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Nirgude S, Naveh NSS, Kavari SL, Traxler EM, Kalish JM. Cancer predisposition signaling in Beckwith-Wiedemann Syndrome drives Wilms tumor development. Br J Cancer 2024; 130:638-650. [PMID: 38142265 PMCID: PMC10876704 DOI: 10.1038/s41416-023-02538-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 11/25/2023] [Accepted: 12/01/2023] [Indexed: 12/25/2023] Open
Abstract
BACKGROUND Wilms tumor (WT) exhibits structural and epigenetic changes at chromosome 11p15, which also cause Beckwith-Wiedemann Syndrome (BWS). Children diagnosed with BWS have increased risk for WT. The aim of this study is to identify the molecular signaling signatures in BWS driving these tumors. METHODS We performed whole exome sequencing, methylation array analysis, and gene expression analysis on BWS-WT samples. Our data were compared to publicly available nonBWS data. We categorized WT from BWS and nonBWS patients by assessment of 11p15 methylation status and defined 5 groups- control kidney, BWS-nontumor kidney, BWS-WT, normal-11p15 nonBWS-WT, altered-11p15 nonBWS-WT. RESULTS BWS-WT samples showed single nucleotide variants in BCORL1, ASXL1, ATM and AXL but absence of recurrent gene mutations associated with sporadic WT. We defined a narrow methylation range stratifying nonBWS-WT samples. BWS-WT and altered-11p15 nonBWS-WT showed enrichment of common and unique molecular signatures based on global differential methylation and gene expression analysis. CTNNB1 overexpression and broad range of interactions were seen in the BWS-WT interactome study. CONCLUSION While WT predisposition in BWS is well-established, as are 11p15 alterations in nonBWS-WT, this study focused on stratifying tumor genomics by 11p15 status. Further investigation of our findings may identify novel therapeutic targets in WT oncogenesis.
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Affiliation(s)
- Snehal Nirgude
- Division of Human Genetics and Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Natali S Sobel Naveh
- Division of Human Genetics and Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Sanam L Kavari
- Division of Human Genetics and Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Emily M Traxler
- Division of Human Genetics and Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Jennifer M Kalish
- Division of Human Genetics and Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
- Departments of Pediatrics and Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 19104, USA.
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de Souza FKM, Fanelli MCA, Duarte AAB, Alves MTDS, Lederman HM, Cypriano MDS, Abib SDCV. Surgery in Bilateral Wilms Tumor-A Single-Center Experience. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1790. [PMID: 38002881 PMCID: PMC10670692 DOI: 10.3390/children10111790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023]
Abstract
The treatment of bilateral Wilms tumors (BWT) involves curing the cancer, preserving long-term renal function, and maintaining a good quality of life. Established methods for achieving these goals include preoperative chemotherapy and nephron-sparing surgery (NSS). This study aimed to evaluate the experience of a single institution in treating patients with BWT. We analyzed cases of BWT treated at the Pediatric Oncology Institute-GRAACC-Federal University of São Paulo over a period of 35 years. Bleeding control was performed with manual compression of the renal parenchyma. Thirty-three patients were included in the study. Thirty cases were synchronous tumors. The mean age at diagnosis was 30.4 months (±22 m) and 66.7% were girls. The median follow-up period was 83 months. Neoadjuvant chemotherapy was the primary approach in most patients (87.9%), with a simultaneous upfront surgical approach performed in 84.8%. Most patients underwent bilateral NSS (70.4%). There were no early complications in this series, but 39.4% had clinical complications. The five-year survival rate was 76%. Therefore, it is clear that the surgical approach to BWT plays a crucial role in achieving good outcomes. However, it is difficult to standardize surgical techniques and technology may have the potential to enhance safety.
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Affiliation(s)
- Fernanda Kelly Marques de Souza
- Department of Pediatric Surgery, Pediatric Oncology Institute, GRAACC, Federal University of São Paulo, São Paulo 04039-001, Brazil; (M.C.A.F.); (A.A.B.D.); (S.d.C.V.A.)
| | - Mayara Caroline Amorim Fanelli
- Department of Pediatric Surgery, Pediatric Oncology Institute, GRAACC, Federal University of São Paulo, São Paulo 04039-001, Brazil; (M.C.A.F.); (A.A.B.D.); (S.d.C.V.A.)
| | - Alexandre Alberto Barros Duarte
- Department of Pediatric Surgery, Pediatric Oncology Institute, GRAACC, Federal University of São Paulo, São Paulo 04039-001, Brazil; (M.C.A.F.); (A.A.B.D.); (S.d.C.V.A.)
- Department of Pediatric Surgery, Foundation Regional Faculty of Medicine of São José do Rio Preto, Children’s and Maternity Hospital, São José do Rio Preto 15091-240, Brazil
| | | | - Henrique Manoel Lederman
- Department of Radiology, Pediatric Oncology Institute, GRAACC, Federal University of São Paulo, São Paulo 04039-001, Brazil;
| | - Monica dos Santos Cypriano
- Department of Pediatric Oncology, Pediatric Oncology Institute, GRAACC, Federal University of São Paulo, São Paulo 04039-001, Brazil;
| | - Simone de Campos Vieira Abib
- Department of Pediatric Surgery, Pediatric Oncology Institute, GRAACC, Federal University of São Paulo, São Paulo 04039-001, Brazil; (M.C.A.F.); (A.A.B.D.); (S.d.C.V.A.)
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Semeraro M, Fouquet C, Vial Y, Amiel J, Galmiche L, Cretolle C, Blanc T, Jolaine V, Garcelon N, Entz-Werle N, Pellier I, Vérité C, Sophie Taque, Coulomb A, Petit A, Corradini N, Bouazza N, Lacour B, Clavel J, Brugières L, Bourdeaut F, Sarnacki S. Pediatric Tumors and Developmental Anomalies: A French Nationwide Cohort Study. J Pediatr 2023; 259:113451. [PMID: 37169337 DOI: 10.1016/j.jpeds.2023.113451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/17/2023] [Accepted: 04/23/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVE To assess the associations between congenital abnormalities and pediatric malignancies and evaluate the potential underlying molecular basis by collecting information on pediatric patients with cancer and congenital abnormalities. STUDY DESIGN Tumeur Et Développement is a national, prospective, and retrospective multicenter study recording data of children with cancer and congenital abnormalities. When feasible, blood and tumoral samples are collected for virtual biobanking. RESULTS From June 2013 to December 2019, 679 associations between pediatric cancers and congenital abnormalities were recorded. The most represented cancers were central nervous system tumors (n = 139; 20%), leukemia and myelodysplastic syndromes (n = 123; 18.1%), and renal tumors (n = 101; 15%). Congenital abnormalities were not related to any known genetic disorder in 66.5% of cases. In this group, the most common anomaly was intellectual disability (22.3%), followed by musculoskeletal (14.2%) and genitourinary anomalies (12.4%). Intellectual disability was mostly associated with hematologic malignancies. Embryonic tumors (neuroblastoma, Wilms tumor, and rhabdomyosarcoma) were associated with consistent abnormalities, sometimes with a close anatomical neighborhood between the abnormality and the neoplasm. CONCLUSIONS In the first Tumeur Et Développement analysis, 3 major themes have been identified: (1) germline mutations with or without known cancer predisposition, (2) postzygotic events responsible for genomic mosaicism, (3) coincidental associations. New pathways involved in cancer development need to be investigated to improve our understanding of childhood cancers.
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Affiliation(s)
- Michaela Semeraro
- Centre d'Investigation Clinique-Unité de Recherche Clinique, Hôpital Universitaire Necker Enfants-Malades, AP-HP Centre - Université Paris Cité, Paris, France; Université de Paris Cité, Paris, France; Equipe d'Accueil 7323, Université de Paris, Paris, France.
| | - Cyrielle Fouquet
- Départment de Pédiatrie, Unité d'onco-hématologie pédiatrique, Hôpital Pellegrin, Bordeaux, France
| | - Yoann Vial
- Université de Paris Cité, Paris, France; Département de génétique, CHU Paris-Hôpital Robert Debré, Paris, France
| | - Jeanne Amiel
- Université de Paris Cité, Paris, France; Laboratoire 408 Embryologie et génétique des malformations, INSERM UMR-1163, Institut Imagine, Paris, France
| | - Louise Galmiche
- Départment de Pédiatrie, Service Anatomie Pathologique, Hôpital Necker Enfants Malades, Paris, France
| | - Célia Cretolle
- Départment de Pédiatrie, Service de Chirurgie viscérale pédiatrique, Hôpital Universitaire Necker Enfants-Malades, GH Paris Centre, Paris, France
| | - Thomas Blanc
- Université de Paris Cité, Paris, France; Départment de Pédiatrie, Service de Chirurgie viscérale pédiatrique, Hôpital Universitaire Necker Enfants-Malades, GH Paris Centre, Paris, France
| | - Valérie Jolaine
- Centre d'Investigation Clinique-Unité de Recherche Clinique, Hôpital Universitaire Necker Enfants-Malades, AP-HP Centre - Université Paris Cité, Paris, France
| | - Nicolas Garcelon
- Départment de Pédiatrie, UMR 1163, Imagine Institute, Université de Paris, Paris, France
| | - Natacha Entz-Werle
- Départment de Pédiatrie, CHRU Hautepierre Strasbourg, Service de Pédiatrie Onco-Hématologie, Strasbourg, France
| | - Isabelle Pellier
- Hematology-Oncology-Immunology Department, CHU Angers, Angers, France
| | - Cécile Vérité
- Départment de Pédiatrie, Unité d'onco-hématologie pédiatrique, Hôpital Pellegrin, Bordeaux, France
| | - Sophie Taque
- Départment de Pédiatrie, Hôpital Universitaire de Rennes, Rennes, France
| | - Aurore Coulomb
- Department of Pathology, AP-HP, Armand Trousseau Hospital, Paris, France
| | - Arnaud Petit
- Department of Onco-Haematology, AP-HP, Armand Trousseau Hospital, Paris, France
| | - Nadège Corradini
- Department of Pediatric Oncology, Institut d'hématologie et d'oncologie pédiatrique, Lyon, France
| | - Naim Bouazza
- Université de Paris Cité, Paris, France; Clinical Research Unit, Tarnier Hospital, Paris, France
| | - Brigitte Lacour
- INSERM UMRS1018, Paris-Sud University, Villejuif, France; National Registry of Childhood Hematopoietic Malignancies, Villejuif, France
| | - Jacqueline Clavel
- INSERM UMRS1018, Paris-Sud University, Villejuif, France; National Registry of Childhood Hematopoietic Malignancies, Villejuif, France
| | - Laurence Brugières
- Child and Adolescent Cancer Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Franck Bourdeaut
- Université de Paris Cité, Paris, France; Laboratoire de Recherche Translationnelle en Oncologie Pédiatrique, INSERM U830, Institut Curie, Paris, France
| | - Sabine Sarnacki
- Université de Paris Cité, Paris, France; Départment de Pédiatrie, Service de Chirurgie viscérale pédiatrique, Hôpital Universitaire Necker Enfants-Malades, GH Paris Centre, Paris, France
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Quarello P, Carli D, Biasoni D, Gerocarni Nappo S, Morosi C, Cotti R, Garelli E, Zucchetti G, Spadea M, Tirtei E, Spreafico F, Fagioli F. Implications of an Underlying Beckwith-Wiedemann Syndrome for Wilms Tumor Treatment Strategies. Cancers (Basel) 2023; 15:cancers15041292. [PMID: 36831633 PMCID: PMC9954715 DOI: 10.3390/cancers15041292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
Beckwith-Wiedemann Syndrome (BWS) is a pediatric overgrowth disorder involving a predisposition to embryonal tumors. Most of the tumors associated with BWS occur in the first 8-10 years of life, and the most common is Wilms tumor (WT). BWS clinical heterogeneity includes subtle overgrowth features or even silent phenotypes, and WT may be the presenting symptom of BWS. WT in BWS individuals exhibit distinct characteristics from those of sporadic WT, and the management of these patients needs a peculiar approach. The most important feature is a higher risk of developing bilateral disease at some time in the course of the illness (synchronous bilateral disease at diagnosis or metachronous recurrence after initial presentation with unilateral disease). Accordingly, neoadjuvant chemotherapy is the recommended approach also for BWS patients with unilateral WT to facilitate nephron-sparing surgical approaches. This review emphasizes the importance of early BWS recognition, particularly if a WT has already occurred, as this will result in an urgent consideration of first-line cancer therapy.
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Affiliation(s)
- Paola Quarello
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
- Correspondence: ; Tel.: +39-011-313-5801
| | - Diana Carli
- Immunogenetics and Transplant Biology Service, Città della Salute e della Scienza University Hospital, 10126 Turin, Italy
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
| | - Davide Biasoni
- Pediatric Surgical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | | | - Carlo Morosi
- Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Roberta Cotti
- Pediatric Radiology, Regina Margherita Children’s Hospital, 10126 Turin, Italy
| | - Emanuela Garelli
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
| | - Giulia Zucchetti
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy
| | - Manuela Spadea
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
| | - Elisa Tirtei
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
| | - Filippo Spreafico
- Pediatric Oncology Unit, Department of Medical Oncology and Hematology, Fondazione IRCCS, Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Franca Fagioli
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
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Welter N, Furtwängler R, Schneider G, Graf N, Schenk JP. [Tumor predisposition syndromes and nephroblastoma : Early diagnosis with imaging]. RADIOLOGIE (HEIDELBERG, GERMANY) 2022; 62:1033-1042. [PMID: 36008692 DOI: 10.1007/s00117-022-01056-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 06/15/2023]
Abstract
CLINICAL/METHODICAL ISSUE The Beckwith-Wiedemann spectrum (BWSp) as well as the WT1-related syndromes, Denys-Drash syndrome (DDS) and WAGR spectrum (Wilms tumor, Aniridia, genitourinary anomalies and a range of developmental delays) are tumor predisposition syndromes (TPS) of Wilms tumor (WT). Patients with associated TPS are at higher risk of developing chronic kidney disease and bilateral and metachronous tumors as well as nephrogenic rests. STANDARD RADIOLOGICAL METHODS Standard imaging diagnostics for WT include renal ultrasound and magnetic resonance imaging (MRI). In the current renal tumor studies Umbrella SIOP-RTSG 2016 and Randomet 2017, thoracic computed tomography (CT) is also recommended as standard. Positron emission tomography (PET)-CT and whole-body MRI, on the other hand, are not part of routine diagnostics. METHODOLOGICAL INNOVATIONS In recent publications, renal ultrasound is recommended every 3 months until the age of 7 years in cases of clinical suspicion or molecularly proven TPS. PERFORMANCE Patients with TPS and regular renal ultrasounds have smaller tumor volumes and lower tumor stages at WT diagnosis than patients without such a screening. This allows a reduction of therapy intensity and facilitates the performance of nephron sparing surgery, which is prognostically relevant especially in bilateral WT. ACHIEVEMENTS Early diagnosis of WT in the context of TPS ensures the greatest possible preservation of healthy and functional renal tissue. Standardized screening by regular renal ultrasounds should therefore be firmly established in clinical practice. PRACTICAL RECOMMENDATIONS The initial diagnosis of TPS is clinical and requires a skilled and attentive examiner in the presence of sometimes subtle clinical manifestations, especially in the case of BWSp. Clinical diagnosis should be followed by genetic testing, which should then be followed by sonographic screening.
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Affiliation(s)
- N Welter
- Klinik für pädiatrische Onkologie und Hämatologie, Universitätsklinikum des Saarlandes, 66421, Homburg/Saar, Deutschland.
| | - R Furtwängler
- Klinik für pädiatrische Onkologie und Hämatologie, Universitätsklinikum des Saarlandes, 66421, Homburg/Saar, Deutschland
| | - G Schneider
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum des Saarlandes, Homburg, Deutschland
| | - N Graf
- Klinik für pädiatrische Onkologie und Hämatologie, Universitätsklinikum des Saarlandes, 66421, Homburg/Saar, Deutschland
| | - J-P Schenk
- Sektion Pädiatrische Radiologie, Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
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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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de Souza VS, da Cunha GCR, Versiani BR, de Oliveira CP, Rosa MTAS, de Oliveira SF, Moretti PN, Mazzeu JF, Pic-Taylor A. Characterization of Associated Nonclassical Phenotypes in Patients with Deletion in the WAGR Region Identified by Chromosomal Microarray: New Insights and Literature Review. Mol Syndromol 2022; 13:290-304. [PMID: 36158055 PMCID: PMC9421677 DOI: 10.1159/000518872] [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: 03/16/2021] [Accepted: 08/03/2021] [Indexed: 01/03/2023] Open
Abstract
WAGR syndrome (Wilms' tumor, aniridia, genitourinary changes, and intellectual disability) is a contiguous gene deletion syndrome characterized by the joint deletion of PAX6 and WT1 genes, located in the short arm of chromosome 11. However, most deletions include other genes, leading to multiple associated phenotypes. Therefore, understanding how genes deleted together can contribute to other clinical phenotypes is still considered a challenge. In order to establish genotype-phenotype correlation in patients with interstitial deletions of the short arm of chromosome 11, we selected 17 patients with deletions identified by chromosomal microarray analysis: 4 new subjects and 13 subjects previously described in the literature with detailed clinical data. Through the analysis of deleted regions and the phenotypic changes, it was possible to suggest the contribution of specific genes to several nonclassical phenotypes, contributing to the accuracy of clinical characterization of the syndrome and emphasizing the broad phenotypic spectrum found in the patients. This study reports the first patient with a PAX6 partial deletion who does not present any eye anomaly thus opening a new set of questions about the functional activity of PAX6.
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Affiliation(s)
- Vanessa Sodré de Souza
- Programa de Pós-graduação em Biologia Animal, Universidade de Brasília, Brasília, Brazil,Programa de Pós-graduação em Ciências da Saúde, Universidade de Brasília, Brasília, Brazil
| | - Gabriela Corassa Rodrigues da Cunha
- Programa de Pós-graduação em Biologia Animal, Universidade de Brasília, Brasília, Brazil,Programa de Pós-graduação em Ciências da Saúde, Universidade de Brasília, Brasília, Brazil
| | - Beatriz R. Versiani
- Hospital de Apoio de Brasília, Secretária de Estado de Saúde do Distrito Federal, Brasília, Brazil,Hospital Universitário, Universidade de Brasília, Brasília, Brazil
| | - Claudiner Pereira de Oliveira
- Hospital de Apoio de Brasília, Secretária de Estado de Saúde do Distrito Federal, Brasília, Brazil,Hospital Universitário, Universidade de Brasília, Brasília, Brazil
| | - Maria Teresa Alves Silva Rosa
- Hospital Universitário, Universidade de Brasília, Brasília, Brazil,Programa de Pós-graduação em Ciências Médicas, Universidade de Brasília, Brasília, Brazil
| | - Silviene F. de Oliveira
- Programa de Pós-graduação em Biologia Animal, Universidade de Brasília, Brasília, Brazil,Programa de Pós-graduação em Ciências da Saúde, Universidade de Brasília, Brasília, Brazil,Departamento de Genética e Morfologia, Instituto de Ciências Biológicas, Universidade de Brasília, Brasília, Brazil
| | - Patricia N. Moretti
- Programa de Pós-graduação em Ciências Médicas, Universidade de Brasília, Brasília, Brazil
| | - Juliana F. Mazzeu
- Programa de Pós-graduação em Ciências da Saúde, Universidade de Brasília, Brasília, Brazil,Programa de Pós-graduação em Ciências Médicas, Universidade de Brasília, Brasília, Brazil,Faculdade de Medicina, Universidade de Brasília, Brasília, Brazil,*Juliana F. Mazzeu,
| | - Aline Pic-Taylor
- Programa de Pós-graduação em Biologia Animal, Universidade de Brasília, Brasília, Brazil,Programa de Pós-graduação em Ciências da Saúde, Universidade de Brasília, Brasília, Brazil,Programa de Pós-graduação em Ciências Médicas, Universidade de Brasília, Brasília, Brazil,Departamento de Genética e Morfologia, Instituto de Ciências Biológicas, Universidade de Brasília, Brasília, Brazil,**Aline Pic-Taylor,
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Turner JT, Hill DA, Dome JS. Revisiting the Threshold for Cancer Genetics Referral in Patients With Wilms Tumor. J Clin Oncol 2022; 40:1853-1860. [DOI: 10.1200/jco.22.00411] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in the Journal of Clinical Oncology , to patients seen in their own clinical practice.
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Affiliation(s)
- Joyce T. Turner
- Division of Genetics and Metabolism, Children's National Hospital and the George Washington University School of Medicine and Health Sciences, Washington, DC
- Division of Oncology, Children's National Hospital and the George Washington University School of Medicine and Health Sciences, Washington, DC
| | - D. Ashley Hill
- Division of Pathology and Laboratory Medicine, Children's National Hospital and the George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Jeffrey S. Dome
- Division of Oncology, Children's National Hospital and the George Washington University School of Medicine and Health Sciences, Washington, DC
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Hol JA, Kuiper RP, van Dijk F, Waanders E, van Peer SE, Koudijs MJ, Bladergroen R, van Reijmersdal SV, Morgado LM, Bliek J, Lombardi MP, Hopman S, Drost J, de Krijger RR, van den Heuvel-Eibrink MM, Jongmans MCJ. Prevalence of (Epi)genetic Predisposing Factors in a 5-Year Unselected National Wilms Tumor Cohort: A Comprehensive Clinical and Genomic Characterization. J Clin Oncol 2022; 40:1892-1902. [PMID: 35230882 PMCID: PMC9177240 DOI: 10.1200/jco.21.02510] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Wilms tumor (WT) is associated with (epi)genetic predisposing factors affecting a growing number of WT predisposing genes and loci, including those causing Beckwith-Wiedemann spectrum (BWSp) or WT1-related syndromes. To guide genetic counseling and testing, we need insight into the prevalence of WT predisposing (epi)genetic factors. PATIENTS AND METHODS All children diagnosed with WT in the Netherlands between 2015 and 2020 were referred to a clinical geneticist. Phenotypic data, disease characteristics, and diagnostic test results were collected. If no genetic predisposition was identified by targeted diagnostic testing, germline (trio-)whole-exome sequencing and BWSp testing on normal kidney-derived DNA were offered. RESULTS A total of 126 cases were analyzed of 128 identified patients. (Epi)genetic predisposing factors were present in 42 of 126 patients (33.3%) on the basis of a molecular diagnosis in blood-derived DNA (n = 26), normal kidney-derived DNA (n = 12), or solely a clinical diagnosis of BWSp (n = 4). Constitutional, heterozygous DIS3L2 variants were identified as a recurrent predisposing factor in five patients (4%), with a second somatic hit in 4 of 5 tumors. Twenty patients (16%) were diagnosed with BWSp while four additional patients without BWSp features harbored chromosome 11p15 methylation defects in normal kidney tissue. Remaining findings included WT1-related syndromes (n = 10), Fanconi anemia (n = 1), neurofibromatosis type 1 (n = 1), and a pathogenic REST variant (n = 1). In addition, (likely) pathogenic variants in adult-onset cancer predisposition genes (BRCA2, PMS2, CHEK2, and MUTYH) were identified in 5 of 56 (8.9%) patients with available whole-exome sequencing data. Several candidate WT predisposition genes were identified, which require further validation. CONCLUSION (Epi)genetic WT predisposing factors, including mosaic aberrations and recurrent heterozygous DIS3L2 variants, were present in at least 33.3% of patients with WT. On the basis of these results, we encourage standard genetic testing after counseling by a clinical geneticist.
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Affiliation(s)
- Janna A Hol
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Roland P Kuiper
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Department of Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Freerk van Dijk
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Esmé Waanders
- Department of Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Sophie E van Peer
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Marco J Koudijs
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Department of Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Reno Bladergroen
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | | | - Lionel M Morgado
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Jet Bliek
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Maria Paola Lombardi
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Saskia Hopman
- Department of Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jarno Drost
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Oncode Institute, Utrecht, the Netherlands
| | - Ronald R de Krijger
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Marjolijn C J Jongmans
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Department of Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
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10
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Mussa A, Carli D, Cardaropoli S, Ferrero GB, Resta N. Lateralized and Segmental Overgrowth in Children. Cancers (Basel) 2021; 13:cancers13246166. [PMID: 34944785 PMCID: PMC8699773 DOI: 10.3390/cancers13246166] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/02/2021] [Accepted: 12/04/2021] [Indexed: 01/19/2023] Open
Abstract
Congenital disorders of lateralized or segmental overgrowth (LO) are heterogeneous conditions with increased tissue growth in a body region. LO can affect every region, be localized or extensive, involve one or several embryonic tissues, showing variable severity, from mild forms with minor body asymmetry to severe ones with progressive tissue growth and related relevant complications. Recently, next-generation sequencing approaches have increased the knowledge on the molecular defects in LO, allowing classifying them based on the deranged cellular signaling pathway. LO is caused by either genetic or epigenetic somatic anomalies affecting cell proliferation. Most LOs are classifiable in the Beckwith-Wiedemann spectrum (BWSp), PI3KCA/AKT-related overgrowth spectrum (PROS/AROS), mosaic RASopathies, PTEN Hamartoma Tumor Syndrome, mosaic activating variants in angiogenesis pathways, and isolated LO (ILO). These disorders overlap over common phenotypes, making their appraisal and distinction challenging. The latter is crucial, as specific management strategies are key: some LO is associated with increased cancer risk making imperative tumor screening since childhood. Interestingly, some LO shares molecular mechanisms with cancer: recent advances in tumor biological pathway druggability and growth downregulation offer new avenues for the treatment of the most severe and complicated LO.
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Affiliation(s)
- Alessandro Mussa
- Department of Public Health and Pediatric Sciences, University of Torino, 10126 Torino, Italy; (D.C.); (S.C.)
- Pediatric Clinical Genetics Unit, Regina Margherita Children’s Hospital, Città della Salute e della Scienza di Torino, 10126 Torino, Italy
- Correspondence: ; Tel.: +39-0113135372
| | - Diana Carli
- Department of Public Health and Pediatric Sciences, University of Torino, 10126 Torino, Italy; (D.C.); (S.C.)
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cell Therapy Division, Regina Margherita Children’s Hospital, Città della Salute e della Scienza di Torino, 10126 Torino, Italy
| | - Simona Cardaropoli
- Department of Public Health and Pediatric Sciences, University of Torino, 10126 Torino, Italy; (D.C.); (S.C.)
| | | | - Nicoletta Resta
- Department of Biomedical Sciences and Human Oncology (DIMO), Medical Genetics, University of Bari “Aldo Moro”, 70121 Bari, Italy;
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11
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Nakata K, Williams R, Kinoshita Y, Koshinaga T, Moroz V, Al-Saadi R, Vujanic G, Oue T, Pritchard-Jones K. Comparative analysis of the clinical characteristics and outcomes of patients with Wilms tumor in the United Kingdom and Japan. Pediatr Blood Cancer 2021; 68:e29143. [PMID: 34056846 DOI: 10.1002/pbc.29143] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 04/28/2021] [Accepted: 05/07/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Wilms tumor (WT) demonstrates epidemiological differences by world region and ethnicity. To enhance understanding of these differences, we retrospectively analyzed clinical trial data sets from the UK and Japan over a 20-year period. PROCEDURE We used data from three consecutive clinical trials in the UK and a single study in Japan that enrolled patients diagnosed during 1996-2015, to compare clinical characteristics and outcomes between countries. RESULTS During 1996-2015, 1395 patients in the UK and 537 in Japan were included. Japanese patients have a significantly younger median age at diagnosis than those in the UK (28 months vs 39 months). The proportion of patients with stage IV, large tumors, and anaplastic histology appears to be higher in the UK than in Japan (18% vs 11%, 62% vs 49%, 8% vs 3%, respectively). During 2005-2015, 77 hospitals treated WT in Japan compared with only 20 hospitals in the UK. Five-year overall survival of patients with WT was over 90% in both countries, but five-year event-free survival of patients with stage IV was significantly lower in Japan than in the UK (50.0% vs 76.2%, P = 0.001). CONCLUSIONS Differences in age of onset, tumor size at diagnosis, and histology may reflect differences in the genetic background of patients with WT between countries, but population-based phenotype-genotype data are lacking. The difference in survival probability for stage IV patients may be due to different diagnostic criteria or different treatment strategies. Prospective, international clinical studies including genomic analyses are needed to confirm these findings and improve clinical practice.
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Affiliation(s)
- Kayo Nakata
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Richard Williams
- Developmental Biology and Cancer Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Imperial BRC Genomics Facility, Imperial College London, London, UK
| | - Yoshiaki Kinoshita
- Malignant Tumor Committee, Japanese Society of Pediatric Surgeons, Tokyo, Japan
| | | | - Veronica Moroz
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Reem Al-Saadi
- Developmental Biology and Cancer Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | | | - Takaharu Oue
- Department of Pediatric Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Kathy Pritchard-Jones
- Developmental Biology and Cancer Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
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12
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Groenendijk A, Spreafico F, de Krijger RR, Drost J, Brok J, Perotti D, van Tinteren H, Venkatramani R, Godziński J, Rübe C, Geller JI, Graf N, van den Heuvel-Eibrink MM, Mavinkurve-Groothuis AMC. Prognostic Factors for Wilms Tumor Recurrence: A Review of the Literature. Cancers (Basel) 2021; 13:cancers13133142. [PMID: 34201787 PMCID: PMC8268923 DOI: 10.3390/cancers13133142] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/08/2021] [Accepted: 06/18/2021] [Indexed: 01/10/2023] Open
Abstract
Simple Summary A Wilms tumor is a childhood kidney tumor. In high-income countries, 90% of patients with this tumor survive. However, the tumor recurs in 15% of patients. It is important to identify the patients at risk of recurrence in order to adjust treatment in such a way that recurrence may potentially be prevented. However, we are currently unable to determine precisely which patients are at risk of recurrence. Therefore, we present an overview of factors that influence the risk of recurrence, also known as prognostic factors. These factors range from patient-, tumor- and treatment-related characteristics to geographic and socioeconomic factors. In addition to these factors, biological markers, such as genetic alterations, should be studied more intensively as these markers may be able to better identify patients at risk of tumor recurrence. Abstract In high-income countries, the overall survival of children with Wilms tumors (WT) is ~90%. However, overall, 15% of patients experience tumor recurrence. The adverse prognostic factors currently used for risk stratification (advanced stage, high risk histology, and combined loss of heterozygosity at 1p and 16q in chemotherapy-naïve WTs) are present in only one third of these cases, and the significance of these factors is prone to change with advancing knowledge and improved treatment regimens. Therefore, we present a comprehensive, updated overview of the published prognostic variables for WT recurrence, ranging from patient-, tumor- and treatment-related characteristics to geographic and socioeconomic factors. Improved first-line treatment regimens based on clinicopathological characteristics and advancing knowledge on copy number variations unveil the importance of further investigating the significance of biological markers for WT recurrence in international collaborations.
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Affiliation(s)
- Alissa Groenendijk
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (H.v.T.); (M.M.v.d.H.-E.); (A.M.C.M.-G.)
- Correspondence:
| | - Filippo Spreafico
- Department of Medical Oncology and Hematology, Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy;
| | - Ronald R. de Krijger
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (H.v.T.); (M.M.v.d.H.-E.); (A.M.C.M.-G.)
- Department of Pathology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Jarno Drost
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (H.v.T.); (M.M.v.d.H.-E.); (A.M.C.M.-G.)
- Oncode Institute, 3584 CS Utrecht, The Netherlands
| | - Jesper Brok
- Department of Pediatric Oncology and Hematology, Rigshospitalet, 2100 Copenhagen, Denmark;
- Developmental Biology and Cancer Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, London WC1N 1EH, UK
| | - Daniela Perotti
- Molecular Bases of Genetic Risk and Genetic Testing Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy;
| | - Harm van Tinteren
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (H.v.T.); (M.M.v.d.H.-E.); (A.M.C.M.-G.)
| | | | - Jan Godziński
- Department of Pediatric Surgery, Marciniak Hospital, Fieldorfa 2, 54-049 Wroclaw, Poland;
- Department of Pediatric Traumatology and Emergency Medicine, Wroclaw Medical University, Bujwida 44a, 50-345 Wroclaw, Poland
| | - Christian Rübe
- Department of Radiation Oncology, Saarland University Medical Center and Saarland University Faculty of Medicine, D-66421 Homburg, Germany;
| | - James I. Geller
- Division of Oncology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229, USA;
| | - Norbert Graf
- Department of Pediatric Oncology and Hematology, Saarland University Medical Center and Saarland University Faculty of Medicine, D-66421 Homburg, Germany;
| | - Marry M. van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (H.v.T.); (M.M.v.d.H.-E.); (A.M.C.M.-G.)
| | - Annelies M. C. Mavinkurve-Groothuis
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (H.v.T.); (M.M.v.d.H.-E.); (A.M.C.M.-G.)
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13
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Radley JA, Connolly M, Sabir A, Kanani F, Carley H, Jones RL, Hyder Z, Gompertz L, Reardon W, Richardson R, McClelland L, Maher ER. Isolated- and Beckwith-Wiedemann syndrome related- lateralised overgrowth (hemihypertrophy): Clinical and molecular correlations in 94 individuals. Clin Genet 2021; 100:292-297. [PMID: 33993487 DOI: 10.1111/cge.13997] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 01/07/2023]
Abstract
The congenital imprinting disorder, Beckwith-Wiedemann syndrome (BWS) is associated with variable clinical features including hemihypertrophy/lateralised overgrowth (LO) and embryonal tumour predisposition. BWS-associated (epi)genetic alterations occur in a subset of patients with isolated LO (ILO), leading to the concept of BWS spectrum disorder (BWSp). We investigated the relationship between clinical features and molecular diagnostic results in a cohort with LO using the BWSp international consensus group (BWSICG) clinical scoring system. Clinical/molecular findings in 94 previously-unreported patients with LO referred for BWSp molecular studies were reviewed retrospectively. The BWSICG score was assigned and diagnostic rate calculated. BWSp-associated (epi)genetic alteration was identified in 15/94 (16%). The molecular diagnostic rate by MS-MLPA (blood DNA) for BWS-related molecular findings in patients with LO was positively correlated with the BWSICG score. 3/48 with ILO had a molecular alteration. No individuals with ILO had developed an embryonal tumour at last follow up. Among a cohort of individuals with LO referred for BWSp molecular testing, the BWSICG score correlated with diagnostic yield. The embryonal tumour risk in children with ILO and negative molecular testing appeared very low, however longer- and more complete follow up is required to better define tumour risks in this group.
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Affiliation(s)
- Jessica A Radley
- West Midlands Regional Clinical Genetics Service and Birmingham Health Partners, Birmingham Women's and Children's Hospitals NHS Foundation Trust, Birmingham, UK.,London North West Regional Genetics Service, St. Mark's and Northwick Park hospitals, Harrow, UK
| | - Melissa Connolly
- West Midlands Regional Genetics Laboratory, Birmingham Women's and Children's Hospitals NHS Foundation Trust, Birmingham, UK
| | - Ataf Sabir
- West Midlands Regional Clinical Genetics Service and Birmingham Health Partners, Birmingham Women's and Children's Hospitals NHS Foundation Trust, Birmingham, UK
| | - Farah Kanani
- Sheffield Clinical Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Helena Carley
- Clinical Genetics, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Rachel L Jones
- Clinical Genetics, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Zerin Hyder
- Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Lianne Gompertz
- Manchester Centre for Genomic Medicine, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Willie Reardon
- Department of Clinical Genetics, Children's Hospital Ireland, Dublin, Ireland
| | - Ruth Richardson
- Northern Genetics Service, Newcastle upon Tyne hospitals NHS Foundation Trust, Newcastle, UK
| | - Louise McClelland
- West Midlands Regional Genetics Laboratory, Birmingham Women's and Children's Hospitals NHS Foundation Trust, Birmingham, UK
| | - Eamonn R Maher
- Department of Medical Genetics, University of Cambridge and NIHR Cambridge Biomedical Research Centre, and Cancer Research UK Cambridge Centre, Cambridge Biomedical Campus, Cambridge, UK
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14
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Fischer KM, Mittal S, Long CJ, Duffy KA, Kalish JM, Evageliou NF, Kolon TF. The following 3 cases were presented at the 2020 virtual PUOWG conferenceLate Presentation of Wilms Tumor in a Patient with Hemihypertrophy after Normal Screening. Urology 2021; 154:271-274. [PMID: 33581236 DOI: 10.1016/j.urology.2021.01.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 01/31/2021] [Indexed: 11/30/2022]
Abstract
An identifiable genetic malformation or predisposition syndrome is present in 18% of Wilms tumor cases. Given this, children with conditions associated with a greater than 1% risk of developing Wilms tumor are recommended to have regular surveillance imaging with renal ultrasound until age 7. Seven years is the recommended screening duration because 95% of cases will occur by this age. We present a case of a child with isolated hemihypertrophy, associated with 5% risk of Wilms tumor, who presented with a tumor after the recommended screening, at age 9, brining into question the age cutoffs currently used.
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Affiliation(s)
- Katherine M Fischer
- Division of Urology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Care, Philadelphia, PA; Division of Urology, Children's Hospital of Philadelphia, Philadelphia, PA.
| | - Sameer Mittal
- Division of Urology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Care, Philadelphia, PA; Division of Urology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Christopher J Long
- Division of Urology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Care, Philadelphia, PA; Division of Urology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Kelly A Duffy
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Jennifer M Kalish
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Nicholas F Evageliou
- Division of Hematology and Oncology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Thomas F Kolon
- Division of Urology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Care, Philadelphia, PA; Division of Urology, Children's Hospital of Philadelphia, Philadelphia, PA
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15
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Lind KT, Cost NG, Zegar K, Kuldanek SA, Enzenauer RW, Schneider KW. A rare case of an isolated PAX6 mutation, aniridia, and Wilms tumor. Ophthalmic Genet 2020; 42:216-217. [PMID: 33300417 DOI: 10.1080/13816810.2020.1852577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Introduction: Wilms tumor (WT) is the most common renal malignancy of children and can be seen in WAGR syndrome (WT, aniridia, genitourinary anomalies, and intellectual disability). WAGR results from a contiguous gene deletion within the 11p13 region, encompassing the WT1 gene, often responsible for WT development, and the PAX6 gene, responsible for aniridia. Aniridia, a pan-ocular disease resulting from iris hypoplasia, is thought to increase the risk for WT development if their genetic alteration spans both the WT1 and the PAX6 genes on 11p13.Case Description: We describe a unique case of a patient with aniridia secondary to a heterozygous PAX6 nonsense mutation who developed WT despite no additional identifiable germline genetic drivers for this disease.Discussion: Isolated mutations in PAX6 previously have not been associated with increased risk of WT development case raises the question of if surveillance for WT should be continued in patients with aniridia with an isolated PAX6 mutation identified.
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Affiliation(s)
- Katherine T Lind
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Nicholas G Cost
- Department of Surgery, Division of Urology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Kelsey Zegar
- Genetic Services, InformedDNA, St. Petersburg, FL, USA
| | - Susan A Kuldanek
- Center for Cancer and Blood Disorders, Children's Hospital Colorado, Aurora, CO, USA
| | - Robert W Enzenauer
- Department of Ophthalmology, Children's Hospital of Colorado, Aurora, CO, USA
| | - Kami W Schneider
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.,Center for Cancer and Blood Disorders, Children's Hospital Colorado, Aurora, CO, USA
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16
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Liu EK, Suson KD. Syndromic Wilms tumor: a review of predisposing conditions, surveillance and treatment. Transl Androl Urol 2020; 9:2370-2381. [PMID: 33209710 PMCID: PMC7658145 DOI: 10.21037/tau.2020.03.27] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Predisposing syndromes associated with an increased risk of Wilms tumor (WT) are responsible for 9–17% of all cases of the malignancy. Due to an earlier age at WT diagnosis and an increased incidence of bilateral and metachronous disease, management of syndromic WT warrants a distinct approach from that of non-syndromic WT. This review of English-language manuscripts about WT focuses on the most common syndromes, surveillance protocols and current treatment strategies. Highlighted syndromes include those associated with WT1, such as WAGR (Wilms-Aniridia-Genitourinary-mental Retardation), Denys-Drash syndrome (DDS), and Frasier syndrome, 11p15 defects, such as Beckwith-Wiedemann syndrome (BWS), among others. General surveillance guidelines include screening renal or abdominal ultrasound every 3–4 months until the age of 5 or 7, depending on the syndrome. Further, some of the predisposing conditions also increase the risk of other malignancies, such as gonadoblastoma and hepatoblastoma. With promising results for nephron-sparing surgery in bilateral non-syndromic WT, there are increasing reports and recommendations to pursue nephron-sparing for these patients who are at greater risk of bilateral, metachronous lesions. In addition to the loss of renal parenchyma from malignancy, many patients are at risk of developing renal insufficiency as part of their syndrome. Although there may be some increase in the complication rate, recurrence free survival seems equivalent. Some conditions require specialized approaches to adjuvant therapy, as their syndrome may make them especially susceptible to side effects.
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Affiliation(s)
- Esther K Liu
- Detroit Medical Center Urology, Detroit, MI, USA
| | - Kristina D Suson
- Pediatric Urology, Children's Hospital of Michigan, Detroit, MI, USA
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17
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Doganis D, Katsimpris A, Panagopoulou P, Bouka P, Bouka E, Moschovi M, Polychronopoulou S, Papakonstantinou E, Tragiannidis A, Katzilakis N, Dana H, Antoniadi K, Stefanaki K, Strantzia K, Dessypris N, Schüz J, Petridou ET. Maternal lifestyle characteristics and Wilms tumor risk in the offspring: A systematic review and meta-analysis. Cancer Epidemiol 2020; 67:101769. [PMID: 32659726 DOI: 10.1016/j.canep.2020.101769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 06/06/2020] [Accepted: 06/13/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Little is known about the etiology of childhood Wilms tumor (WT) and potentially modifiable maternal risk factors, in particular. METHODS Unpublished data derived from the hospital-based, case-control study of the Greek Nationwide Registry for Childhood Hematological Malignancies and Solid Tumors (NARECHEM-ST) were included in an ad hoc conducted systematic literature review and meta-analyses examining the association between modifiable maternal lifestyle risk factors and WT. Eligible data were meta-analysed in separate strands regarding the associations of WT with (a) maternal folic acid and/or vitamins supplementation, (b) alcohol consumption and (c) smoking during pregnancy. The quality of eligible studies was evaluated using the Newcastle-Ottawa Scale. RESULTS Effect estimates from 72 cases and 72 age- and sex-matched controls contributed by NARECHEM-ST were meta-analysed together with those of another 17, mainly medium size, studies of ecological, case-control and cohort design. Maternal intake of folic acid and/or other vitamins supplements during pregnancy was inversely associated with WT risk (6 studies, OR: 0.78; 95 %CI: 0.69-0.89, I2 = 5.4 %); of similar size was the association for folic acid intake alone (4 studies, OR: 0.79; 95 %CI: 0.69-0.91, I2 = 0.0 %), derived mainly from ecological studies. In the Greek study a positive association (OR: 5.31; 95 %CI: 2.00-14.10) was found for mothers who consumed alcohol only before pregnancy vs. never drinkers whereas in the meta-analysis of the four homogeneous studies examining the effect of alcohol consumption during pregnancy the respective overall result showed an OR: 1.60 (4 studies, 95 %CI: 1.28-2.01, I2 = 0.0 %). Lastly, no association was seen with maternal smoking during pregnancy (14 studies, OR: 0.93; 95 %CI: 0.80-1.09, I2 = 0.0 %). CONCLUSIONS In the largest to-date meta-analysis, there was an inverse association of maternal folic acid or vitamins supplementation with WT risk in the offspring, derived mainly from ecological studies. The association with maternal alcohol consumption found in our study needs to be further explored whereas no association with maternal smoking was detected. Given the proven benefits for other health conditions, recommendations regarding folic acid supplementation as well as smoking and alcohol cessation should apply. The maternal alcohol consumption associations, however, should be further explored given the inherent limitations in the assessment of exposures of the published studies.
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Affiliation(s)
- Dimitrios Doganis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece; Oncology Department, "P & A Kyriakou" Children's Hospital, Athens, Greece
| | - Andreas Katsimpris
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Paraskevi Panagopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece; 4th Department of Pediatrics, Aristotle University of Thessaloniki, Greece
| | - Panagiota Bouka
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Evdoxia Bouka
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Maria Moschovi
- Pediatric Hematology-Oncology Unit, First Department of Pediatrics, National and Kapodistrian University of Athens, "Agia Sofia" Children's Hospital, Athens, Greece
| | - Sofia Polychronopoulou
- Department of Pediatric Hematology-Oncology, "Agia Sofia" Children's Hospital, Athens, Greece
| | | | - Athanasios Tragiannidis
- Hematology-Oncology Unit, 2nd Pediatric Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Nick Katzilakis
- Department of Pediatric Hematology-Oncology, University of Crete, University of Crete General Hospital, Heraklion, Greece
| | - Helen Dana
- Pediatric Hematology-Oncology Department, "Mitera" Children's Hospital, Athens, Greece
| | - Kondilia Antoniadi
- Department of Pediatric Hematology-Oncology, "Agia Sofia" Children's Hospital, Athens, Greece
| | | | - Katerina Strantzia
- Pathology Laboratory, "P & A. Kyriakou" Children's Hospital, Athens, Greece
| | - Nick Dessypris
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Joachim Schüz
- International Agency for Research on Cancer (IARC/WHO), Section of Environment and Radiation, Lyon, France
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece; Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden.
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18
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Guan B, Qi F, Tian Y. Comprehensive analysis of competing endogenous RNA network in Wilms tumor based on the TARGET database. Transl Androl Urol 2020; 9:473-484. [PMID: 32420153 PMCID: PMC7214997 DOI: 10.21037/tau.2020.01.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Wilms tumor (WT) was the most common malignant tumor of urinary system in children. With the advances in gene sequencing, research of molecular mechanism of WT tumor was gradually increasing. However, few studies have explored the influence of competing endogenous RNA (ceRNA) in WT. Accordingly, we aimed to explore the mechanisms of ceRNA co-expression network in WT. Methods A total of 6 non-tumor controls and 127 WT patients’ RNA-seq data combined with clinical data was acquired from Therapeutically Applicable Research to Generate Effective Treatments (TARGET) database. Differentially expressed lncRNA, miRNA and mRNA between WT tissues and normal tissues were analyzed using “edgeR” package in R software. Weighted gene co-expression network analysis (WGCNA) was utilized to construct the ceRNA co-expression network while Molecular Complex Detection (MCODE) algorithm was used to extract the pivotal sub-network. Function annotation of mRNA was performed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). Survival analysis was then conducted based on long-rank test and Kaplan-Meier curves using the survival package. Results By applying the “edgeR” package in R, the transcriptome expression data of 127 WT tissues with 6 normal tissues were normalized. Moreover, 146 DElncRNAs, 62 DEmiRNAs, 287 DEmRNAs of them were involved in ceRNA network after applying WGCNA. According to MCODE, we identified that the interactions between LINC002253 (lncRNA) and TRIM71 (mRNA) was mediated by hsa-mir-301a and hsa-mir-301b (miRNA). Furthermore, we detected 13 DElncRNAs which were significantly associated with the progression of WT. Conclusions We used WGCNA method to construct the WT ceRNA network for the first time. TRIM71 was identified to be the most closely related genes involved in hub sub-network by MCDOE, suggesting it might act as a new drug target and prognostic factor based on our comprehensive results.
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Affiliation(s)
- Bo Guan
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Feng Qi
- Department of Urology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Ye Tian
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
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19
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Bauer H, Rios P, Schleiermacher G, Valteau-Couanet D, Bertozzi AI, Thebaud E, Gandemer V, Pellier I, Verschuur A, Spiegel A, Notz-Carrere A, Bergeron C, Orsi L, Lacour B, Clavel J. Maternal and perinatal characteristics, congenital malformations and the risk of wilms tumor: the ESTELLE study. Cancer Causes Control 2020; 31:491-501. [PMID: 32144681 DOI: 10.1007/s10552-020-01288-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 02/24/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Wilms tumor (WT), or nephroblastoma, is an embryonic tumor that constitutes the most common renal tumor in children. Little is known about the etiology of WT. The aim of this study was to investigate whether maternal or perinatal characteristics were associated with the risk of WT. METHODS The ESTELLE study is a national-based case-control study that included 117 cases of WT and 1,100 controls younger than 11 years old. The cases were children diagnosed in France in 2010-2011 and the controls were frequency matched with cases by age and gender. The mothers of case and control children responded to a telephone questionnaire addressing sociodemographic and perinatal characteristics, childhood environment, and lifestyle. Unconditional logistic regression models adjusted on potential cofounders were used to estimate the odds ratios (OR) and their confidence intervals (95% CI). RESULTS High birth weight and the presence of congenital malformation were associated with WT (OR 1.9 [95% CI 1.0-3.7] and OR 2.5 [95% CI 1.1-5.8], respectively). No association with breastfeeding or folic acid supplementation was observed. CONCLUSIONS Although potential recall bias cannot be excluded, our findings reinforce the hypothesis that high birth weight and the presence of congenital malformation may be associated with an increased risk of WT. Further investigations are needed to further elucidate the possible role of maternal characteristics in the etiology of WT.
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Affiliation(s)
- Hélène Bauer
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France
| | - Paula Rios
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France.
| | | | - Dominique Valteau-Couanet
- Children and Adolescent Cancerology Department, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | | | | | | | | | | | | | | | | | - Laurent Orsi
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France
| | - Brigitte Lacour
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France.,National Registry of Childhood Cancers, APHP, CHU Paul Brousse, Villejuif, France.,CHU de Nancy, Nancy, France
| | - Jacqueline Clavel
- CRESS, UMR1153, INSERM, Université de Paris, Villejuif, France.,National Registry of Childhood Cancers, APHP, CHU Paul Brousse, Villejuif, France.,CHU de Nancy, Nancy, France
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20
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de Sá Pereira BM, Azevedo RMD, Aguirre Neto JCD, Menezes CF, Rodrigues KE, Faria PA, Camargo BD, Maschietto M. Intra-tumor genetic heterogeneity in Wilms tumor samples. ACTA ACUST UNITED AC 2020; 65:1496-1501. [PMID: 31994632 DOI: 10.1590/1806-9282.65.12.1496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/18/2019] [Indexed: 12/20/2022]
Abstract
Childhood renal tumors account for ~7% of all childhood cancers, and most cases are embryonic Wilms' tumors (WT). Children with WT are usually treated by either COG or SIOP. The later treats the children using preoperative chemotherapy, but both have around 90% of overall survival in five years. WT is a genetically heterogeneous group with a low prevalence of known somatic alterations. Only around 30% of the cases present mutation in known genes, and there is a relatively high degree of intra-tumor genetic heterogeneity (ITGH). Besides potentially having an impact on the clinical outcome of patients, ITGH may interfere with the search for molecular markers that are prospectively being tested by COG and SIOP. In this review, we present the proposal of the current UMBRELLA SIOP Study 2017/Brazilian Renal Tumor Group that requires the multi-sampling collection of each tumor to better evaluate possible molecular markers, as well as to understand WT biology.
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Affiliation(s)
- Bruna M de Sá Pereira
- . Centro de Pesquisas (CPQ), Instituto Nacional de Câncer (Inca), Rio de Janeiro, RJ, Brasil
| | | | | | | | | | - Paulo A Faria
- . Divisão de Patologia (Dipat), Instituto Nacional de Câncer (Inca), Rio de Janeiro, RJ, Brasil
| | - Beatriz de Camargo
- . Centro de Pesquisas (CPQ), Instituto Nacional de Câncer (Inca), Rio de Janeiro, RJ, Brasil
| | - Mariana Maschietto
- . Laboratório Nacional de Biociências (LNBio), Centro Nacional de Pesquisa em Energia e Materiais (CNPEM), Campinas, SP, Brasil
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21
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Rančelytė M, Nemanienė R, Ragelienė L, Rascon J. Wilms tumour in children: 18 years of experience at Vilnius University Hospital Santaros Klinikos, Lithuania. Acta Med Litu 2019; 26:125-133. [PMID: 31632187 DOI: 10.6001/actamedica.v26i2.4033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Introduction Wilms tumour (WT) is the most common childhood abdominal malignancy, with an average annual incidence of 1 in 10,000 children. The study published in 2002 reported lower survival rates of WT in Lithuania in comparison to the data of SIOP-9 study and the European Organization for Research and Treatment of Cancer (EORTC). We aimed to assess current diagnostic approach and treatment results of patients with WT treated at our institution and to compare the results with the previously published study. Materials and methods A retrospective single-centre study was performed. 48 patients with WT registered at the institutional data-base from 2000 to 2018 were enrolled. An estimated 5-year overall survival (OS5y) and 2-year event-free survival (EFS2y) by stage and risk groups was calculated using IBM SPSS. A comparative analysis of two time periods - 2000-2008 and 2009-2018 - was carried out. Results Forty-two (87.5%) patients presented with localised disease and 6 (12.5%) with primary metastatic disease. The majority of cases were of the intermediate-risk group (77%). The OS5yof all analysed children was 86.4%. The EFS2y was 88.9% in stage I, 91.7% in stage II, 83.3% in stage III, and 50% in stage IV. The EFS2y was 100% in the low-risk group, 86.5% in the intermediate-risk group, and 25% in the high-risk group. Improvement of outcomes was observed over the analysed period: OS5y changed from 81.0% in 2000-2008 to 92.6% in 2009-2018. Among 48 cases, ten patients showed recurrence: eight - early relapse and two - late relapse. Six patients died. Conclusions WT was diagnosed at early stages in most cases. The survival was better among the patients diagnosed in earlier stages and with favourable risk group. Better survival rates were observed in patients treated in 2009-2018 compared to the 2000-2008 period.
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Affiliation(s)
| | - Rolanda Nemanienė
- Centre for Paediatric Oncology and Haematology, Children's Hospital, Affiliate of Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Lina Ragelienė
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Jelena Rascon
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Centre for Paediatric Oncology and Haematology, Children's Hospital, Affiliate of Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
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22
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Cullinan N, Villani A, Mourad S, Somers GR, Reichman L, van Engelen K, Stephens D, Weksberg R, Foulkes WD, Malkin D, Grant R, Goudie C. An eHealth decision-support tool to prioritize referral practices for genetic evaluation of patients with Wilms tumor. Int J Cancer 2019; 146:1010-1017. [PMID: 31286500 DOI: 10.1002/ijc.32561] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 05/29/2019] [Accepted: 06/19/2019] [Indexed: 12/19/2022]
Abstract
Over 10% of children with Wilms tumor (WT) have an underlying cancer predisposition syndrome (CPS). Cognizant of increasing demand for genetic evaluation and limited resources across health care settings, there is an urgent need to rationalize genetic referrals for this population. The McGill Interactive Pediatric OncoGenetic Guidelines study, a Canadian multi-institutional initiative, aims to develop an eHealth tool to assist physicians in identifying children at elevated risk of having a CPS. As part of this project, a decisional algorithm specific to WT consisting of five tumor-specific criteria (age <2 years, bilaterality/multifocality, stromal-predominant histology, nephrogenic rests, and overgrowth features) and universal criteria including features of family history suspicious for CPS and congenital anomalies, was developed. Application of the algorithm generates a binary recommendation-for or against genetic referral for CPS evaluation. To evaluate the algorithm's sensitivity for CPS identification, we retrospectively applied the tool in consecutive pediatric patients (n = 180) with WT, diagnosed and/or treated at The Hospital for Sick Children (1997-2016). Odds ratios were calculated to evaluate the strengths of associations between each criterion and specific CPS subtypes. Application of the algorithm identified 100% of children with WT and a confirmed CPS (n = 27). Age <2 years, bilaterality/multifocality, and congenital anomalies were strongly associated with pathogenic variants in WT1. Presence of >1 overgrowth feature was strongly associated with Beckwith-Wiedemann syndrome. Stromal-predominant histology did not contribute to CPS identification. We recommend the incorporation of the WT algorithm in the routine assessment of children with WT to facilitate prioritization of genetic referrals in a sustainable manner.
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Affiliation(s)
- Noelle Cullinan
- Division of Hematology-Oncology, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Anita Villani
- Division of Hematology-Oncology, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Stephanie Mourad
- Division of Hematology-Oncology, Montreal Children's Hospital, Department of Pediatrics, McGill University, Montreal, QC, Canada
| | - Gino R Somers
- Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Lara Reichman
- Research Institute of the McGill University Health Centre, Child Health and Human Development, McGill University, Montreal, QC, Canada
| | - Kalene van Engelen
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Derek Stephens
- Division of Biostatistics, Design and Analysis, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Rosanna Weksberg
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - William D Foulkes
- Department of Human Genetics, Research Institute of the McGill University Health Centre and Lady Davis Institute, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - David Malkin
- Division of Hematology-Oncology, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Ronald Grant
- Division of Hematology-Oncology, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Catherine Goudie
- Division of Hematology-Oncology, Montreal Children's Hospital, Department of Pediatrics, McGill University, Montreal, QC, Canada
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23
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Vaiman M, Shilco P, Roitblat Y, Padilla-Raygoza N, Leit A, Kavin A, Schonberger E, Nehuliaieva L, Buchris N, Shterenshis M. Screening Procedure for Hemihypertrophy: Preliminary Results of International Multicenter Prospective Study. Cent Asian J Glob Health 2019; 8:336. [PMID: 31321153 PMCID: PMC6564096 DOI: 10.5195/cajgh.2019.336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction Isolated or congenital hemihypertrophy is a rare disorder characterized by asymmetric overgrowth of one side of the body. This article describes the protocol and preliminary results of a lateral body asymmetry (hemihypertrophy) screening procedure performed in healthy adolescents in a multicenter study. The reported incidence of hemihypertrophy varies between different publications and standardized protocols are needed to improve research in this area. Methods Our screening program is taking place in Australia, Israel, Mexico, Ukraine and USA. Procedure includes two steps: (1) “three measurements – three questions” screening, or assessment of face, palms, and shins; (2) in-depth assessment of selected cases in order to exclude localized, lesional, and syndrome-related cases as well as body asymmetry within normative range and to select suspected cases of isolated hemihypertrophy. This step includes measurements of various anatomical regions and a detailed questionnaire. Results At this stage, the screening procedure is completed and the selected participants are advised to refer to medical institutions for further clinical and genetic follow up to exclude possible tumors and other accompanying disorders. Conclusion We present an easy-to-use selection tool to identify children with suspected IH, which results in the selection of the risk group that may benefit from referral to a pediatrician and a clinical geneticist.
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Affiliation(s)
- Michael Vaiman
- Department of Otolaryngology, Assaf Harofeh Medical Center, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Phillip Shilco
- "Briut HaShen" Dental Health Clinic, Jerusalem, Israel.,Science Research Department, Alexander Muss High School in Israel (AMHSI) affiliated with Alexander Muss Institute for Israel Education (AMIIE), Hod HaSharon, Israel
| | - Yulia Roitblat
- Department of Sciences, Belkind School for Special Education, Rishon-LeZion, Israel
| | - Nicolas Padilla-Raygoza
- Department of Nursing and Obstetrics, Division of Health Sciences and Engineering, Campus Celaya-Salvatierra, University of Guanajuato, Mexico
| | - Aidan Leit
- Department of Sciences, The Harley School, Rochester, NY, USA
| | - Aaron Kavin
- Department of Anatomy, Mount Moriah College, Sydney, Australia
| | | | - Liliia Nehuliaieva
- Department of Pediatrics, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Noa Buchris
- Dept. of Sciences, El Camino Real Charter High School, Woodland Hills, CA, USA.,Science Research Department, Alexander Muss High School in Israel (AMHSI) affiliated with Alexander Muss Institute for Israel Education (AMIIE), Hod HaSharon, Israel
| | - Michael Shterenshis
- Science Research Department, Alexander Muss High School in Israel (AMHSI) affiliated with Alexander Muss Institute for Israel Education (AMIIE), Hod HaSharon, Israel
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24
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Anvar Z, Acurzio B, Roma J, Cerrato F, Verde G. Origins of DNA methylation defects in Wilms tumors. Cancer Lett 2019; 457:119-128. [PMID: 31103718 DOI: 10.1016/j.canlet.2019.05.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 05/10/2019] [Accepted: 05/13/2019] [Indexed: 12/14/2022]
Abstract
Wilms tumor is an embryonic renal cancer that typically presents in early childhood and accounts for 7% of all paediatric cancers. Different genetic alterations have been described in this malignancy, however, only a few of them are associated with a majority of Wilms tumors. Alterations in DNA methylation, in contrast, are frequent molecular defects observed in most cases of Wilms tumors. How these epimutations are established in this tumor is not yet completely clear. The recent identification of the molecular actors required for the epigenetic reprogramming during embryogenesis suggests novel possible mechanisms responsible for the DNA methylation defects in Wilms tumor. Here, we provide an overview of the DNA methylation alterations observed in this malignancy and discuss the distinct molecular mechanisms by which these epimutations can arise.
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Affiliation(s)
- Zahra Anvar
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Institute of Genetics and Biophysics 'A. Buzzati-Traverso', CNR, Naples, Italy
| | - Basilia Acurzio
- Institute of Genetics and Biophysics 'A. Buzzati-Traverso', CNR, Naples, Italy; Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania 'Luigi Vanvitelli', Caserta, Italy
| | - Josep Roma
- Vall d'Hebron Research Institute-Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Flavia Cerrato
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania 'Luigi Vanvitelli', Caserta, Italy
| | - Gaetano Verde
- Faculty of Medicine and Health Sciences, International University of Catalonia, Sant Cugat del Vallès, Barcelona, Spain.
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25
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Abstract
Wilms tumour is the most common renal malignancy of childhood. The disease is curable in the majority of cases, albeit at considerable cost in terms of late treatment-related effects in some children. However, one in ten children with Wilms tumour will die of their disease despite modern treatment approaches. The genetic changes that underpin Wilms tumour have been defined by studies of familial cases and by unbiased DNA sequencing of tumour genomes. Together, these approaches have defined the landscape of cancer genes that are operative in Wilms tumour, many of which are intricately linked to the control of fetal nephrogenesis. Advances in our understanding of the germline and somatic genetic changes that underlie Wilms tumour may translate into better patient outcomes. Improvements in risk stratification have already been seen through the introduction of molecular biomarkers into clinical practice. A host of additional biomarkers are due to undergo clinical validation. Identifying actionable mutations has led to potential new targets, with some novel compounds undergoing testing in early phase trials. Avenues that warrant further exploration include targeting Wilms tumour cancer genes with a non-redundant role in nephrogenesis and targeting the fetal renal transcriptome.
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Affiliation(s)
- Taryn Dora Treger
- Wellcome Sanger Institute, Cambridge, UK
- Department of Paediatrics, University of Cambridge, Cambridge, UK
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Tanzina Chowdhury
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Kathy Pritchard-Jones
- UCL Great Ormond Street Institute of Child Health, London, UK.
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
| | - Sam Behjati
- Wellcome Sanger Institute, Cambridge, UK
- Department of Paediatrics, University of Cambridge, Cambridge, UK
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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26
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Chen W, Zhuang J, Gong L, Dai Y, Diao H. Investigating the dysfunctional pathogenesis of Wilms' tumor through a multidimensional integration strategy. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:136. [PMID: 31157257 DOI: 10.21037/atm.2019.03.37] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background Wilms' tumor (WT) is a common kidney tumor in early childhood which is characterized by multiple congenital anomalies and syndromes. With the continuous improvement of medical standards, the cure rate and survival period of WT have increased. However, its molecular mechanism is still elusive. Methods A comprehensive multidimensional integration strategy was used to comprehensively analyze the mechanisms of WT. Results By integrating the potential pathogenic genes of kidney cancer and performing co-expression analysis on the disease-related genes, 23 functional modules were obtained. All the genes were differentially expressed in WT, and were mainly involved in many biological processes and signaling pathways, such as Wnt/β-catenin, mTOR/ERK and calcineurin. Additionally, based on the relationship between transcriptional and post-transcriptional regulatory systems, in functional modules, transcription factors (TFs) including STAT3, HDAC1 and SP1 as well as non-coding RNAs (ncRNAs) such as miR-335-5p, miR-21-5p and TUG1 were identified. Finally, potential drugs for these multifactor regulated dysfunctional modules which may have certain pharmacological or toxicological effects on WT such as cisplatin, sorafenib, and zinc were predicted. Conclusions A multidimensional dysfunction mechanism, involving disease-related genes, TFs and ncRNAs was revealed in the pathogenesis of WT. Functional modules were used to predict potential drugs which can be used in personalized therapy and drug delivery. This study explored the pathogenesis of WT from a new perspective, and provides new candidate targets and therapeutic drugs for improving the cure rate of WT.
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Affiliation(s)
- Wenbiao Chen
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Jia Zhuang
- Department of Urinary Surgery, Puning People's Hospital Affiliated to Southern Medical University, Jieyang 515300, China
| | - Lan Gong
- Microbiome Research Centre, St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Yong Dai
- Clinical Medical Research Center, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, Shenzhen 518020, China
| | - Hongyan Diao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
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27
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Stein R, Graf N. Urologic Tumors in Childhood: Nephroblastoma and Wilms Tumor. Urol Oncol 2019. [DOI: 10.1007/978-3-319-42623-5_43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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28
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Stein R, Graf N. Urologic Tumors in Childhood: Nephroblastoma and Wilms Tumor. Urol Oncol 2019. [DOI: 10.1007/978-3-319-42603-7_43-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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29
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Vujanić GM, Gessler M, Ooms AHAG, Collini P, Coulomb-l'Hermine A, D'Hooghe E, de Krijger RR, Perotti D, Pritchard-Jones K, Vokuhl C, van den Heuvel-Eibrink MM, Graf N. The UMBRELLA SIOP-RTSG 2016 Wilms tumour pathology and molecular biology protocol. Nat Rev Urol 2018; 15:693-701. [PMID: 30310143 PMCID: PMC7136175 DOI: 10.1038/s41585-018-0100-3] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
On the basis of the results of previous national and international trials and studies, the Renal Tumour Study Group of the International Society of Paediatric Oncology (SIOP-RTSG) has developed a new study protocol for paediatric renal tumours: the UMBRELLA SIOP-RTSG 2016 protocol (the UMBRELLA protocol). Currently, the overall outcomes of patients with Wilms tumour are excellent, but subgroups with poor prognosis and increased relapse rates still exist. The identification of these subgroups is of utmost importance to improve treatment stratification, which might lead to reduction of the direct and late effects of chemotherapy. The UMBRELLA protocol aims to validate new prognostic factors, such as blastemal tumour volume and molecular markers, to further improve outcome. To achieve this aim, large, international, high-quality databases are needed, which dictate optimization and international harmonization of specimen handling and comprehensive sampling of biological material, refine definitions and improve logistics for expert review. To promote broad implementation of the UMBRELLA protocol, the updated SIOP-RTSG pathology and molecular biology protocol for Wilms tumours has been outlined, which is a consensus from the SIOP-RTSG pathology panel.
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Affiliation(s)
| | - Manfred Gessler
- Theodor-Boveri-Institute/Biocenter, Developmental Biochemistry, Wuerzburg University, Wuerzburg, Germany
- Comprehensive Cancer Center Mainfranken, Wuerzburg University, Wuerzburg, Germany
| | | | - Paola Collini
- Department of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Aurore Coulomb-l'Hermine
- Sorbonne Université, Department of Pathology, Hopitaux Universitaires Est Parisien, Paris, France
| | - Ellen D'Hooghe
- Department of Pathology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | | | - Daniela Perotti
- Molecular Bases of Genetic Risk and Genetic Testing Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Kathy Pritchard-Jones
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Christian Vokuhl
- Kiel Paediatric Tumour Registry, Department of Paediatric Pathology, University Hospital of Kiel, Kiel, Germany
| | | | - Norbert Graf
- Department of Paediatric Oncology & Haematology, Saarland University, Homburg, Germany
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Carlos EC, Ajay D, Muniz-Alers S, Wechsler DS, Sushama DV, Rice HE, Madden J, Routh JC. Wilms Tumor After Orthotopic Liver Transplant in a Patient With Alagille Syndrome. Urology 2018; 121:171-174. [PMID: 29879405 DOI: 10.1016/j.urology.2018.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 05/16/2018] [Accepted: 05/22/2018] [Indexed: 11/20/2022]
Abstract
We present a case of Wilms Tumor in a patient with Alagille syndrome 10 months after liver transplant. We explore a suggested genetic connection between these 2 diseases. In children with Wilms Tumor, we propose a pathoembryologic explanation for not just the tumor, but also for the cause of associated benign ureteral and renal parenchymal aberrancies that are commonly seen in the Alagille population. We also discuss the diagnostic and therapeutic challenges that can arise in a liver transplant patient with Alagille syndrome who subsequently develops a renal mass.
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Affiliation(s)
- Evan C Carlos
- Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC.
| | - Divya Ajay
- Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC
| | - Saisha Muniz-Alers
- Division of Hematology-Oncology, Department of Pediatrics, Duke University Medical Center, Durham, NC
| | - Daniel S Wechsler
- Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Emory University, Durham, NC
| | - Deepak Vikraman Sushama
- Division of Transplant Surgery, Department of Surgery, Duke University Medical Center, Durham, NC
| | - Henry E Rice
- Division of Pediatric General Surgery, Department of Surgery, Duke University Medical Center, Durham, NC
| | - John Madden
- Department of Pathology, Duke University Medical Center, Durham, NC
| | - Jonathan C Routh
- Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC
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Doganis D, Panagopoulou P, Tragiannidis A, Georgakis MK, Moschovi M, Polychronopoulou S, Rigatou E, Papakonstantinou E, Stiakaki E, Dana H, Bouka E, Antunes L, Bastos J, Coza D, Demetriou A, Agius D, Eser S, Ryzhov A, Sekerija M, Trojanowski M, Zagar T, Zborovskaya A, Perisic SZ, Stefanaki K, Dessypris N, Petridou ET. Childhood nephroblastoma in Southern and Eastern Europe and the US: Incidence variations and temporal trends by human development index. Cancer Epidemiol 2018; 54:75-81. [PMID: 29655086 DOI: 10.1016/j.canep.2018.03.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 02/22/2018] [Accepted: 03/23/2018] [Indexed: 10/17/2022]
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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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Kalish JM, Doros L, Helman LJ, Hennekam RC, Kuiper RP, Maas SM, Maher ER, Nichols KE, Plon SE, Porter CC, Rednam S, Schultz KAP, States LJ, Tomlinson GE, Zelley K, Druley TE. Surveillance Recommendations for Children with Overgrowth Syndromes and Predisposition to Wilms Tumors and Hepatoblastoma. Clin Cancer Res 2018; 23:e115-e122. [PMID: 28674120 DOI: 10.1158/1078-0432.ccr-17-0710] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 04/23/2017] [Accepted: 05/09/2017] [Indexed: 12/13/2022]
Abstract
A number of genetic syndromes have been linked to increased risk for Wilms tumor (WT), hepatoblastoma (HB), and other embryonal tumors. Here, we outline these rare syndromes with at least a 1% risk to develop these tumors and recommend uniform tumor screening recommendations for North America. Specifically, for syndromes with increased risk for WT, we recommend renal ultrasounds every 3 months from birth (or the time of diagnosis) through the seventh birthday. For HB, we recommend screening with full abdominal ultrasound and alpha-fetoprotein serum measurements every 3 months from birth (or the time of diagnosis) through the fourth birthday. We recommend that when possible, these patients be evaluated and monitored by cancer predisposition specialists. At this time, these recommendations are not based on the differential risk between different genetic or epigenetic causes for each syndrome, which some European centers have implemented. This differentiated approach largely represents distinct practice environments between the United States and Europe, and these guidelines are designed to be a broad framework within which physicians and families can work together to implement specific screening. Further study is expected to lead to modifications of these recommendations. Clin Cancer Res; 23(13); e115-e22. ©2017 AACRSee all articles in the online-only CCR Pediatric Oncology Series.
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Affiliation(s)
- Jennifer M Kalish
- Division of Human Genetics, Children's Hospital of Philadelphia and the Department of Pediatrics at the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Leslie Doros
- Cancer Genetics Clinic, Children's National Medical Center, Washington, DC
| | - Lee J Helman
- Center for Cancer Research and Pediatric Oncology Branch, National Cancer Institute, Rockville, Maryland
| | - Raoul C Hennekam
- Department of Pediatrics, University of Amsterdam, Amsterdam, the Netherlands
| | - Roland P Kuiper
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Saskia M Maas
- Department of Clinical Genetics, Academic Medical Center, Amsterdam, the Netherlands
| | - Eamonn R Maher
- Department of Medical Genetics, University of Cambridge, and Cambridge NIHR Biomedical Research Centre, Cambridge, United Kingdom
| | - Kim E Nichols
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Sharon E Plon
- Department of Pediatrics/Hematology-Oncology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
| | | | - Surya Rednam
- Department of Pediatrics/Hematology-Oncology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
| | - Kris Ann P Schultz
- Division of Cancer and Blood Disorders, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota
| | - Lisa J States
- Division of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Gail E Tomlinson
- Division of Pediatric Hematology-Oncology and Greehey Children's Cancer Research Institute, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Kristin Zelley
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Todd E Druley
- Division of Pediatric Hematology and Oncology, Washington University, St. Louis, Missouri
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Tan XH, Zhang DY, Liu X, Lin T, He DW, Li XL, Wei GH. Retrospective analysis to determine outcomes of patients with bilateral Wilms tumor undergoing nephron sparing surgery: 15-year tertiary single-institution experience. Pediatr Surg Int 2018; 34:427-433. [PMID: 29368077 DOI: 10.1007/s00383-018-4232-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/20/2018] [Indexed: 01/27/2023]
Abstract
PURPOSE To describe our clinical experience with nephron sparing surgery (NSS) for bilateral Wilms tumor and evaluate the outcomes of patients treated at one of the largest pediatric medical centers in China. METHODS Medical records of children with bilateral Wilms tumor undergoing NSS in the Children's Hospital of Chongqing Medical University during a 15-year period were retrospectively analyzed. Data collected were composed of age at surgery, tumor response, tumor rupture during resection, final pathologic margins, use of radiation therapy, pathology reports, renal function, and patient survival. RESULTS A total of 18 eligible patients (10 males, 8 females) with bilateral Wilms tumor at a mean age of 2.28 ± 1.12 years were identified. The administration of preoperative chemotherapy did not result in universally successful outcomes. All children underwent successfully unilateral or bilateral NSS, of which one had positive pathologic margins and five received radiation therapy postoperatively. The rates of tumor rupture and positive lymph nodes involvement were 11.1 and 19.4%, respectively. The pathological study showed favorable histology and unfavorable histology in 32 and 4 kidneys, respectively. The 4-year event-free survival and overall survival rates were 68.18 and 85.56%. In univariable analysis, tumor histology (p = 0.0028) and disease stage (p = 0.0303) appeared significantly associated with overall survival. After a median follow-up period of 41.5 months (range 10-89), three of the surviving patients were diagnosed with hypertension and one had renal insufficiency. CONCLUSIONS Our experience suggests that NSS has become a feasible and effective option with good oncologic outcomes. Further research, ideally in a multicenter randomized manner, is warranted to better assess the role of NSS in this challenging clinical scenario.
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Affiliation(s)
- Xiao-Hui Tan
- Department of Urology, Children's Hospital of Chongqing Medical University, 136, Zhongshan 2nd RD, Yuzhong District, Chongqing, 400014, China
| | - De-Ying Zhang
- Department of Urology, Children's Hospital of Chongqing Medical University, 136, Zhongshan 2nd RD, Yuzhong District, Chongqing, 400014, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Xing Liu
- Department of Urology, Children's Hospital of Chongqing Medical University, 136, Zhongshan 2nd RD, Yuzhong District, Chongqing, 400014, China.
| | - Tao Lin
- Department of Urology, Children's Hospital of Chongqing Medical University, 136, Zhongshan 2nd RD, Yuzhong District, Chongqing, 400014, China
| | - Da-Wei He
- Department of Urology, Children's Hospital of Chongqing Medical University, 136, Zhongshan 2nd RD, Yuzhong District, Chongqing, 400014, China.
| | - Xu-Liang Li
- Department of Urology, Children's Hospital of Chongqing Medical University, 136, Zhongshan 2nd RD, Yuzhong District, Chongqing, 400014, China
| | - Guang-Hui Wei
- Department of Urology, Children's Hospital of Chongqing Medical University, 136, Zhongshan 2nd RD, Yuzhong District, Chongqing, 400014, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
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Scollon S, Anglin AK, Thomas M, Turner JT, Wolfe Schneider K. A Comprehensive Review of Pediatric Tumors and Associated Cancer Predisposition Syndromes. J Genet Couns 2017; 26:387-434. [PMID: 28357779 DOI: 10.1007/s10897-017-0077-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 01/30/2017] [Indexed: 12/11/2022]
Abstract
An understanding of the role of inherited cancer predisposition syndromes in pediatric tumor diagnoses continues to develop as more information is learned through the application of genomic technology. Identifying patients and their relatives at an increased risk for developing cancer is an important step in the care of this patient population. The purpose of this review is to highlight various tumor types that arise in the pediatric population and the cancer predisposition syndromes associated with those tumors. The review serves as a guide for recognizing genes and conditions to consider when a pediatric cancer referral presents to the genetics clinic.
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Affiliation(s)
- Sarah Scollon
- Department of Pediatrics, Baylor College of Medicine, Texas Children's Cancer Center, Texas Children's Hospital, 1102 Bates St, FC 1200, Houston, TX, 77030, USA.
| | | | | | - Joyce T Turner
- Department of Genetics and Metabolism, Children's National Medical Center, Washington, DC, USA
| | - Kami Wolfe Schneider
- Department of Pediatrics, University of Colorado, Center for Cancer and Blood Disorders, Children's Hospital Colorado, Aurora, CO, USA
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Xing T, Deng S, Lu M, Qiu M, Tian X, Ma L. WITHDRAWN: Sacroanterior extrarenal Wilms tumor: Case report and literature review. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2017. [DOI: 10.1016/j.epsc.2017.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Outcome of Nephroblastoma Treatment According to the SIOP-2001 Strategy at a Single Institution in Argentina. J Pediatr Hematol Oncol 2017; 39:50-55. [PMID: 27379530 DOI: 10.1097/mph.0000000000000632] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Wilms tumor (WT) is a disease with a good prognosis. The aim of this study was to evaluate the outcome of patients with WT, treated according to the SIOP-2001 strategy. METHODS A retrospective analysis of 141 consecutive patients with WT diagnosed at our institution between December 2001 and 2013 was performed. RESULTS A total of 114 patients, median age 38.8 months (3 to 155 mo), were assessable for analysis. Fine-needle aspiration was initially performed in 88 patients (84.6%). Stage distribution was: I: 33%, II: 9.6%, III: 28%, IV: 14%, V: 14.9%. Six patients were stage III because of tumor spillage. The remaining patients received preoperative chemotherapy. Adjuvant chemotherapy was given without randomization, using vincristine-actinomycin for stage II and vincristine-doxorubicin-actinomycin plus radiotherapy for stage III. After a median follow-up of 52 months, 5-year overall survival and event-free survival were 91% and 85%, respectively. Overall survival according to stage was: I: 96%, II: 99%, III: 88%, IV: 78%, V: 90% (P=0.16). There was no significant difference in event-free survival (P=0.7). Seventy-eight (85.7%) were intermediate-risk and 11 (12%) were high-risk patients. Seventeen patients (14.9%) relapsed within 2 to 99 months (median 29.9 mo). Eight patients (7%) died of progressive disease. There were no treatment-related deaths. CONCLUSIONS The SIOP-01 protocol proposes a treatment strategy that is feasible in our institution, achieving good results.
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Brok J, Treger TD, Gooskens SL, van den Heuvel-Eibrink MM, Pritchard-Jones K. Biology and treatment of renal tumours in childhood. Eur J Cancer 2016; 68:179-195. [PMID: 27969569 DOI: 10.1016/j.ejca.2016.09.005] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 08/25/2016] [Accepted: 09/01/2016] [Indexed: 02/08/2023]
Abstract
In Europe, almost 1000 children are diagnosed with a malignant renal tumour each year. The vast majority of cases are nephroblastoma, also known as Wilms' tumour (WT). Most children are treated according to Société Internationale d'Oncologie Pédiatrique Renal Tumour Study Group (SIOP-RTSG) protocols with pre-operative chemotherapy, surgery, and post-operative treatment dependent on stage and histology. Overall survival approaches 90%, but a subgroup of WT, with high-risk histology and/or relapsed disease, still have a much poorer prognosis. Outcome is similarly poor for the rare non-WT, particularly for malignant rhabdoid tumour of the kidney, metastatic clear cell sarcoma of the kidney (CCSK), and metastatic renal cell carcinoma (RCC). Improving outcome and long-term quality of life requires more accurate risk stratification through biological insights. Biomarkers are also needed to signpost potential targeted therapies for high-risk subgroups. Our understanding of Wilms' tumourigenesis is evolving and several signalling pathways, microRNA processing and epigenetics are now known to play pivotal roles. Most rhabdoid tumours display somatic and/or germline mutations in the SMARCB1 gene, whereas CCSK and paediatric RCC reveal a more varied genetic basis, including characteristic translocations. Conducting early-phase trials of targeted therapies is challenging due to the scarcity of patients with refractory or relapsed disease, the rapid progression of relapse and the genetic heterogeneity of the tumours with a low prevalence of individual somatic mutations. A further consideration in improving population survival rates is the geographical variation in outcomes across Europe. This review provides a comprehensive overview of the current biological knowledge of childhood renal tumours alongside the progress achieved through international collaboration. Ongoing collaboration is needed to ensure consistency of outcomes through standardised diagnostics and treatment and incorporation of biomarker research. Together, these objectives constitute the rationale for the forthcoming SIOP-RTSG 'UMBRELLA' study.
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Affiliation(s)
- Jesper Brok
- Cancer Section, University College London, Institute of Child Health, UK; Department of Paediatric Haematology and Oncology, Rigshospitalet, Copenhagen University Hospital, Denmark.
| | - Taryn D Treger
- Cancer Section, University College London, Institute of Child Health, UK
| | - Saskia L Gooskens
- Department of Paediatric Oncology, Princess Máxima Center for Pediatric Oncology and University of Utrecht, The Netherlands; Department of Paediatric Haematology and Oncology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Marry M van den Heuvel-Eibrink
- Department of Paediatric Oncology, Princess Máxima Center for Pediatric Oncology and University of Utrecht, The Netherlands
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Santoro C, Apicella A, Casale F, La Manna A, Di Martino M, Di Pinto D, Indolfi C, Perrotta S. Unusual association of non-anaplastic Wilms tumor and Cornelia de Lange syndrome: case report. BMC Cancer 2016; 16:365. [PMID: 27291393 PMCID: PMC4904356 DOI: 10.1186/s12885-016-2402-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 06/09/2016] [Indexed: 01/23/2023] Open
Abstract
Background Cornelia de Lange syndrome is the prototype for cohesinopathy disorders, which are characterized by defects in chromosome segregation. Kidney malformations, including nephrogenic rests, are common in Cornelia de Lange syndrome. Only one post-mortem case report has described an association between Wilms tumor and Cornelia de Lange syndrome. Here, we describe the first case of a living child with both diseases. Case presentation Non-anaplastic triphasic nephroblastoma was diagnosed in a patient carrying a not yet reported mutation in NIPBL (c.4920 G > A). The patient had the typical facial appearance and intellectual disability associated with Cornelia de Lange syndrome in absence of limb involvement. The child’s kidneys were examined by ultrasound at 2 years of age to exclude kidney abnormalities associated with the syndrome. She underwent pre-operative chemotherapy and nephrectomy. Seven months later she was healthy and without residual detectable disease. Conclusion The previous report of such co-occurrence, together with our report and previous reports of nephrogenic rests, led us to wonder if there may be any causal relationship between these two rare entities. The wingless/integrated (Wnt) pathway, which is implicated in kidney development, is constitutively activated in approximately 15–20 % of all non-anaplastic Wilms tumors. Interestingly, the Wnt pathway was recently found to be perturbed in a zebrafish model of Cornelia de Lange syndrome. Mutations in cohesin complex genes and regulators have also been identified in several types of cancers. On the other hand, there is no clear evidence of an increased risk of cancer in Cornelia de Lange syndrome, and no other similar cases have been published since the fist one reported by Cohen, and this prompts to think Wilms tumor and Cornelia de Lange syndrome occurred together in our patient by chance.
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Affiliation(s)
- Claudia Santoro
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Seconda Università degli Studi di Napoli, Via Luigi De Crecchio 4, Naples, 80138, Italy
| | - Andrea Apicella
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Seconda Università degli Studi di Napoli, Via Luigi De Crecchio 4, Naples, 80138, Italy
| | - Fiorina Casale
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Seconda Università degli Studi di Napoli, Via Luigi De Crecchio 4, Naples, 80138, Italy
| | - Angela La Manna
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Seconda Università degli Studi di Napoli, Via Luigi De Crecchio 4, Naples, 80138, Italy
| | - Martina Di Martino
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Seconda Università degli Studi di Napoli, Via Luigi De Crecchio 4, Naples, 80138, Italy
| | - Daniela Di Pinto
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Seconda Università degli Studi di Napoli, Via Luigi De Crecchio 4, Naples, 80138, Italy
| | - Cristiana Indolfi
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Seconda Università degli Studi di Napoli, Via Luigi De Crecchio 4, Naples, 80138, Italy
| | - Silverio Perrotta
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Seconda Università degli Studi di Napoli, Via Luigi De Crecchio 4, Naples, 80138, Italy.
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Gleason JM, Lorenzo AJ, Bowlin PR, Koyle MA. Innovations in the management of Wilms' tumor. Ther Adv Urol 2014; 6:165-76. [PMID: 25083165 DOI: 10.1177/1756287214528023] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Advances in the management of Wilms' tumor have been dramatic over the past half century, not in small part due to the institution of multimodal therapy and the formation of collaborative study groups. While different opinions exist in the management of Wilms' tumors depending on where one lives and practices, survival rates have surpassed 90% across the board in Western societies. With more children surviving into adulthood, the concerns about morbidity have reached the forefront and now represent as much a consideration as oncologic outcomes these days. Innovations in treatment are on the horizon in the form of potential tumor markers, molecular biological means of testing for chemotherapeutic responsiveness, and advances in the delivery of chemotherapy for recurrent or recalcitrant tumors. Other technological innovations are being applied to childhood renal tumors, such as minimally invasive and nephron-sparing approaches. Risk stratification also allows for children to forego potentially unnecessary treatments and their associated morbidities. Wilms' tumor stands as a great example of the gains that can be made through protocol-driven therapy with strenuous outcomes analyses. These gains continue to spark interest in minimization of morbidity, while avoiding any compromise in oncologic efficacy. While excitement and innovation are important in the advancement of treatment delivery, we must continue to temper this enthusiasm and carefully evaluate options in order to continue to provide the highest standard of care in the management of this now highly curable disease.
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Affiliation(s)
- Joseph M Gleason
- Division of Paediatric Urology, The Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Armando J Lorenzo
- Division of Paediatric Urology, The Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Paul R Bowlin
- Division of Paediatric Urology, The Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Martin A Koyle
- Division of Paediatric Urology, The Hospital for Sick Children, Department of Surgery, University of Toronto, 555 University Avenue, Toronto, ON, Canada M5G 1X8
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Ward E, DeSantis C, Robbins A, Kohler B, Jemal A. Childhood and adolescent cancer statistics, 2014. CA Cancer J Clin 2014; 64:83-103. [PMID: 24488779 DOI: 10.3322/caac.21219] [Citation(s) in RCA: 1487] [Impact Index Per Article: 148.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 12/09/2013] [Indexed: 12/11/2022] Open
Abstract
In this article, the American Cancer Society provides estimates of the number of new cancer cases and deaths for children and adolescents in the United States and summarizes the most recent and comprehensive data on cancer incidence, mortality, and survival from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries (which are reported in detail for the first time here and include high-quality data from 45 states and the District of Columbia, covering 90% of the US population). In 2014, an estimated 15,780 new cases of cancer will be diagnosed and 1960 deaths from cancer will occur among children and adolescents aged birth to 19 years. The annual incidence rate of cancer in children and adolescents is 186.6 per 1 million children aged birth to 19 years. Approximately 1 in 285 children will be diagnosed with cancer before age 20 years, and approximately 1 in 530 young adults between the ages of 20 and 39 years is a childhood cancer survivor. It is therefore likely that most pediatric and primary care practices will be involved in the diagnosis, treatment, and follow-up of young patients and survivors. In addition to cancer statistics, this article will provide an overview of risk factors, symptoms, treatment, and long-term and late effects for common pediatric cancers.
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Affiliation(s)
- Elizabeth Ward
- National Vice President, Intramural Research, American Cancer Society, Atlanta, GA
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