [Indexed: 02/07/2023] Open
Abstract
We present a case of metastatic neuroblastoma to the mandible in an 11-month-old patient presenting with worsening right-sided proptosis and scalp swelling after a fall 2 weeks prior. Initial evaluation with computed tomography of the head demonstrated soft tissue masses centered at the right sphenoid and right mandible. These masses proved to be metastatic lesions from an intra-abdominal neuroblastoma. Review of the literature revealed 20 cases of neuroblastoma metastasis to the mandible over the past 70 years. To our knowledge, our patient is the youngest reported case with asymptomatic mandibular metastasis related to neuroblastoma and the first to be characterized with magnetic resonance imaging.
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Affiliation(s)
- Gregory Wade
- Department of Radiology, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Jonathan Revels
- University of Washington Department of Radiology, Seattle, WA, USA
| | - Lauren Hartman
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Wendy Brown
- Department of Radiology, Eastern Virginia Medical School, Norfolk, VA, USA
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26
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Pediatric soft tissue sarcoma of the limbs: clinical outcome of 97 patients. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2017; 28:1-7. [PMID: 28766068 DOI: 10.1007/s00590-017-2019-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Accepted: 07/19/2017] [Indexed: 01/10/2023]
Abstract
PURPOSE Soft tissue sarcomas (STS) of the extremities in children are a heterogeneous group of tumors with a very different prognosis for which optimal treatment remains controversial. PATIENTS AND METHODS We retrospectively evaluated 97 patients younger than 15 years old affected by limb soft tissue sarcomas. All cases were histologically revised, and tumor grade was assessed according to the FNLCC system. Thirty-two were rhabdomyosarcoma (RMS) and 65 non-rhabdomyosarcoma (NRMSTS); among these, 40 (61.5%) were grade 3 according to FNLCC classification. Overall survival, local recurrence and distant metastasis were analyzed. RESULTS Overall survival was 77.8% at 5 years and 69.7% at 10 years. Among grade 3 tumors, RMS had a worse prognosis over NRSTS. Similarly, tumors larger than 5 cm had a worse prognosis compared to smaller ones. Local recurrence-free survival was 90.7% at 5 years and 87.1% at 10 years with a better local control in grade 3 NRSTS over RMS and in tumors smaller than 2 cm. CONCLUSION Children affected by extremities RMS were confirmed to have the worst prognosis, in particular in case of metastasis at presentation. Differently from adult patients, hand and feet locations are frequent site for STS and 2 cm diameter should be taken as cut off for higher risk of LR. Similarly to adulthood STS, grading correlates with prognosis in NRSTS. The identification of prognostic variables should enable risk-adapted therapies to be planned.
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27
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Polosukhina D, Love HD, Moses HL, Lee E, Zent R, Clark PE. Pharmacologic Inhibition of β-Catenin With Pyrvinium Inhibits Murine and Human Models of Wilms Tumor. Oncol Res 2017; 25:1653-1664. [PMID: 28695795 PMCID: PMC5670010 DOI: 10.3727/096504017x14992942781895] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Wilms tumor (WT) is the most common renal malignancy in children and the fourth most common pediatric solid malignancy in the US. Although the mechanisms underlying the WT biology are complex, these tumors most often demonstrate activation of the canonical Wnt/β-catenin pathway. We and others have shown that constitutive activation of β-catenin restricted to the renal epithelium is sufficient to induce primitive renal epithelial tumors, which resemble human WT. Here we demonstrate that pharmacologic inhibition of β-catenin gene transcription with pyrvinium inhibits tumor growth and metastatic progression in a murine model of WT. Cellular invasion is significantly inhibited in both murine WT-like and human WT cells and is accompanied by downregulation of the oncogenes Myc and Birc5 (survivin). Our studies provide proof of the concept that the canonical Wnt/β-catenin pathway may be a novel therapeutic target in the management of WT.
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28
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Polosukhina D, Love HD, Correa H, Su Z, Dahlman KB, Pao W, Moses HL, Arteaga CL, Lovvorn HN, Zent R, Clark PE. Functional KRAS mutations and a potential role for PI3K/AKT activation in Wilms tumors. Mol Oncol 2017; 11:405-421. [PMID: 28188683 PMCID: PMC5378659 DOI: 10.1002/1878-0261.12044] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 01/18/2017] [Accepted: 02/02/2017] [Indexed: 12/18/2022] Open
Abstract
Wilms tumor (WT) is the most common renal neoplasm of childhood and affects 1 in 10 000 children aged less than 15 years. These embryonal tumors are thought to arise from primitive nephrogenic rests that derive from the metanephric mesenchyme during kidney development and are characterized partly by increased Wnt/β-catenin signaling. We previously showed that coordinate activation of Ras and β-catenin accelerates the growth and metastatic progression of a murine WT model. Here, we show that activating KRAS mutations can be found in human WT. In addition, high levels of phosphorylated AKT are present in the majority of WT. We further show in a mouse model and in renal epithelial cells that Ras cooperates with β-catenin to drive metastatic disease progression and promotes in vitro tumor cell growth, migration, and colony formation in soft agar. Cellular transformation and metastatic disease progression of WT cells are in part dependent on PI3K/AKT activation and are inhibited via pharmacological inhibition of this pathway. Our studies suggest both KRAS mutations and AKT activation are present in WT and may represent novel therapeutic targets for this disease.
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Affiliation(s)
- Dina Polosukhina
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Harold D Love
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hernan Correa
- Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Zengliu Su
- Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Kimberly B Dahlman
- Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.,Department of Cancer Biology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - William Pao
- Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.,Department of Medicine (Hematology-Oncology), Vanderbilt University Medical Center, Nashville, TN, USA
| | - Harold L Moses
- Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.,Department of Cancer Biology, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Medicine (Hematology-Oncology), Vanderbilt University Medical Center, Nashville, TN, USA
| | - Carlos L Arteaga
- Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.,Department of Cancer Biology, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Medicine (Hematology-Oncology), Vanderbilt University Medical Center, Nashville, TN, USA
| | - Harold N Lovvorn
- Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Roy Zent
- Department of Medicine, Nephrology & Cancer Biology Division, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Peter E Clark
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
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29
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Schiavon JLDO, Caran EMM, Odone Filho V, Lederman HM. The value of anterior displacement of the abdominal aorta in diagnosing neuroblastoma in children. Radiol Bras 2017; 49:369-375. [PMID: 28100931 PMCID: PMC5238411 DOI: 10.1590/0100-3984.2015.0138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective To determine the value of anterior displacement of the abdominal aorta, when
present at any level or only at the level of the adrenal gland,
contralateral to the mass, in diagnosing neuroblastoma on computed
tomography or magnetic resonance imaging in children up to 7 years of
age. Materials and Methods Imaging examinations of 66 patients were classified by consensus as for the
presence of anterior aorta displacement and were compared with the pathology
report. Results We found anterior abdominal aorta displacement in 26 (39.39%) of the 66
patients evaluated. Among those 26 patients, we identified neuroblastoma in
22 (84.62%), nephroblastoma in 3 (11.54%), and Burkitt lymphoma in 1
(3.85%). The positive predictive value was 84.62%, and the specificity was
88.24%. The displacement of the aorta was at the adrenal level,
contralateral to the mass, in 14 cases, all of which were attributed to
neuroblastoma. Conclusion When the abdominal aorta is displaced at the level of the adrenal gland,
contralateral to the mass, it can be said that the diagnosis is
neuroblastoma, whereas abdominal aorta displacement occurring at other
abdominal levels has a positive predictive value for neuroblastoma of
approximately 85%.
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Affiliation(s)
- Jose Luiz de Oliveira Schiavon
- Radiologist, Master Student in Science in the Department of Diagnostic Imaging of the Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | - Eliana Maria Monteiro Caran
- PhD, Pediatric Oncologist, Advisor for the Graduate Program in Pediatrics and Applied Sciences in Pediatrics at the Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | - Vicente Odone Filho
- Oncologist, Tenured Full Professor in the Pediatrics Department of the Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
| | - Henrique Manoel Lederman
- Radiologist, Tenured Full Professor and Coordinator of the Graduate Program in Radiological Sciences in the Department of Diagnostic Imaging of the Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
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30
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Liver Transplantation for Biliary Rhabdomyosarcoma With Liver Metastasis: Report of One Case. Transplant Proc 2017; 49:185-187. [DOI: 10.1016/j.transproceed.2016.11.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 11/16/2016] [Indexed: 12/12/2022]
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31
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Vogel J, Lin H, Both S, Tochner Z, Balis F, Hill-Kayser C. Pencil beam scanning proton therapy for treatment of the retroperitoneum after nephrectomy for Wilms tumor: A dosimetric comparison study. Pediatr Blood Cancer 2017; 64:39-45. [PMID: 27565764 DOI: 10.1002/pbc.26176] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 06/25/2016] [Accepted: 07/08/2016] [Indexed: 11/12/2022]
Abstract
BACKGROUND Multimodality treatment for patients with Wilms tumor has improved patient survival, but is associated with acute and long-term toxicity, partially due to irradiation. Proton therapy using pencil beam scanning (PBS) is a promising technique to reduce dose to organs at risk (OAR). In this study, we evaluate PBS plans for postoperative irradiation in patients with Wilms tumor. PROCEDURE Patients were treated with anterior-posterior-posterior-anterior (AP-PA) photon fields encompassing the preoperative tumor volume. Patients requiring whole lung irradiation were treated with AP-PA photon fields covering the bilateral lungs. Prescription doses were generally 1,080 and 1,200 cGy, respectively. Flank PBS plans encompassing the ipsilateral retroperitoneum and para-arotic nodes were generated for dosimetric evaluation. RESULTS Treatment records and comparison plans of 11 patients were reviewed. Mean dose and median dose to 50% or more of the contralateral kidney (D50) were 135 cGy and 139 cGy with photons and 52 cGy relative biological effectiveness (RBE) (P = 0.009) and 5 cGy RBE (P = 0.000001) with PBS. Mean dose and median D50 to bowel was 639 cGy and 979 cGy with photons and 379 cGy RBE (P = 0.001) and 47 cGy RBE (P = 0.004) with PBS. Mean dose and median D50 to the liver were 755 cGy and 1,013 cGy with photons and 411 cGy RBE (P = 0.02) and 132 cGy RBE (P = 0.02) with PBS. For patients with right-sided tumors, mean liver dose following sequential whole lung irradiation was 1,252 cGy with photons and 845 cGy RBE (P = 0.04) with PBS. DISCUSSIONS PBS proton therapy is a feasible method for irradiating the retroperitoneum and provides significant sparing of dose to critical OAR. This may translate to improved long-term health outcomes for patients and warrants further clinical investigation.
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Affiliation(s)
- Jennifer Vogel
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Haibo Lin
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Stefan Both
- Medical Physics Department, Memorial Sloan-Kettering Cancer Center, 1275 First Avenue, New York, NY 10065
| | - Zelig Tochner
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Frank Balis
- Department of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Christine Hill-Kayser
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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32
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Richards MK, Goldin AB, Savinkina A, Doski J, Goldfarb M, Nuchtern J, Langer M, Beierle EA, Vasudevan S, Gow KW, Raval MV. The association between nephroblastoma-specific outcomes and high versus low volume treatment centers. J Pediatr Surg 2017; 52:104-108. [PMID: 27836364 DOI: 10.1016/j.jpedsurg.2016.10.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 10/20/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND Though the volume-outcome relationship has been well-established in adults, low mortality rates and small sample sizes have precluded definitive demonstration in children. This study compares treatment-specific factors for children with nephroblastoma at high (HVC) versus low volume centers (LVC). METHODS We performed a retrospective cohort study comparing patients ≤18years with unilateral nephroblastoma treated at HVCs and LVCs using the National Cancer Data Base (1998-2012). Definitions of HVCs included performing above the median, the upper two quartiles, and the highest decile of nephroblastoma resections. Outcomes included nodal sampling, margin status, time to chemotherapy and radiation, and survival. Statistical analyses included χ2, t-tests, generalized linear, and Cox regression models (p<0.05). RESULTS Of 2911 patients from 210 centers, 1443 (49.6%) were treated at HVCs. There was no difference in frequency of preoperative biopsy or days to radiation (p>0.05). High volume centers were more likely to perform nodal sampling (RR 1.04, 95%CI 1.01-1.08) and had fewer days to chemotherapy (RR 0.80, 95%CI 0.69-0.93). Five-year survival was similar (HVC: 0.93, 95%CI 0.92-0.94; LVC: 0.93, 95%CI 0.91-0.94). CONCLUSIONS HVCs were more likely to perform nodal sampling and had fewer days to chemotherapy. There was no difference in days to radiation or survival between centers. LEVEL OF EVIDENCE Level II (retrospective prognosis study).
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Affiliation(s)
- Morgan K Richards
- University of Washington, Department of Surgery; Seattle Children's Hospital, Department of Thoracic and General Surgery.
| | - Adam B Goldin
- Seattle Children's Hospital, Department of Thoracic and General Surgery
| | | | - John Doski
- Methodist Children's Hospital of South Texas
| | | | | | | | | | | | - Kenneth W Gow
- Seattle Children's Hospital, Department of Thoracic and General Surgery
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Goyal S, Mishra K, Sarkar U, Sharma S, Kumari A. Diagnostic utility of Wilms' tumour-1 protein (WT-1) immunostaining in paediatric renal tumours. Indian J Med Res 2016; 143:S59-S67. [PMID: 27748279 PMCID: PMC5080930 DOI: 10.4103/0971-5916.191776] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background & objectives: Renal tumours constitute about 7 per cent of all neoplasms in children. It is important to differentiate Wilms’ tumour (commonest tumour) from non-Wilms’ tumours. The aim of this study was to evaluate the immunoexpression and diagnostic role of Wilms’ tumour-1 protein (WT1) in paediatric renal tumours. Methods: A total of 53 cases of renal tumours in children (below 18 yr) who underwent total nephrectomy were included in this retrospective study. WT1 immunostaining was done using mouse monoclonal WT1 antibody (clone: 6F-H2). Results: Of the 53 cases, 38 (72%) were of Wilms’ tumour. Non-Wilms’ group (15) included six cases of mesoblastic nephroma (MN), two each of clear cell sarcoma (CCSK), renal cell carcinoma (RCC) and peripheral neuroectodermal tumour (PNET) and one each of angiomyolipoma (AML), rhabdomyosarcoma (RMS) and malignant rhabdoid tumour (MRT). Proportion of WT1 positivity in Wilms’ tumour was 100 per cent in contrast to 26.7 per cent in non-Wilms’ tumours (P<0.001). Epithelial and blastemal components of Wilms’ tumour showed moderate (2+) nuclear and cytoplasmic staining in 80 (24/30) and 75 per cent (24/32) cases, respectively. MN, PNET, CCSK and AML were negative for WT1. RMS, RCC and MRT showed cytoplasmic staining, strongest in RMS. No significant association was seen between WT1 expression and NWTSG (National Wilms’ Tumor Study Group) stage. Interpretation & conclusions: WT1 helps to differentiate Wilms’ tumour from other paediatric renal tumours. It may help in differentiating the two subgroups of Wilms’ tumour which have distinct molecular pathogenesis and biological behaviour, however, further prospective studies are required for validation of this hypothesis.
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Affiliation(s)
- Surbhi Goyal
- Department of Pathology, University College of Medical Sciences, Delhi, India
| | - Kiran Mishra
- Department of Pathology, University College of Medical Sciences, Delhi, India
| | - Urvee Sarkar
- Department of Pathology, University College of Medical Sciences, Delhi, India
| | - Satendra Sharma
- Department of Pathology, University College of Medical Sciences, Delhi, India
| | - Anita Kumari
- Department of Pathology, University College of Medical Sciences, Delhi, India
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Zarzosa P, Navarro N, Giralt I, Molist C, Almazán-Moga A, Vidal I, Soriano A, Segura MF, Hladun R, Villanueva A, Gallego S, Roma J. Patient-derived xenografts for childhood solid tumors: a valuable tool to test new drugs and personalize treatments. Clin Transl Oncol 2016; 19:44-50. [PMID: 27718156 DOI: 10.1007/s12094-016-1557-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 09/22/2016] [Indexed: 12/23/2022]
Abstract
The use of preclinical models is essential in translational cancer research and especially important in pediatric cancer given the low incidence of each particular type of cancer. Cell line cultures have led to significant advances in cancer biology. However, cell lines have adapted to growth in artificial culture conditions, thereby undergoing genetic and phenotypic changes which may hinder the translational application. Tumor grafts developed in mice from patient tumor tissues, generally known as patient-derived xenografts (PDXs), are interesting alternative approaches to reproducing the biology of the original tumor. This review is focused on highlighting the interest of PDX models in pediatric cancer research and supporting strategies of personalized medicine. This review provides: (1) a description of the background of PDX in cancer, (2) the particular case of PDX in pediatric cancer, (3) how PDX can improve personalized medicine strategies, (4) new methods to increase engraftment, and, finally, (5) concluding remarks.
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Affiliation(s)
- P Zarzosa
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Navarro
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Giralt
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Molist
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Almazán-Moga
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Vidal
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Soriano
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M F Segura
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - R Hladun
- Pediatric Oncology and Hematology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Villanueva
- Chemoresistance and Predicitive Factors Laboratory, Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908, Barcelona, Spain
- Xenopat S.L. Business Bioincubator Bellvitge Health Science Campus, L'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - S Gallego
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain
- Pediatric Oncology and Hematology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Roma
- Laboratory of Translational Research in Childhood and Adolescent Cancer, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Barcelona, Spain.
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35
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Rais F, Benhmidou N, Rais G, Loughlimi H, Kouhen F, Maghous A, Aarab J, Bellahammou K, Moukinebillah M, Khattab M, Chala S, Elmejjaoui S, Kebdani T, Elkacemi H, Benjaafar N. Wilms tumor in childhood: Single centre retrospective study from the National Institute of Oncology of Rabat and literature review. PEDIATRIC HEMATOLOGY ONCOLOGY JOURNAL 2016. [DOI: 10.1016/j.phoj.2016.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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36
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Rabeh W, Akel S, Eid T, Muwakkit S, Abboud M, El Solh H, Saab R. Wilms tumor: Successes and challenges in management outside of cooperative clinical trials. Hematol Oncol Stem Cell Ther 2016; 9:20-5. [PMID: 26802622 DOI: 10.1016/j.hemonc.2015.12.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 12/01/2015] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE/BACKGROUND Management of Wilms tumor (WT) in children depends on a multidisciplinary approach to treatment, and outcomes have significantly improved as reported by cooperative group clinical trials. Here, we review the clinical outcomes of patients with WT and identify challenges and barriers encountered in multidisciplinary management outside of cooperative clinical trials. METHODS We retrospectively reviewed the clinical records of 35 children with WT treated between April 2002 and June 2013 at the Children's Cancer Institute in Lebanon. RESULTS Upfront resection was performed in 23 cases. Biopsies were performed for Stage V tumors (n=4), those with unresectable tumors or inferior vena caval thrombus (n=5), and patients who had partial surgery performed elsewhere prior to presentation (n=2). One patient died due to toxicity prior to surgery. The tumor was Stage I in eight patients, Stage II in five patients, Stages III and IV in nine patients each, and bilateral (Stage V) in four patients. Adherence to The National Wilms Tumor Study-5 recommendations was adequate. At the time of analysis, 30 patients were free of disease and four patients had relapse-all having metastatic disease initially. CONCLUSION The National Wilms Tumor Study-5 therapy resulted in favorable outcomes in children with nonmetastatic Wilms tumor in the setting of a multidisciplinary approach to therapy and resolution of financial barriers to medical care. Upstaging due to prior intervention and lung radiation therapy to all those with computed tomography-detected lung nodules may both have resulted in overtreatment of a subset of patients. Finally, the relatively high incidence of bilateral tumors suggests the need for further genetic and molecular studies in this patient population.
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Affiliation(s)
- Wissam Rabeh
- Children's Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Samir Akel
- Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Toufic Eid
- Department of Radiation Oncology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Samar Muwakkit
- Children's Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Miguel Abboud
- Children's Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hassan El Solh
- Children's Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Raya Saab
- Children's Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon.
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Yi Y, Polosukhina D, Love HD, Hembd A, Pickup M, Moses HL, Lovvorn HN, Zent R, Clark PE. A Murine Model of K-RAS and β-Catenin Induced Renal Tumors Expresses High Levels of E2F1 and Resembles Human Wilms Tumor. J Urol 2015; 194:1762-70. [PMID: 25934441 PMCID: PMC4782590 DOI: 10.1016/j.juro.2015.04.090] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2015] [Indexed: 01/05/2023]
Abstract
PURPOSE Wilms tumor is the most common renal neoplasm of childhood. We previously found that restricted activation of the WNT/β-catenin pathway in renal epithelium late in kidney development is sufficient to induce small primitive neoplasms with features of epithelial Wilms tumor. Metastatic disease progression required simultaneous addition of an activating mutation of the oncogene K-RAS. We sought to define the molecular pathways activated in this process and their relationship to human renal malignancies. MATERIALS AND METHODS Affymetrix® expression microarray data from murine kidneys with activation of K-ras and/or Ctnnb1 (β-catenin) restricted to renal epithelium were analyzed and compared to publicly available expression data on normal and neoplastic human renal tissue. Target genes were verified by immunoblot and immunohistochemistry. RESULTS Mouse kidney tumors with activation of K-ras and Ctnnb1, and human renal malignancies had similar mRNA expression signatures and were associated with activation of networks centered on β-catenin and TP53. Up-regulation of WNT/β-catenin targets (MYC, Survivin, FOXA2, Axin2 and Cyclin D1) was confirmed by immunoblot. K-RAS/β-catenin murine kidney tumors were more similar to human Wilms tumor than to other renal malignancies and demonstrated activation of a TP53 dependent network of genes, including the transcription factor E2F1. Up-regulation of E2F1 was confirmed in murine and human Wilms tumor samples. CONCLUSIONS Simultaneous activation of K-RAS and β-catenin in embryonic renal epithelium leads to neoplasms similar to human Wilms tumor and associated with activation of TP53 and up-regulation of E2F1. Further studies are warranted to evaluate the role of TP53 and E2F1 in human Wilms tumor.
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Affiliation(s)
- Yajun Yi
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Dina Polosukhina
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Harold D Love
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Austin Hembd
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Michael Pickup
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Harold L Moses
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Harold N Lovvorn
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Roy Zent
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Peter E Clark
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
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Rice HE, Englum BR, Gulack BC, Adibe OO, Tracy ET, Kreissman SG, Routh JC. Use of patient registries and administrative datasets for the study of pediatric cancer. Pediatr Blood Cancer 2015; 62:1495-500. [PMID: 25807938 PMCID: PMC4515152 DOI: 10.1002/pbc.25506] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 02/17/2015] [Indexed: 12/11/2022]
Abstract
Analysis of data from large administrative databases and patient registries is increasingly being used to study childhood cancer care, although the value of these data sources remains unclear to many clinicians. Interpretation of large databases requires a thorough understanding of how the dataset was designed, how data were collected, and how to assess data quality. This review will detail the role of administrative databases and registry databases for the study of childhood cancer, tools to maximize information from these datasets, and recommendations to improve the use of these databases for the study of pediatric oncology.
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Affiliation(s)
- Henry E. Rice
- Department of Surgery, Duke University Medical Center, Durham, North Carolina
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
| | - Brian R. Englum
- Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Brian C. Gulack
- Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Obinna O. Adibe
- Department of Surgery, Duke University Medical Center, Durham, North Carolina
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
| | - Elizabeth T. Tracy
- Department of Surgery, Duke University Medical Center, Durham, North Carolina
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
| | - Susan G. Kreissman
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
| | - Jonathan C. Routh
- Department of Surgery, Duke University Medical Center, Durham, North Carolina
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
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Kembhavi SA, Shah S, Rangarajan V, Qureshi S, Popat P, Kurkure P. Imaging in neuroblastoma: An update. Indian J Radiol Imaging 2015; 25:129-36. [PMID: 25969636 PMCID: PMC4419422 DOI: 10.4103/0971-3026.155844] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Neuroblastoma is the third common tumor in children. Imaging plays an important role in the diagnosis, staging, treatment planning, response evaluation and in follow-up of a case of Neuroblastoma. The International Neuroblastoma Risk Group task force has recently introduced an imaging-based staging system and laid down guidelines for uniform reporting of imaging studies. This review is an update on imaging in neuroblastoma, with emphasis on these guidelines.
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Affiliation(s)
- Seema A Kembhavi
- Department of Radiodiagnosis, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Sneha Shah
- Department of Bio-imaging, Tata Memorial Centre, Mumbai, Maharashtra, India
| | | | - Sajid Qureshi
- Department of Surgery, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Palak Popat
- Department of Radiodiagnosis, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Purna Kurkure
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
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Abstract
Renal malignancies are common in children. While the majority of malignant renal masses are secondary to Wilms tumor, it can be challenging to distinguish from more aggressive renal masses. For suspicious renal lesions, it is crucial to ensure prompt diagnosis in order to select the appropriate surgical procedure and treatment. This review article will discuss the common differential diagnosis that can be encountered when evaluating a suspicious renal mass in the pediatric population. This includes clear cell sarcoma of the kidney, malignant rhabdoid tumor, renal medullary carcinoma and lymphoma.
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Isolated late CNS relapse in a young adult 10 years after initial treatment for neuroblastoma. J Pediatr Hematol Oncol 2015; 37:75-7. [PMID: 24755834 DOI: 10.1097/mph.0000000000000163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Tai E, Beaupin L, Bleyer A. Clinical trial enrollment among adolescents with cancer: supplement overview. Pediatrics 2014; 133 Suppl 3:S85-90. [PMID: 24918212 PMCID: PMC6069529 DOI: 10.1542/peds.2014-0122b] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Survival rates for children with cancer have significantly increased over the past 35 years. However, adolescents with cancer aged 15 to 19 years have had less progress in survival prolongation compared with younger children, which may be due to lower clinical trial enrollment among adolescents with cancer. To help address this issue, the Centers for Disease Control and Prevention (CDC) convened a series of webinars to identify salient issues and measures to address this problem. This supplement is intended to raise awareness about the unique challenges of clinical trial enrollment among adolescents with cancer. METHODS The CDC convened a workgroup of researchers and health care providers in the field of adolescent and young adult oncology and cancer survivorship to examine the barriers and challenges limiting the participation of adolescents in clinical trials and to define ways to improve on these concerns. RESULTS The workgroup identified 3 distinct issues affecting clinical trial enrollment among adolescents with cancer: (1) many adolescents with cancer are not referred to institutions where clinical trials are offered, (2) there are limited numbers of clinical trials for adolescents with cancer, and (3) psychosocial barriers impede adolescents with cancer from enrolling in clinical trials. CONCLUSIONS Adolescents with cancer have the smallest proportion and least number of patients enrolled in clinical trials in pediatric oncology. Successfully addressing this challenge requires improving referral to existing clinical trials, addressing regulatory barriers to clinical trial enrollment, increasing the number of clinical trials for adolescents, and addressing unique psychosocial barriers to clinical trial enrollment.
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Affiliation(s)
- Eric Tai
- Centers for Disease Control and Prevention, Atlanta, Georgia;
| | | | - Archie Bleyer
- St Charles Health System, Quality Department, Bend, Oregon
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44
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Kim YS, Lee HA, Lim JY, Kim Y, Jung CH, Yoo SH, Kim Y. β-Carotene inhibits neuroblastoma cell invasion and metastasis in vitro and in vivo by decreasing level of hypoxia-inducible factor-1α. J Nutr Biochem 2014; 25:655-64. [DOI: 10.1016/j.jnutbio.2014.02.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 01/28/2014] [Accepted: 02/06/2014] [Indexed: 12/12/2022]
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45
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A Comparison of Renal Function Outcomes After Nephron-sparing Surgery and Radical Nephrectomy for Nonsyndromic Unilateral Wilms Tumor. Urology 2014; 83:1388-93. [DOI: 10.1016/j.urology.2014.01.051] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 01/15/2014] [Accepted: 01/24/2014] [Indexed: 11/22/2022]
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de Miranda DO, Barros JEXS, Vieira MMS, Lima ELS, Moraes VLL, da Silva HA, Garcia HLBO, Lima CA, Gomes AV, Santos N, Muniz MTC. Reduced folate carrier-1 G80a gene polymorphism is associated with neuroblastoma's development. Mol Biol Rep 2014; 41:5069-75. [PMID: 24771227 DOI: 10.1007/s11033-014-3372-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 01/06/2014] [Indexed: 10/25/2022]
Abstract
Neuroblastoma is a malignant embryonal tumor of neural crest cells that give rise to the sympathetic nervous system, responsible for 10-70% of all cases of childhood cancer. Because of its early appearance, it has been suggested that risk factors active in the prenatal can be associated with the pathogenesis of neuroblastoma. The aim of this study was to investigate whether the genetic polymorphisms MTHFR C677T and A1298C, MTR A2756G, TYMS 2R/3R and SLC19A1 G80A, involved in folate metabolism, increase the risk of neuroblastoma in Brazilian children. This study comprised 31 Brazilian children (0-14 years old) diagnosed with neuroblastoma compared with 92 controls. Investigation of polymorphisms MTHFR C677T, MTR A2756G and SLC19A1 A80G was performed using PCR-RFLP, the TYMS 2R/3R using PCR and MTHFR A1298C using AS-PCR. The SLC19A1 A80A genotype was significantly associated with the development of neuroblastoma, compared with the control group (Williams G-Test = 0.0286; OR = 5.1667; 95% CI = 1.4481-18.4338; p = 0.0175). When analyzed together, the 80AG+AA genotypes showed a trend toward association (OR = 3.3033; 95% CI = 1.0586-10.3080; p = 0.0563). Our results suggest that individuals carriers of genotype AA for the SLC19A1 gene present risk for the development of neuroblastoma and possibly have difficulty in absorption of folic acid by the cells, and this may adversely affect the metabolism of folate causing genomic instability and promoting the development of cancer. This is the first retrospective/prospective study to examine the relationship between polymorphisms of folate pathway genes and risk of neuroblastoma.
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Affiliation(s)
- Dyego O de Miranda
- Laboratório de Biologia Molecular, Centro de Oncohematologia Pediátrica (CEONHPE), Hospital Universitário Oswaldo Cruz - HUOC/UPE, Universidade de Pernambuco - UPE, Arnóbio Marques, 310 - Santo Amaro, Recife, 50100-130, Pernambuco, Brazil,
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Wang HHS, Abern MR, Cost NG, Chu DI, Ross SS, Wiener JS, Routh JC. Use of nephron sparing surgery and impact on survival in children with Wilms tumor: a SEER analysis. J Urol 2014; 192:1196-202. [PMID: 24735935 DOI: 10.1016/j.juro.2014.04.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2014] [Indexed: 01/27/2023]
Abstract
PURPOSE Nephron sparing surgery is the standard of care for many adults with renal tumors and has been described in some children with Wilms tumor. However, beyond case series the data concerning nephron sparing surgery application and outcomes in patients with Wilms tumor are scarce. We examined nephron sparing surgery outcomes and factors associated with its application in children with Wilms tumor. MATERIALS AND METHODS We retrospectively reviewed the 1998 to 2010 SEER database. We identified patients 18 years old or younger with Wilms tumor. Clinical, demographic and socioeconomic data were abstracted, and statistical analysis was performed using multivariate logistic regression (predicting use of nephron sparing surgery limited to unilateral tumors smaller than 15 cm) and Cox regression (predicting overall survival) models. RESULTS We identified 876 boys and 956 girls with Wilms tumor (mean ± SD age 3.3 ± 2.9 years). Of these patients 114 (6.2%) underwent nephron sparing surgery (unilateral Wilms tumor in 74 and bilateral in 37). Median followup was 7.1 years. Regarding procedure choice, nephron sparing surgery was associated with unknown lymph node status (Nx vs N0, p <0.001) and smaller tumor size (p <0.001). Regarding survival, only age (HR 1.09, p = 0.002), race (HR 2.48, p = 0.002), stage (HR 2.99, p <0.001) and lymph node status (HR 2.17, p = 0.001) predicted decreased overall survival. Survival was not significantly different between children undergoing nephron sparing surgery and radical nephrectomy (HR 0.79, p = 0.58). CONCLUSIONS In children with Wilms tumor included in the SEER database nephron sparing surgery has been infrequently performed. Nephron sparing surgery application is associated with smaller, bilateral tumors and with omission of lymphadenectomy. However, there are no evident differences in application of nephron sparing surgery based on demographic or socioeconomic factors. Despite lymph node under staging, overall survival is similar between patients undergoing nephron sparing surgery and radical nephrectomy.
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Affiliation(s)
- Hsin-Hsiao S Wang
- Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina
| | - Michael R Abern
- Department of Urology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois
| | - Nicholas G Cost
- Division of Urology, University of Colorado Anschutz Medical Campus, Denver, Colorado
| | - David I Chu
- Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina
| | - Sherry S Ross
- Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina
| | - John S Wiener
- Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina
| | - Jonathan C Routh
- Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina.
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Sanchez TR, Ducore J, Balagtas J, Molloy C, Wootton-Gorges SL. WARM N COLD: malignant and benign renal tumors in children. Emerg Radiol 2014; 21:261-9. [PMID: 24570120 DOI: 10.1007/s10140-014-1202-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 02/04/2014] [Indexed: 12/22/2022]
Abstract
Although Wilms tumor is the most common renal malignancy in children, the differential diagnosis is extensive and includes both malignant and benign disorders. We present a simple mnemonic-WARM N COLD, to aid in remembering these diverse tumors. Imaging clues including age of the patient, associated disease or syndrome as well as salient imaging characteristics such as bilaterality, and type or presence of metastasis are also presented and can help differentiate between these renal tumors of childhood.
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Affiliation(s)
- Thomas Ray Sanchez
- Division of Pediatric Radiology, Davis Children's Hospital, University of California, Sacramento, CA, USA,
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Pierse J, Ying-Peng Wun E, Pellecchia R, Wollenberg J. Treatment of a rare ganglioneuroma with resection and reconstruction of the mandible: a case report and literature review. J Oral Maxillofac Surg 2013; 72:748.e1-9. [PMID: 24529569 DOI: 10.1016/j.joms.2013.12.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 12/17/2013] [Accepted: 12/17/2013] [Indexed: 11/18/2022]
Abstract
Ganglioneuromas are rare neuroblastic tumors that develop from the neural crests of the sympathetic nervous system. Because ganglioneuromas of the mandible have been infrequent, they do not have a standardized management protocol. As of 2000, only 5 cases had been reported. Ganglioneuromas are unique tumors that can undergo histologic maturation from a malignancy to a benign variant. We present the case of a 15-year-old boy with a ganglioneuroma of the mandible and the results of surgical management, including immediate reconstruction with a free fibula microvascular flap.
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Affiliation(s)
- Joseph Pierse
- Chief Resident, Department of Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, Brooklyn, NY
| | | | - Robert Pellecchia
- Chairman, Department of Oral and Maxillofacial Surgery and Dental Medicine, Geisinger Medical Center, Danville, PA.
| | - Jessica Wollenberg
- Chief Resident, Department of Oral Pathology, New York Hospital, New York, NY
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Blijdorp K, van den Heuvel-Eibrink MM, Pieters R, Pluijm SMF, Wagner A, Segers H, van der Lely AJ, Neggers SJCMM. Final height and IGF1 in adult survivors of Wilms tumour. Eur J Endocrinol 2013; 169:445-51. [PMID: 23892354 DOI: 10.1530/eje-13-0297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE One-sided nephrectomy is followed by increased levels of IGF1, associated with linear growth during childhood. The aim was to evaluate final height and IGF1 levels in nephrectomized Wilms tumour survivors when compared with healthy Dutch references and survivors of other cancer types. DESIGN Cross-sectional retrospective study. METHODS Data of 575 adult childhood cancer survivors were analysed. median follow-up time was 17.8 (range 5.048.8) years. Analysis of (co)variance was performed to evaluate differences between subgroups: nephrectomized Wilms survivors treated with or without abdominal irradiation (n=41 and n=36) and survivors of other cancer types treated with or without irradiation involving the cranium, abdomen or total body (n=149 and n=349). Main outcome measures were IGF1 and height, expressed as SDS. RESULTS After adjustment for age at diagnosis, former corticosteroid treatment and renal impairment, height SDS in non-irradiated nephrectomized Wilms survivors was significantly higher than that in non-irradiated survivors of other cancer types (estimated mean SDS -0.09 vs -0.49, P=0.044), abdominal irradiated survivors (SDS -0.70, P=0.015) and other irradiated survivors (SDS -1.47, P<0.001). Non-irradiated nephrectomized Wilms tumour survivors had significantly higher IGF1 SDS than other irradiated survivors (estimated mean SDS -0.05 vs -1.36, P<0.001 and 0.11 vs 1.37, P<0.001), while there was no significant difference with the other two subgroups. CONCLUSIONS Adult survivors of Wilms tumour showed better attainment of final height and relatively higher IGF1 levels than those of other cancer types who had significantly shorter stature and lower IGF1 levels than Dutch references.
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Affiliation(s)
- K Blijdorp
- Department of Paediatric Oncology/Haematology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, PO Box 2060, 3000 CB Rotterdam, The Netherlands
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