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Tao J, Yang H, Hao Z, Liang C, Du Y, Zhang C, Yin Y, Zhou J. Positive response of a recurrent clear cell sarcoma to anlotinib combined with chemotherapy: A case report. Medicine (Baltimore) 2022; 101:e32109. [PMID: 36482604 PMCID: PMC9726286 DOI: 10.1097/md.0000000000032109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
RATIONALE Renal clear cell sarcoma is a rare and highly invasive malignant renal tumor that easily relapses after treatment. Recurrent recurrent clear cell carcinoma (CCSK) responds poorly to chemotherapy and has no established standardized treatment, and need to be explored potentially useful treatments. PATIENT CONCERNS A 18-years-old patient with renal clear cell sarcoma recurrence after open radical nephrectomy. DIAGNOSIS Recurrent clear cell sarcoma. INTERVENTIONS After chemotherapy alone failed, the patient received 6 courses of anlotinib combined with chemotherapy. The tumor had significantly reduced in size and the recurrent tumor and part of the liver were resected. OUTCOMES No tumor recurrence or metastasis was detected during the follow-up 8 months after the operation. LESSONS This is the first report describing the use of anlotinib in treating CCSK. We believe that anlotinib combined with chemotherapy may be a useful treatment option for patients with recurrent CCSK.
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Affiliation(s)
- Junyue Tao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Hao Yang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Zongyao Hao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Chaozhao Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Yingying Du
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Chao Zhang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Yu Yin
- Department of Pathology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Jun Zhou
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China
- * Correspondence: Jun Zhou, Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, People’s Republic of China (e-mail: )
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Ayaz E, Ozcan HN, Oguz B, Haliloglu M. Beyond Wilms tumor: imaging findings and outcomes of rare renal tumors in children. Pediatr Radiol 2022; 52:2557-2567. [PMID: 35760918 DOI: 10.1007/s00247-022-05422-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/10/2022] [Accepted: 06/02/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Compared to Wilms, non-Wilms renal tumors in children are less well understood due to their rare occurrence which limits precise definition of the typical imaging patterns. OBJECTIVE This study aims to identify distinctive imaging findings, demographic characteristics and prognosis of pediatric non-Wilms renal tumors. MATERIALS AND METHODS From January 2007 to December 2018, 207 patients with a diagnosis of primary kidney neoplasia were yielded from our radiology archive, 171 of whom were diagnosed with Wilms tumor, 4 with angiomyolipoma and one with nephrogenic rest. The remaining 31 patients with a diagnosis of primary kidney neoplasia were enrolled in this retrospective study. Imaging data, age, gender, prognosis and findings regarding follow-up were noted. RESULTS Eight patients had renal cell carcinoma, seven had clear cell sarcoma, six had mesoblastic nephroma, four had rhabdoid tumor, three had desmoplastic small round cell tumor, two had cystic nephroma and one had metanephric stromal tumor. The age of diagnosis was > 8 years for renal cell carcinoma and desmoplastic small round cell tumor, < 5 years for rhabdoid tumor and < 7 months for mesoblastic nephroma. There was no gender preference for any tumor type. The prognosis for rhabdoid tumor was extremely poor in that all the patients followed up in our institute were deceased, whereas no recurrence was found in other tumors. Translocation type renal cell carcinoma had lower T2-weighted signal intensity, mesoblastic nephroma was a predominantly cystic mass, clear cell sarcoma was generally larger at presentation and extensive amorphous calcifications were seen in desmoplastic small round cell tumor. CONCLUSION For the differential diagnosis of pediatric non-Wilms renal tumors, age is the most important factor, followed by propensity to metastasize/aggressive behavior of the mass. Knowledge of specific imaging findings of these tumors may help to narrow the differential diagnosis.
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Affiliation(s)
- Ercan Ayaz
- Division of Pediatric Radiology, Department of Radiology, Hacettepe University School of Medicine, Sıhhiye, 06230, Ankara, Turkey. .,Department of Radiology, Diyarbakır Children's Hospital, Diyarbakır, Turkey.
| | - H Nursun Ozcan
- Division of Pediatric Radiology, Department of Radiology, Hacettepe University School of Medicine, Sıhhiye, 06230, Ankara, Turkey
| | - Berna Oguz
- Division of Pediatric Radiology, Department of Radiology, Hacettepe University School of Medicine, Sıhhiye, 06230, Ankara, Turkey
| | - Mithat Haliloglu
- Division of Pediatric Radiology, Department of Radiology, Hacettepe University School of Medicine, Sıhhiye, 06230, Ankara, Turkey
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Schulpen M, Roy P, Wijnen MHWA, Tytgat GAM, van den Heuvel-Eibrink MM, van Tinteren H, Karim-Kos HE. Incidence and survival of paediatric renal tumours in the Netherlands between 1990 and 2014. Eur J Cancer 2022; 175:282-290. [PMID: 36174300 DOI: 10.1016/j.ejca.2022.08.021] [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: 05/19/2022] [Revised: 08/09/2022] [Accepted: 08/17/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND This population-based study is the first to provide a detailed analysis of trends in incidence and survival of children and adolescents diagnosed with renal malignancies in the Netherlands. METHODS Data on all renal malignancies diagnosed in paediatric patients (0-18 years) between 1990 and 2014 [N = 648, 92% Wilms tumour (WT)] were extracted from the Netherlands Cancer Registry. Five-year overall survival (OS) was estimated using the actuarial method. Time trends in incidence were assessed by calculating average annual percentage change. A parametric survival model was used to compare the multivariable-adjusted risk of dying from WT between two diagnostic periods. RESULTS The incidence was 8 per million person-years and was constant over time (average annual percentage change -0.8%, p = 0.29). Patients with WT had a favourable outcome in both time periods; 5-year OS was 88% in 1990-2001 and 91% in 2002-2014. Multivariable analysis showed that the risk of dying from WT was not significantly decreased in the latest period (hazard ratio, 95% CI: 0.7, 0.4-1.3). Five-year OS decreased with increasing disease stage, ranging from 95 to 100% for stage I-II and about 80% for stage III-IV to 74% for bilateral disease. Five-year OS were 81% for renal cell carcinoma, 77% for clear cell sarcoma of the kidney and 20% for malignant rhabdoid tumour of the kidney. CONCLUSIONS Incidence of paediatric renal malignancies in the Netherlands has been stable since the 1990s. Five-year OS of WT reached 91% and was similar to findings for other developed countries. Contrary to the excellent outcome for WT, the outcome of malignant rhabdoid tumour of the kidney remained inferior.
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Affiliation(s)
- Maya Schulpen
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Prakriti Roy
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Marc H W A Wijnen
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | | | | | - Harm van Tinteren
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Henrike E Karim-Kos
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands.
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Zhang Y, Chu Q, Ma Y, Miao C, Diao JJ. Overall survival nomogram and relapse-related factors of clear cell sarcoma of the kidney: A study based on published patients. Front Pediatr 2022; 10:943141. [PMID: 36186639 PMCID: PMC9523514 DOI: 10.3389/fped.2022.943141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022] Open
Abstract
Background Rarity limits the breadth of study on clear cell sarcoma of the kidney (CCSK). There is currently no predictive model that quantifies the overall survival (OS) of CCSK and a few large sample-based analysis of relapse-related factors. Methods Patients were collected both from the Surveillance, Epidemiology, and End Results (SEER) database and case report articles extracted from the global online document database to form 2 groups. The first was the OS group, which was used to build and verify the nomogram for predicting the OS of CCSK. Independent predictors of OS were screened by Cox regression analysis to develop the nomogram. Nomogram accuracy was assessed by C-index, receiver operating characteristic (ROC), calibration, and decision curve analysis (DCA) curves. In addition, the difference in OS between receiving radiotherapy or not in stage I patients was analyzed by the Chi-square test. The second was the relapse group, which was used to analyze the relapse-related factors by Cox regression analysis and the Kaplan-Meier method with the log-rank test. Result 256 patients were included in the OS group. The stage, chemotherapy, and radiotherapy were independent OS-related factors of CCSK, and the nomogram for predicting the OS of CCSK was established based on them. The results of the C-index, ROC, calibration, and DCA curves showed that the nomogram has good discrimination, accuracy, and clinical profitability. The Chi-squared test showed no significant difference in OS with receiving radiotherapy or not in stage I patients. The relapse group included 153 patients, of which 60 relapsed. The univariate Cox regression analysis showed no correlation between radiotherapy and relapse. The multivariate Cox regression analysis showed that stage and surgery/chemotherapy sequence were the independent factors for relapse. The log-rank test of seven chemotherapeutic drugs showed that etoposide (E), cyclophosphamide (C), vincristine (V), and doxorubicin (D) (all P < 0.05) had significant differences in preventing relapse, and then drew the relapse-free survival curves of these four drugs. Conclusion Our nomogram accurately quantified the OS of CCSK. There was no significant difference in OS between receiving radiotherapy or not in stage I patients. Stage, surgery/chemotherapy sequence, and the use of ECVD were relapse-related factors. Radiotherapy had no significant contribution to preventing relapse.
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Affiliation(s)
- Yuan Zhang
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
- Department of Pediatrics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Qian Chu
- Department of Preventive Treatment, District Second Hospital of Qingdao Huangdao of Traditional Chinese Medicine, Qingdao, China
| | - Yue Ma
- Guang'an men Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chunshu Miao
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Juan-juan Diao
- Department of Pediatrics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
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Zhu Y, Mao W, Zhang G, Sun S, Tao S, Jiang T, Wang Q, Meng Y, Wu J, Chen M. Development and validation of a prognostic nomogram for adult patients with renal sarcoma: A retrospective study based on the SEER database. Front Public Health 2022; 10:942608. [PMID: 36187680 PMCID: PMC9524186 DOI: 10.3389/fpubh.2022.942608] [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] [Received: 05/12/2022] [Accepted: 08/22/2022] [Indexed: 01/21/2023] Open
Abstract
Background Renal sarcoma (RS) is rarely seen in clinical practice. The purpose of this study was to develop a prognostic nomogram model, which could predict the probability of overall survival (OS) and cancer-specific survival (CSS) in adult patients with RS. Methods Patients diagnosed with RS were recruited from the SEER database between 2004 and 2015, and randomized to two cohorts: the training cohort and the validation cohort. Uni- and multivariate Cox regression analyses in the training cohort were used to screen independent prognostic factors for OS and CSS. Prognostic nomograms for OS and CSS were created separately for adult RS patients based on independent risk factors. The area under the receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were used to validate the nomograms. Results A total of 232 eligible patients were recruited, including 162 in the training cohort and 70 in the validation cohort. Sex, histological type, SEER stage, and surgery were independent prognostic factors for OS, while histological type, SEER stage, surgery, chemotherapy were independent prognostic factors for CSS. Based on the above independent prognostic factors, prognostic nomograms for OS and CSS were created respectively. In the training cohort, the AUCs of the nomograms for OS and CSS were 0.742 and 0.733, respectively. In the validation cohort, the AUCs of the nomograms for OS and CSS were 0.837 and 0.758, respectively. The calibration curves of the nomograms showed high consistencies between the predicted and actual survival rates. Finally, the DCA demonstrated that the nomograms in the wide high-risk threshold had a higher net benefit than the SEER stage. Conclusion A prognostic nomogram for renal sarcoma was created and validated for reliability and usefulness in our study, which assisted urologists in accurately assessing the prognosis of adult RS patients.
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Affiliation(s)
- Yongkun Zhu
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China,Department of Medical College, Southeast University, Nanjing, China
| | - Weipu Mao
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Guangyuan Zhang
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Si Sun
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China,Department of Medical College, Southeast University, Nanjing, China
| | - Shuchun Tao
- Department of Medical College, Southeast University, Nanjing, China
| | - Tiancheng Jiang
- Department of Medical College, Southeast University, Nanjing, China
| | - Qingbo Wang
- Department of Chemotherapy, Affiliated the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yuan Meng
- Department of Urology, Nanjing Lishui People's Hospital, Zhongda Hospital Lishui Branch of Southeast University, Nanjing, China,Yuan Meng
| | - Jianping Wu
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China,Jianping Wu
| | - Ming Chen
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China,*Correspondence: Ming Chen
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Fang YW, Song HC, Sun N, Zhang WP. Non-Wilms' renal tumors in children: experience with 139 cases treated at a single center. BMC Urol 2022; 22:89. [PMID: 35733141 PMCID: PMC9219123 DOI: 10.1186/s12894-022-01042-3] [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] [Received: 02/22/2022] [Accepted: 06/08/2022] [Indexed: 11/17/2022] Open
Abstract
Background Pediatric non-Wilms renal tumors (NWRTs), which comprise a small proportion of renal tumors, are a heterogeneous group of neoplasms with variable malignant potential, mortality, and response to treatment. We performed this study to determine the clinical characteristics, management and prognosis of children with Pediatric NWRTs. Methods Medical records of all patients (n = 139) treated for NWRTs over a 12-year period (2008.01–2019.10) at a single center were reviewed retrospectively. Results The histopathological groups of NWRTs included malignant rhabdoid tumor of the kidney (MRTK) (n: 30, 21.6%), renal cell cancer (RCC) (n: 26,18.7%), clear cell sarcoma of the kidney (CCSK) (n: 24,17.3%), congenital mesoblastic nephroma (CMN) (n: 21,15.1%), cystic nephroma (CN) (n: 16,11.5%), metanephric tumors (n: 12, 8.6%), renal angiomyoliporma (RAML) (n: 3, 2.2%), renal primitive neuroectodermal tumor (n: 2, 1.4%), renal hemangioma (n: 2, 1.4%), inflammatory myofibroblastic tumor (n: 2, 1.4%), ossifying renal tumor of infancy (ORTI) (n: 1, 0.7%). The distribution of all malignant NWRTs, including MRTK, CCSK, RCC and PNET, according to stage was as follows: stages I (n = 26), II (n = 16), III (n = 29), and IV (n = 11). The summary table shows the treatment offered to children with NWRTs. A total of 123 children were followed up for an average of 42 months. Sixteen children were lost to follow-up. Tumor-free survival was observed in 94 children. One patient who suffered from RCC is currently receiving targeted therapy and survives with the tumor. Twenty-eight children (22.8%) died. Conclusions Pediatric NWRTs comprise 19.1% of all renal tumors in our single center. Most NWRTs can readily be distinguished using a range of immunohistochemical markers. Molecular genetic profiling has allowed much progress in the understanding of this group of tumors, making diagnosis and classification less difficult. The mainstay treatment of malignant NWRTs, including MRTK, CCSK, RCC and PNET, is comprehensive treatment. The mainstay treatment of benign NWRTs, including RAML, CN, ORTI, CMN, metanephric tumors, and renal hemangioma, is surgical resection alone and when the tumor diameter is smaller than 7 cm and the tumor locates in one pole, NSS can be performed.
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Affiliation(s)
- Yi Wei Fang
- Department of Urology, National Children's Medical Center, Beijing Children's Hospital of Capital Medical University, No. 56 Nanlishi St, Xicheng District, Beijing, 100045, China
| | - Hong Cheng Song
- Department of Urology, National Children's Medical Center, Beijing Children's Hospital of Capital Medical University, No. 56 Nanlishi St, Xicheng District, Beijing, 100045, China.
| | - Ning Sun
- Department of Urology, National Children's Medical Center, Beijing Children's Hospital of Capital Medical University, No. 56 Nanlishi St, Xicheng District, Beijing, 100045, China.
| | - Wei Ping Zhang
- Department of Urology, National Children's Medical Center, Beijing Children's Hospital of Capital Medical University, No. 56 Nanlishi St, Xicheng District, Beijing, 100045, China
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Doganis D, Karalexi MA, Panagopoulou P, Bouka P, Bouka E, Markozannes G, Ntzani EE, Steliarova-Foucher E, Petridou ET. Incidence patterns of childhood non-Wilms renal tumors: Comparing data of the Nationwide Registry of Childhood Hematological Malignancies and Solid Tumors (NARECHEM-ST), Greece, and the Surveillance, Epidemiology, and End Results Program (SEER), USA. Cancer Epidemiol 2022; 78:102153. [PMID: 35390585 DOI: 10.1016/j.canep.2022.102153] [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: 12/20/2021] [Revised: 02/21/2022] [Accepted: 03/26/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND We used, for the first time, data registered in the Nationwide Registry for Childhood Hematological Malignancies and Solid Tumors (NARECHEM-ST)-Greece to estimate incidence/time trends of the rare childhood (0-14 years) non-Wilms tumors (non-WT), and compared the results of malignant non-WT to those from the Surveillance, Epidemiology, and End Results Program (SEER)-USA. METHODS Fifty-five cases (n = 33 malignant-only) were extracted from NARECHEM-ST (2001-2020) and 332 malignant cases from SEER (1990-2017). To allow between-country comparisons, age-standardized incidence rates (AIR) of malignant-only non-WT were calculated, and temporal trends were evaluated using Poisson and joinpoint regressions. RESULTS In NARECHEM-ST, malignant and non-malignant non-WT accounted for 22.6% of all renal tumors. Among malignant tumors, the AIR was 1.0/106 children in Greece, similar to that calculated for SEER, USA (AIR=0.9/106). The proportion of infant malignant and non-malignant non-WT was 27% (20% before 6 months) in NARECHEM-ST. Most common non-WT in Greece were congenital mesoblastic nephromas (CMN) diagnosed mainly in infancy (CIR=7.2/106). The proportion of infant malignant non-WT was 20% in SEER (AIRinfancy=2.5/106), mainly attributed to rhabdoid tumors (CIR=1.6/106). The male-to-female (M:F) ratio of malignant non-WT was 0.9 in NARECHEM-ST vs. 1.2 in SEER, whereas boys outnumbered girls with clear cell sarcoma in NARECHEM-ST (M:F=4.0). Lastly, significantly increasing trends in incidence rates were noted in NARECHEM-ST [+ 6.8%, 95% confidence intervals (CI): 0.5, 13.3] and in SEER (+7.3%, 95%CI: 5.6, 9.0). CONCLUSIONS Observed incidence, time trends and sociodemographic variations of non-WT may reflect differential registration practices and healthcare delivery patterns including differences regarding surveillance, coding and treatment practices.
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Affiliation(s)
- Dimitrios Doganis
- Hellenic Society for Social Pediatrics and Health Promotion, Athens, Greece; Department of Pediatric Hematology-Oncology, "P&A Kyriakou" Children's Hospital, Athens, Greece
| | - Maria A Karalexi
- Hellenic Society for Social Pediatrics and Health Promotion, Athens, Greece; Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | | | - Panagiota Bouka
- Hellenic Society for Social Pediatrics and Health Promotion, Athens, Greece
| | - Evdoxia Bouka
- Hellenic Society for Social Pediatrics and Health Promotion, Athens, Greece
| | - Georgios Markozannes
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Evangelia E Ntzani
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece; Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, RI, USA
| | - Eva Steliarova-Foucher
- Section of Cancer Surveillance, International Agency for Research on Cancer (IARC), Lyon, France
| | - Eleni Th Petridou
- Hellenic Society for Social Pediatrics and Health Promotion, Athens, Greece; Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
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Nazemi A, Daneshmand S, Chang A. Pediatric genitourinary tumors: Distribution, demographics, and outcomes. Pediatr Investig 2022; 6:85-92. [PMID: 35774527 PMCID: PMC9218969 DOI: 10.1002/ped4.12318] [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] [Received: 10/04/2020] [Accepted: 11/07/2021] [Indexed: 11/06/2022] Open
Abstract
Importance The diversity of pediatric genitourinary malignancies requires a timely resource detailing tumor characteristics and survival. Objective To determine the incidence, demographics, and outcomes of all pediatric genitourinary tumors within the United States. Methods A population-based search for patients diagnosed with genitourinary cancers under age 15 was performed using the National Cancer Institute's Surveillance, Epidemiology, and End Results 18 registry. Information on primary tumor location, histologic type, patient age, sex, year of diagnosis, race, treatment, cause of death, and survival months was extracted. Descriptive epidemiological and survival statistics were calculated for all variables. Results A total of 4576 cases from 1973 through 2015 were identified. The most common primary tumor sites were the kidney (80.3%), testis (12.3%), bladder (2.8%), and vagina (1.5%). Nephroblastoma (87.9%) and sarcoma (3.4%) were the most common renal malignancies. Rhabdomyosarcoma was common in the vagina, bladder, and testis at rates of 66.2%, 61.2%, and 24.6%, respectively. Germ cell tumors (71.0%) were the most common primary tumor of the testis. Ten-year overall survival (OS) for renal nephroblastoma and sarcoma was 88% and 82%, respectively. Ten-year OS for RMS of the testis was 91%, the bladder was 79%, the vagina was 79%, and the prostate was 56%. Germ cell tumor 10-year OS were 96% in the testis and 100% in the vagina. Interpretation A better understanding of the overall distribution and outcomes associated with pediatric genitourinary cancers allows physicians to best understand the patient's disease in the context of current frequency in a genitourinary setting and reported outcomes.
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Affiliation(s)
- Azadeh Nazemi
- Department of UrologyNYU Langone Medical CenterNew YorkUSA
| | - Siamak Daneshmand
- Norris Comprehensive Cancer Center Institute of UrologyKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Andy Chang
- Division of UrologyChildren's Hospital Los AngelesLos AngelesCaliforniaUSA
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Gao H, Cheng QY, Zhao Q, Tao LX, Zhang C. Childhood Clear Cell Sarcoma of Kidney: Incidence and Survival. Front Pediatr 2021; 9:675373. [PMID: 34095035 PMCID: PMC8173214 DOI: 10.3389/fped.2021.675373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/21/2021] [Indexed: 12/26/2022] Open
Abstract
This study is to describe current incidence of childhood clear cell sarcoma of kidney (CCSK) and to investigate the present survival of this cancer. Surveillance, Epidemiology, and End Result (SEER) data was used to identify children with CCSK and Wilms tumor (WT) aged 0-19 years in the US. Age-adjusted incidences were estimated over the decades. Age- and sex-specific epidemiology was also presented. Propensity score matching was used to balance features of CCSK and WT cases. Log rank test was used to compare survivals and Cox regression was used to evaluate independent effects of factors. The present age-adjusted incidence of childhood CCSK was 0.205 per million, which remained stable for years and ranked third in all pediatric renal tumors. The incidence rate ratios for boy and age under 4 were 3 and 21, respectively. The current 5-year overall survival (OS) rate for CCSK was 87%, which is not evidently inferior to that for WT (90%); however the outcome of CCSK was significantly poorer if both groups were well-balanced (OS rate was 86 vs. 95%). Early year of diagnosis and distant metastasis were independent survival factors. In conclusion, occurrence of CCSK remains stable over the years, with an age-adjusted incidence of 0.205 per million. Boy and age under 4 are risk factors for tumor development. CCSK currently has a favorable outcome but its nature may be more aggressive than common kidney tumor, which in turn proves efficacy of modern treatment.
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Affiliation(s)
- Hui Gao
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Qi-Yuan Cheng
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Qian Zhao
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Long-Xiang Tao
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Cheng Zhang
- Anhui Provincial Cancer Institute, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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Mahajan A, Adiga P, Pai V, Raj K. Paediatric RCC with sarcomatoid variation: a rare entity. AFRICAN JOURNAL OF UROLOGY 2020. [DOI: 10.1186/s12301-020-00101-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Malignant renal masses in paediatric age group are mostly Wilms’ tumour. RCC is very rare in this age group, papillary variant being the most common. Sarcomatoid variation occurs in 5% of adult RCC, while it is extremely rare in children. No treatment protocol exists in the management of paediatric RCC.
Case presentation
Here, we present a case of 10-year-old female who presented with left flank mass. Radical nephrectomy was done which showed clear cell carcinoma with sarcomatoid variant on histopathological examination.
Conclusion
RCC with sarcomatoid variation can occur in children. However, further studies and long-term follow-up are needed for formulating a treatment protocol and prognostication factors for the same.
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Qureshi SS, Bhagat M, Verma K, Yadav S, Prasad M, Vora T, Chinnaswamy G, Amin N, Smriti V, Baheti A, Laskar S, Khanna N, Ramadwar M, Shah S. Incidence, treatment, and outcomes of primary and recurrent Non-Wilms renal tumors in children: Report of 109 patients treated at a single institution. J Pediatr Urol 2020; 16:475.e1-475.e9. [PMID: 32620510 DOI: 10.1016/j.jpurol.2020.05.168] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/22/2020] [Accepted: 05/28/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Non-Wilms renal tumors represent a compelling subset of childhood renal tumors. However, their relative rarity renders accurate diagnosis, and therapy challenging which in some instance is inferred from their adult counterparts. OBJECTIVE To describe the incidence and analyze the diagnostic challenges, therapies and, outcomes of non-Wilms renal tumors at the largest tertiary cancer centre in India. METHODS All patients with histologically confirmed non-Wilms renal tumours diagnosed in the paediatric oncology unit of Tata Memorial Hospital between 2006 and 2019 were included. Data regarding clinical and radiological features and treatment outcomes were retrieved from the prospectively maintained institutional database. At the outset, histological types were categorised into a high and low-risk group depending on anticipated survival. Survival analysis was performed utilising the Kaplan-Meier method on SPSS software version 24.0. RESULTS Of the 569 patients with renal tumors, 109 (19%) patients with primary (n = 97) or recurrent (n = 12) non-Wilms renal tumors were included. Histological high-risk group included clear cell sarcoma (CCSK) (39.4%), renal cell carcinoma (RCC) (19.3%), malignant rhabdoid tumor (MRTK) (12.8%), Ewing's sarcoma (rES) (15.6%), synovial sarcoma (2%), and undifferentiated sarcoma (2%). The low-risk group comprised of congenital mesoblastic nephroma (CMN) (4.6%), cystic partially differentiated nephroblastoma (2%), and other rare tumors (3%). Diagnostic error occurred in 2 patients in the high-risk group. All low-risk tumours were treated with surgery alone and most (97%) high-risk tumors were operated either upfront (61.5%) or after preoperative chemotherapy (38.4%). Adjuvant therapy based on histology was offered to 70%. The recurrent tumors received various salvage treatments including chemotherapy; radiotherapy; surgery and immunotherapy, however, only 2 patients could be salvaged. The 3-year overall survival for the entire cohort with primary tumors was 59%, and the survival rates were 76.7%, 77.9%, 0.0%, and 52% for CCSK, RCC, MRTK, and rES (summary figure). Low-risk tumors had 100% survival while the recurrent tumors had a median survival of 10.5 months. CONCLUSIONS Non-Wilms renal tumors constitute a heterogeneous group of tumors, accounting for less than 20% of all renal tumors. Low-risk tumors are associated with excellent outcomes following surgery alone while the high-risk tumours have a variable outcome. MRTK and recurrent non-Wilms tumour have the worst survival. Favourable outcomes for CCSK and RCC and worst outcomes for MRTK were observed in this study. Renal ES have higher incidence of treatment failure and unsatisfactory outcomes. Recurrent non-Wilms tumours have an extremely poor outcome and more alternative or innovative approaches are needed for their treatment.
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Affiliation(s)
- Sajid S Qureshi
- Division of Paediatric Surgical Oncology, Department of Surgical Oncology, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India; Homi Bhabha National Institute (HBNI), Mumbai, India.
| | - Monica Bhagat
- Division of Paediatric Surgical Oncology, Department of Surgical Oncology, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
| | - Kamlesh Verma
- Division of Paediatric Surgical Oncology, Department of Surgical Oncology, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
| | - Subhash Yadav
- Homi Bhabha National Institute (HBNI), Mumbai, India; Department of Pathology, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
| | - Maya Prasad
- Homi Bhabha National Institute (HBNI), Mumbai, India; Division of Pediatric Oncology, Department of Medical Oncology, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
| | - Tushar Vora
- Homi Bhabha National Institute (HBNI), Mumbai, India; Division of Pediatric Oncology, Department of Medical Oncology, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
| | - Girish Chinnaswamy
- Homi Bhabha National Institute (HBNI), Mumbai, India; Division of Pediatric Oncology, Department of Medical Oncology, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
| | - Nayana Amin
- Homi Bhabha National Institute (HBNI), Mumbai, India; Department of Anesthesia, Tata Memorial Hospital, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
| | - Vasundhara Smriti
- Homi Bhabha National Institute (HBNI), Mumbai, India; Department of Radiology, Tata Memorial Hospital, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
| | - Akshay Baheti
- Homi Bhabha National Institute (HBNI), Mumbai, India; Department of Radiology, Tata Memorial Hospital, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
| | - Siddharth Laskar
- Homi Bhabha National Institute (HBNI), Mumbai, India; Department of Radiation Oncology, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
| | - Nehal Khanna
- Homi Bhabha National Institute (HBNI), Mumbai, India; Department of Radiation Oncology, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
| | - Mukta Ramadwar
- Homi Bhabha National Institute (HBNI), Mumbai, India; Department of Pathology, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
| | - Sneha Shah
- Homi Bhabha National Institute (HBNI), Mumbai, India; Department of Nuclear Medicine, Tata Memorial Centre, Bombay, India
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12
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Health disparities among tennessee pediatric renal tumor patients. J Pediatr Surg 2020; 55:1081-1087. [PMID: 32173121 DOI: 10.1016/j.jpedsurg.2020.02.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 02/20/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND/PURPOSE Wilms tumor (WT) poses a cancer health disparity to black children globally, which has not been evaluated thoroughly for other pediatric renal cancers. We aimed to characterize health disparities among Tennessee children treated for any renal cancer. METHODS The Tennessee Cancer Registry (TCR) was queried for patients ≤18 years having any renal cancer (n = 160). To clarify treatment and outcomes, we performed a retrospective cohort study of pediatric renal cancer patients in our institutional cancer registry (ICR; n = 121). Diagnoses in both registries included WT, Sarcoma/Other, and Renal Cell Carcinoma. Wilcoxon/Pearson, Kaplan-Meier, and logistic regression were completed. RESULTS In both registries, WT comprised the most common renal cancer and youngest median age. Sarcoma was intermediate in frequency and age, and RCC was least common, having the oldest age (p < 0.001). In the TCR, black patients comprised 26% of all patients, presented more commonly with distant disease than white patients (37% v. 16%; p = 0.021), and showed worse overall survival (73% v. 89%; p = 0.018), while the ICR showed similar survival between race groups (92% v. 93%, p = 0.868). Sarcoma and metastases were independent predictors of death in both registries (p ≤ 0.002). CONCLUSIONS Black children in Tennessee presented with more advanced disease and experienced worse survival when combining all renal cancer types, particularly RCC and Sarcoma. When treated at a comprehensive pediatric cancer center, these survival disparities appear diminished. TYPE OF STUDY Prognostic study. LEVEL OF EVIDENCE Level II (retrospective cohort).
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13
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Jiang W, Rixiati Y, Kuerban Z, Simayi A, Huang C, Jiao B. Racial/Ethnic Disparities and Survival in Pediatrics with Gliomas Based on the Surveillance, Epidemiology, and End Results Database in the United States. World Neurosurg 2020; 141:e524-e529. [PMID: 32492539 DOI: 10.1016/j.wneu.2020.05.224] [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: 03/18/2020] [Revised: 05/22/2020] [Accepted: 05/24/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND Gliomas are the most common type of primary central nervous system tumor for both children and adults. However, the influence of racial/ethnic disparities on the survival of children with gliomas has not been fully evaluated yet. METHODS Baseline characteristics of patients, including sex, year of diagnosis, surgery, grade, radiation, histology, and races, were collected. Univariate and multivariate analyses for overall survival (OS) were performed using Cox proportional hazards regression model. Survival curves were plotted using Kaplan-Meier methods. RESULTS A total of 4400 childhood patients were enrolled, including 2516 non-Hispanic whites (NHWs), 1050 Hispanic whites (HWs), 519 blacks, 282 Asians or Pacific Islanders (APIs), and 33 American Indian/Alaska Natives. NHWs had the longest overall survival (OS), whereas blacks had the shortest OS (P = 0.003). Stratified by histologic type, OS of children with astrocytoma was better among NHWs and HWs than among blacks and APIs (P = 0.004). OS of children with ependymoma was better among NHWs and APIs than among HWs and blacks (P = 0.008). However, no significant difference was observed in OS for children with medulloblastoma (P = 0.854). CONCLUSIONS Survival outcomes varied significantly by race/ethnicity among childhood gliomas. Better management of childhood gliomas is warranted to close the survival gap between race/ethnicity.
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Affiliation(s)
- Wenli Jiang
- Department of Biochemistry and Molecular Biology, College of Basic Medical, Navy Medical University, Shangha, P.R. China
| | - Youlutuziayi Rixiati
- Department of Pathology and Pathophysiology, Soochow University Medical School, Suzhou, P.R. China
| | - Zumulaiti Kuerban
- Department of Pathology and Pathophysiology, Soochow University Medical School, Suzhou, P.R. China
| | - Aidibai Simayi
- School of Public Health, Xinjiang Medical University, Xinjiang, P.R. China
| | - Caiguo Huang
- Department of Biochemistry and Molecular Biology, College of Basic Medical, Navy Medical University, Shangha, P.R. China
| | - Binghua Jiao
- Department of Biochemistry and Molecular Biology, College of Basic Medical, Navy Medical University, Shangha, P.R. China.
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14
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Ünal E, Yilmaz E, Özcan A, Işik B, Karakükcü M, Turan C, Akgün H, Öztürk F, Coşkun A, Özdemir MA, Patiroğlu T. Twenty children with non-Wilms renal tumors from a reference center in Central Anatolia, Turkey. Turk J Med Sci 2020; 50:18-24. [PMID: 31655501 PMCID: PMC7080372 DOI: 10.3906/sag-1902-106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 07/17/2019] [Indexed: 12/21/2022] Open
Abstract
Background/aim Non-Wilms renal tumors (NWRTs) are rarely encountered in children. The aim of this study is to determine the treatment strategies, prognosis, outcomes, and survival of children with NWRTs at Erciyes University in Kayseri, Turkey. Materials and methods Medical records of all patients (n = 20) treated for NWRTs over a 23-year period (1995–2018) were reviewed retrospectively. Results There was male predominance (female/male: 7/13); the median age at diagnosis was 3.2 years old (0.1–13.5 years old). The major histological groups included mesoblastic nephroma (MBN), (n: 5, 25%), malignant rhabdoid tumor (MRT), (n: 5, 25%), renal cell carcinoma, (n: 3, 15%), inflammatory myofibroblastic tumor (n: 2, 10%), multilocular cystic renal tumors (n: 2, 10%), metanephric adenoma (n: 1, 5%), renal neuroblastoma (n: 1, 5%), and bilateral renal Ewing sarcoma/primitive neuroectodermal tumor (ES/PNET) (n: 1, 5%). All of the patients with NWRTs had radical nephrectomy except the child with bilateral renal ES/PNET. Six children died because of progressive disease; the mortality rate was 30% (n: 6). Conclusion We have made the first report of bilateral renal involvement of ES/PNET in the English medical literature. Physicians dealing with pediatric renal masses should be alert to the high mortality rate in children with MRT, MBN, and ES/PNET and they should design substantial management plans for NWRTs.
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Affiliation(s)
- Ekrem Ünal
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey,Molecular Biology and Genetic Department, Gevher Nesibe Genom and Stem Cell Institution, Genome and Stem Cell Center (GENKÖK), Erciyes University, Kayseri, Turkey
| | - Ebru Yilmaz
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Alper Özcan
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Bilgen Işik
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Musa Karakükcü
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Cüneyt Turan
- Department of Pediatric Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Hülya Akgün
- Department of Pathology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Figen Öztürk
- Department of Pathology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Abdulhakim Coşkun
- Division of Pediatrics Radiology, Department of Radiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Mehmet Akif Özdemir
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Türkan Patiroğlu
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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Stroup EK, Yeu Y, Budhipramono A, Hwang TH, Rakheja D, Erdreich‐Epstein A, Laetsch TW, Amatruda JF, Chen KS. WT‐CLS1
is a rhabdoid tumor cell line and can be inhibited by
miR
‐16. Cancer Rep (Hoboken) 2019. [DOI: 10.1002/cnr2.1110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Emily Kunce Stroup
- Department of PediatricsUniversity of Texas Southwestern Medical Center Dallas TX USA
| | - Yunku Yeu
- Department of Quantitative Health Sciences, Lerner Research InstituteCleveland Clinic Cleveland OH USA
| | - Albert Budhipramono
- Department of PediatricsUniversity of Texas Southwestern Medical Center Dallas TX USA
| | - Tae Hyun Hwang
- Department of Quantitative Health Sciences, Lerner Research InstituteCleveland Clinic Cleveland OH USA
| | - Dinesh Rakheja
- Department of PathologyUniversity of Texas Southwestern Medical Center Dallas TX USA
- Department of Pathology and Laboratory MedicineChildren's Health Children's Medical Center Dallas TX USA
| | - Anat Erdreich‐Epstein
- Department of Pediatrics, Saban Research Institute at Children's Hospital Los Angeles and Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California Los Angeles CA USA
- Department of Pathology, Saban Research Institute at Children's Hospital Los Angeles and Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California Los Angeles CA USA
| | - Theodore W. Laetsch
- Department of PediatricsUniversity of Texas Southwestern Medical Center Dallas TX USA
- Gill Center for Cancer and Blood DisordersChildren's Health Children's Medical Center Dallas TX USA
| | - James F. Amatruda
- Department of PediatricsUniversity of Texas Southwestern Medical Center Dallas TX USA
- Department of Internal MedicineUniversity of Texas Southwestern Medical Center Dallas TX USA
- Department of Molecular BiologyUniversity of Texas Southwestern Medical Center Dallas TX USA
- Gill Center for Cancer and Blood DisordersChildren's Health Children's Medical Center Dallas TX USA
| | - Kenneth S. Chen
- Department of PediatricsUniversity of Texas Southwestern Medical Center Dallas TX USA
- Gill Center for Cancer and Blood DisordersChildren's Health Children's Medical Center Dallas TX USA
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16
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Cheng H, Yang S, Cai S, Ma X, Qin H, Zhang W, Fu L, Zeng Q, Wen M, Peng X, Wang H. Clinical and Prognostic Characteristics of 53 Cases of Extracranial Malignant Rhabdoid Tumor in Children. A Single-Institute Experience from 2007 to 2017. Oncologist 2019; 24:e551-e558. [PMID: 30914466 DOI: 10.1634/theoncologist.2018-0416] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 01/16/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The aim of this study is to add to the current knowledge regarding extracranial malignant rhabdoid tumor (MRT), a rare and highly aggressive tumor that occurs most commonly in infants and young children. PATIENTS AND METHODS A retrospective medical record review was conducted on 53 patients with pathologically confirmed MRT in Beijing Children's Hospital between January 2007 and October 2017. RESULTS Fifty-three patients were diagnosed with MRT at a median age of 16 months, including 32 cases of malignant rhabdoid tumor of the kidney (MRTK) and 21 cases of extrarenal extracranial rhabdoid tumor (EERT). Fourteen (14/32, 43.75%) patients with MRTK and five (5/21, 23.81%) patients with EERT had metastases at diagnosis, and quite a few number of cases occurred tumor rupture (26.42%). Among the 53 patients, 40 (75.47%) patients died, 10 (18.87%) patients survived, and 3 patients (5.66%) were lost to follow-up. Among the 40 dead patients, 38 patients died from rapid progression of the disease or tumor recurrence, and 2 patients died of severe postoperative complications. Most of the recurrent or relapsed cases (94.11%) occurred within 8 months, with a median time of 76 days after diagnosis. The overall survival rates of 3 years and 5 years for the entire cohort were 23.71% and 18.44%, respectively. After survival analysis, it was clear that a younger age at diagnosis and distant stage patients had relatively poor outcomes. The effect of treatment was the most difficult to analyze because patients were not treated uniformly. Statistically significant differences in survival were noted among patients treated with standard chemotherapy, total resection, and radiotherapy. CONCLUSION Extracranial MRT is still a highly aggressive tumor in children. Younger patients and those suffering from metastatic disease were most likely to have a poor outcome because of rapid progression or recurrence of the tumor. IMPLICATIONS FOR PRACTICE This is the largest single-institutional report that investigates the clinical characteristics and outcomes of extracranial malignant rhabdoid tumor (MRT) in China. Our study showed that gross hematuria and tumor rupture were typical characteristics of malignant rhabdoid tumor of the kidney. After survival analysis, it was found that the advanced stage of the tumor and an age ≤12 months at diagnosis were significantly associated with poorer survival. Although extracranial MRT is still a highly aggressive tumor in children, multimodal treatment approach, including chemotherapy, surgery, and radiotherapy, should be employed for this disease.
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Affiliation(s)
- Haiyan Cheng
- Department of Surgical Oncology, Beijing Children's Hospital, National Center for Children's Health, Beijing, People's Republic of China
| | - Shen Yang
- Department of Surgical Oncology, Beijing Children's Hospital, National Center for Children's Health, Beijing, People's Republic of China
| | - Siyu Cai
- Center for Clinical Epidemiology & Evidence-Based Medicine, Beijing Children's Hospital, National Center for Children's Health, Beijing, People's Republic of China
| | - Xiaoli Ma
- Hematology Oncology Center, Beijing Children's Hospital, National Center for Children's Health, Beijing, People's Republic of China
| | - Hong Qin
- Department of Surgical Oncology, Beijing Children's Hospital, National Center for Children's Health, Beijing, People's Republic of China
| | - Weiping Zhang
- Department of Urology Surgery, Beijing Children's Hospital, National Center for Children's Health, Beijing, People's Republic of China
| | - Libing Fu
- Department of Pathology, Beijing Children's Hospital, National Center for Children's Health, Beijing, People's Republic of China
| | - Qi Zeng
- Department of Thoracic Surgery, Beijing Children's Hospital, National Center for Children's Health, Beijing, People's Republic of China
| | - Mingjie Wen
- Department of Immunology, School of Basic Medical Sciences, Beijing, People's Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People's Republic of China
| | - Xiaoxia Peng
- Center for Clinical Epidemiology & Evidence-Based Medicine, Beijing Children's Hospital, National Center for Children's Health, Beijing, People's Republic of China
| | - Huanmin Wang
- Department of Surgical Oncology, Beijing Children's Hospital, National Center for Children's Health, Beijing, People's Republic of China
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17
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Wang JH, Li MJ, Tang DX, Xu S, Mao JQ, Cai JB, He M, Shu Q, Lai C. Neoadjuvant transcatheter arterial chemoembolization and systemic chemotherapy for treatment of clear cell sarcoma of the kidney in children. J Pediatr Surg 2019; 54:550-556. [PMID: 30318310 DOI: 10.1016/j.jpedsurg.2018.09.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 08/27/2018] [Accepted: 09/24/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Clear cell sarcoma of the kidney (CCSK) is a rare and aggressive malignant renal tumor. We describe our experience with neoadjuvant transcatheter arterial chemoembolization (TACE) and systematic chemotherapy for the treatment of advanced CCSK in children. METHODS Between January 2010 and December 2016, seven patients (3 boys and 4 girls; median 2.2 years) with advanced CCSK received preoperative TACE of renal artery and systemic chemotherapy. The chemoembolic emulsion for TACE consisted of cisplatin, pirarubicin, vindesine, and iodized oil. Preoperative systemic chemotherapy with vindesine, ifosfamide, and etoposide was administered three weeks after TACE. Nephrectomy was performed three weeks after systemic chemotherapy. After surgery, patients received radiotherapy and postoperative chemotherapy. RESULTS No cardiotoxicity, renal insufficiency, or hepatic dysfunction was found in any patients. Grade II-III marrow suppression developed in four patients. One patient with tumor progress during neoadjuvant therapy failed to successfully undergo surgery and died. Six patients underwent nephrectomy after neoadjuvant therapy. Median follow-up period was 49.5 months (range, 11-83 months). Five patients have recurrence-free survival. One patient is still in postoperative chemotherapy after nephrectomy, radiotherapy and thoracoscopic resection of lung metastases. CONCLUSIONS Neoadjuvant TACE and systemic chemotherapy appeared to be feasible in the treatment of advanced CCSK in this pilot study. THE TYPE OF STUDY A case series with no comparison group. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Jin-Hu Wang
- Division of Surgical Oncology, Department of Pediatric Surgery, The Children's Hospital, Zhejiang University School of Medicine, No. 3333 Binsheng Road, 310052 Hangzhou, China.
| | - Min-Ju Li
- Division of Surgical Oncology, Department of Pediatric Surgery, The Children's Hospital, Zhejiang University School of Medicine, No. 3333 Binsheng Road, 310052 Hangzhou, China.
| | - Da-Xing Tang
- Division of pediatric urology, Department of Pediatric Surgery, The Children's Hospital, Zhejiang University School of Medicine, No. 3333 Binsheng Road, 310052 Hangzhou, China.
| | - Shan Xu
- Division of pediatric urology, Department of Pediatric Surgery, The Children's Hospital, Zhejiang University School of Medicine, No. 3333 Binsheng Road, 310052 Hangzhou, China.
| | - Jun-Qing Mao
- Division of Surgical Oncology, Department of Pediatric Surgery, The Children's Hospital, Zhejiang University School of Medicine, No. 3333 Binsheng Road, 310052 Hangzhou, China.
| | - Jia-Bin Cai
- Division of Surgical Oncology, Department of Pediatric Surgery, The Children's Hospital, Zhejiang University School of Medicine, No. 3333 Binsheng Road, 310052 Hangzhou, China.
| | - Min He
- Division of Surgical Oncology, Department of Pediatric Surgery, The Children's Hospital, Zhejiang University School of Medicine, No. 3333 Binsheng Road, 310052 Hangzhou, China.
| | - Qiang Shu
- Division of Surgical Oncology, Department of Pediatric Surgery, The Children's Hospital, Zhejiang University School of Medicine, No. 3333 Binsheng Road, 310052 Hangzhou, China.
| | - Can Lai
- Department of Radiology, The Children's Hospital, Zhejiang University School of Medicine, No. 3333 Binsheng Road, 310052 Hangzhou, China.
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18
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Joseph M, Hamilton EC, Hayes-Jordan A, Huh WW, Austin MT. The impact of racial/ethnic disparities on survival for children and young adults with chest wall sarcoma: A population-based study. J Pediatr Surg 2018; 53:1621-1626. [PMID: 29729823 DOI: 10.1016/j.jpedsurg.2018.04.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 03/29/2018] [Accepted: 04/08/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND To determine whether there are racial/ethnic disparities in disease presentation, treatment and survival outcomes among children and young adults with chest wall sarcomas. METHODS The Surveillance, Epidemiology and End Results (SEER) database was analyzed for patients 21 years old and younger with chest wall sarcoma. We performed multivariate logistic regression to investigate the association of race/ethnicity with advanced stage of disease at presentation and likelihood of undergoing surgical resection. Overall survival (OS) was evaluated using Cox regression modeling to calculate hazard ratios with 95% confidence intervals. RESULTS A total of 669 patients were identified: 393 non-Hispanic whites (NHW) (59%), 151 Hispanics (23%), 64 non-Hispanic blacks (NHB) (11%), and 64 other race/ethnicity (9%). The 5- and 10-year OS rates for the entire cohort were 69% and 64%, respectively. NHB had significantly worse 5-year and 10-year OS compared to NHW based on the log rank test (61% versus 70%, 52% versus 66%, respectively; p = 0.037).). Most patients (80%) underwent surgical resection. However, NHB were less likely than NHW to undergo surgical resection by multivariate analysis (OR 0.43, 95% CI 0.22-0.82). CONCLUSIONS NHB children and young adults with chest wall sarcoma have decreased overall survival. In addition, NHB are less likely to undergo surgical resection which may contribute to survival disparities. It is paramount that health care providers work to close the treatment gap between racial/ethnic groups to improve survival in children and young adults with chest wall sarcoma. LEVEL OF EVIDENCE Level III Treatment Study.
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Affiliation(s)
- Michael Joseph
- Department of Pediatric Surgery, McGovern Medical School, Houston, TX; Center for Surgical Trials and Evidence-Based Practice, McGovern Medical School, Houston, TX
| | - Emma C Hamilton
- Department of Pediatric Surgery, McGovern Medical School, Houston, TX; Center for Surgical Trials and Evidence-Based Practice, McGovern Medical School, Houston, TX
| | - Andrea Hayes-Jordan
- Department of Pediatric Surgery, McGovern Medical School, Houston, TX; Division of Pediatrics, Children's Cancer Hospital at the University of Texas M.D. Anderson Cancer Center, Houston, TX; Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Winston W Huh
- Division of Pediatrics, Children's Cancer Hospital at the University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Mary T Austin
- Department of Pediatric Surgery, McGovern Medical School, Houston, TX; Center for Surgical Trials and Evidence-Based Practice, McGovern Medical School, Houston, TX; Division of Pediatrics, Children's Cancer Hospital at the University of Texas M.D. Anderson Cancer Center, Houston, TX; Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
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19
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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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Renal clear cell sarcoma presenting as a spontaneous renal hematoma: A rare presentation. North Clin Istanb 2018; 5:60-63. [PMID: 29607435 PMCID: PMC5864711 DOI: 10.14744/nci.2017.75537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 05/02/2017] [Indexed: 11/30/2022] Open
Abstract
Clear cell sarcoma of the kidney (CCSK) is an uncommon renal neoplasm of childhood. It represents between 2% and 9% of all pediatric renal tumors, and generally arises before the age of 5 years. It often mimics other pediatric renal tumors. Presently described is the case of a 7-year-old girl who presented with complaints of vomiting and abdominal pain. Abdominal ultrasonography revealed a right renal mass, and the patient developed a renal hematoma a few hours after admission. The patient underwent a nephroureterectomy with a provisional diagnosis of Wilms tumor; however, histopathological examination of a specimen revealed CCSK. CCSK is similar to Wilms tumor in terms of the typical age of appearance and clinical and histopathological features, but the treatment method and prognosis are different. Therefore, the differential diagnosis is very important. This case was presented to draw attention to a rare presentation of clear cell sarcoma. CCSK should be kept in mind in the differential diagnosis of a renal mass.
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Affiliation(s)
- Brian T Caldwell
- Department of Pediatric Urology, Children's Hospital Colorado, 13123 E. 16th Avenue, Box 463, Aurora, CO 80045, USA; Division of Urology, Department of Surgery, University of Colorado School of Medicine, 13123 E. 16th Avenue, Box 463, Aurora, CO 80045, USA.
| | - Duncan T Wilcox
- Department of Pediatric Urology, Children's Hospital Colorado, 13123 E. 16th Avenue, Box 463, Aurora, CO 80045, USA; Division of Urology, Department of Surgery, University of Colorado School of Medicine, 13123 E. 16th Avenue, Box 463, Aurora, CO 80045, USA
| | - Nicholas G Cost
- Department of Pediatric Urology, Children's Hospital Colorado, 13123 E. 16th Avenue, Box 463, Aurora, CO 80045, USA; Division of Urology, Department of Surgery, University of Colorado School of Medicine, 13123 E. 16th Avenue, Box 463, Aurora, CO 80045, USA
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Abstract
PURPOSE OF REVIEW As pediatric oncology has become more complex, designing and maintaining pediatric surgical protocols require greater expertise. The primary purpose of this review is to summarize the changes in protocols and new study findings, which have changed surgical practice for children with solid tumors. RECENT FINDINGS The most common solid tumors treated by surgery are reviewed. There are new methods of surgical techniques such as the use of sentinel lymph node techniques for the assessment of lymph nodes in pediatric sarcoma. New studies showing excellent outcomes for the nonoperative treatment for young patients with neuroblastoma are discussed. Surgical quality with the prevention of tumor rupture and the assessment of lymph nodes is essential for good outcomes in patients with Wilm's tumor. The international collaborations within germ cell and liver tumors have provided excellent new study regimens and welcomed a new era of studies that are robust and have the power to change the outcomes for these rare tumors. SUMMARY Surgical practice is evolving with the molecular advances in pediatric oncology. Technical advances and quality improvement endeavors to ensure protocol adherence are essential. International partnerships have allowed for greater advances particularly for rare tumors and improve overall surgical outcomes.
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Waters AM, Stewart JE, Atigadda VR, Mroczek-Musulman E, Muccio DD, Grubbs CJ, Beierle EA. Preclinical Evaluation of UAB30 in Pediatric Renal and Hepatic Malignancies. Mol Cancer Ther 2016; 15:911-21. [PMID: 26873726 DOI: 10.1158/1535-7163.mct-15-0521] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 02/06/2016] [Indexed: 12/13/2022]
Abstract
Rare tumors of solid organs remain some of the most difficult pediatric cancers to cure. These difficult tumors include rare pediatric renal malignancies, such as malignant rhabdoid kidney tumors (MRKT) and non-osseous renal Ewing sarcoma, and hepatoblastoma, a pediatric liver tumor that arises from immature liver cells. There are data in adult renal and hepatic malignancies demonstrating the efficacy of retinoid therapy. The investigation of retinoic acid therapy in cancer is not a new strategy, but the widespread adoption of this therapy has been hindered by toxicities. Our laboratory has been investigating a novel synthetic rexinoid, UAB30, which exhibits a more favorable side-effect profile. In this study, we hypothesized that UAB30 would diminish the growth of tumor cells from both rare renal and liver tumors in vitro and in vivo We successfully demonstrated decreased cellular proliferation, invasion and migration, cell-cycle arrest, and increased apoptosis after treatment with UAB30. Additionally, in in vivo murine models of human hepatoblastoma or rare human renal tumors, there were significantly decreased tumor xenograft growth and increased animal survival after UAB30 treatment. UAB30 should be further investigated as a developing therapeutic in these rare and difficult-to-treat pediatric solid organ tumors. Mol Cancer Ther; 15(5); 911-21. ©2016 AACR.
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Affiliation(s)
- Alicia M Waters
- Department of Surgery, University of Alabama, Birmingham, Birmingham, Alabama
| | - Jerry E Stewart
- Department of Surgery, University of Alabama, Birmingham, Birmingham, Alabama
| | | | | | - Donald D Muccio
- Department of Chemistry, University of Alabama, Birmingham, Birmingham, Alabama
| | - Clinton J Grubbs
- Department of Surgery, University of Alabama, Birmingham, Birmingham, Alabama
| | - Elizabeth A Beierle
- Department of Surgery, University of Alabama, Birmingham, Birmingham, Alabama.
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Kato M, Sato Y, Fukushima K, Okuya M, Kurosawa H, Kuwashima S, Honma K, Okamoto K, Tsuchioka T, Arisaka O. Clear cell sarcoma of the kidney with calcification and a novel chromosomal abnormality: a case report. Diagn Pathol 2015; 10:108. [PMID: 26182914 PMCID: PMC4504129 DOI: 10.1186/s13000-015-0352-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 07/09/2015] [Indexed: 02/06/2023] Open
Abstract
A 9-year-old male presented with a renal tumor that showed a cystic structure with calcification on computed tomography. A pathological analysis of the resected tumor suggested clear cell sarcoma of the kidney (CCSK). Thus, this patient suffered atypical CCSK with significant calcification and gross necrosis. A novel chromosomal abnormality was also identified in the tumor.
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Affiliation(s)
- Masaya Kato
- Department of Pediatrics, Dokkyo Medical University, 880 Kita-Kobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Yuya Sato
- Department of Pediatrics, Dokkyo Medical University, 880 Kita-Kobayashi, Mibu, Tochigi, 321-0293, Japan.
| | - Keitaro Fukushima
- Department of Pediatrics, Dokkyo Medical University, 880 Kita-Kobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Mayuko Okuya
- Department of Pediatrics, Dokkyo Medical University, 880 Kita-Kobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Hidemitsu Kurosawa
- Department of Pediatrics, Dokkyo Medical University, 880 Kita-Kobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Shigeko Kuwashima
- Department of Radiology, Dokkyo Medical University, 880 Kita-Kobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Koichi Honma
- Department of Anatomic and Diagnostic Pathology, Dokkyo Medical University, 880 Kita-Kobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Kentaro Okamoto
- First Department of Surgery, Dokkyo Medical University, 880 Kita-Kobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Takashi Tsuchioka
- First Department of Surgery, Dokkyo Medical University, 880 Kita-Kobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Osamu Arisaka
- Department of Pediatrics, Dokkyo Medical University, 880 Kita-Kobayashi, Mibu, Tochigi, 321-0293, Japan
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Sredni ST, Huang CC, Pundy T, Patel K, Halpern AL, Grupenmacher AT, Chou PM, Bonaldo MDF, Tomita T. A gene signature for a long-term survivor of an atypical teratoid/rhabdoid tumor. Cancer Genet 2014; 207:420-4. [DOI: 10.1016/j.cancergen.2014.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 05/18/2014] [Accepted: 05/22/2014] [Indexed: 10/25/2022]
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Kim JM, Im SA, Oh SN, Chung NG. Alveolar soft part sarcoma arising from the kidney: imaging and clinical features. Korean J Radiol 2014; 15:381-5. [PMID: 24843244 PMCID: PMC4023058 DOI: 10.3348/kjr.2014.15.3.381] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 02/11/2014] [Indexed: 12/16/2022] Open
Abstract
Alveolar soft part sarcoma (ASPS) is an extremely rare malignant soft tissue sarcoma primarily affecting young patients. It usually occurs in the lower extremities, although it can occur in soft tissue anywhere in the body. However, to our knowledge, there has been no case of primary ASPS originating from the kidney in the literature. We herein present the imaging and clinical features of an ASPS which occurred in a 16-year-old male presented as a palpable mass in the left side of the abdomen.
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Affiliation(s)
- Jung Myung Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea
| | - Soo Ah Im
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea
| | - Soon Nam Oh
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea
| | - Nak Gyun Chung
- Department of Pediatrics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea
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Megison ML, Gillory LA, Stewart JE, Nabers HC, Mroczek-Musulman E, Waters AM, Coleman JM, Kelly V, Markert JM, Gillespie GY, Friedman GK, Beierle EA. Preclinical evaluation of engineered oncolytic herpes simplex virus for the treatment of pediatric solid tumors. PLoS One 2014; 9:e86843. [PMID: 24497984 PMCID: PMC3907427 DOI: 10.1371/journal.pone.0086843] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 12/13/2013] [Indexed: 01/01/2023] Open
Abstract
Recently, investigators showed that mice with syngeneic murine gliomas that were treated with a neuroattenuated oncolytic herpes simplex virus-1 (oHSV), M002, had a significant increase in survival. M002 has deletions in both copies of the γ134.5 gene, enabling replication in tumor cells but precluding infection of normal cells. Previous studies have shown antitumor effects of other oHSV against a number of adult tumors including hepatocellular carcinoma and renal cell carcinoma. The purpose of the current study was to investigate the oncolytic potential of M002 against difficult to treat pediatric liver and kidney tumors. We showed that the oHSV, M002, infected, replicated, and decreased cell survival in hepatoblastoma, malignant rhabdoid kidney tumor, and renal sarcoma cell lines. In addition, we showed that in murine xenografts, treatment with M002 significantly increased survival and decreased tumor growth. Finally, these studies showed that the primary entry protein for oHSV, CD111 (nectin-1) was present in human hepatoblastoma and malignant rhabdoid kidney tumor specimens. We concluded that M002 effectively targeted these rare aggressive tumor types and that M002 may have potential for use in children with unresponsive or relapsed pediatric solid tumors.
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Affiliation(s)
- Michael L. Megison
- Department of Surgery, Division of Pediatric Surgery, University of Alabama, Birmingham, Birmingham, Alabama, United States of America
| | - Lauren A. Gillory
- Department of Surgery, Division of Pediatric Surgery, University of Alabama, Birmingham, Birmingham, Alabama, United States of America
| | - Jerry E. Stewart
- Department of Surgery, Division of Pediatric Surgery, University of Alabama, Birmingham, Birmingham, Alabama, United States of America
| | - Hugh C. Nabers
- Department of Surgery, Division of Pediatric Surgery, University of Alabama, Birmingham, Birmingham, Alabama, United States of America
| | | | - Alicia M. Waters
- Department of Surgery, Division of Pediatric Surgery, University of Alabama, Birmingham, Birmingham, Alabama, United States of America
| | - Jennifer M. Coleman
- Department of Surgery, Division of Neurosurgery, University of Alabama, Birmingham, Birmingham, Alabama, United States of America
| | - Virginia Kelly
- Department of Pediatrics, Division of Hematology/Oncology, University of Alabama, Birmingham, Birmingham, Alabama, United States of America
| | - James M. Markert
- Department of Surgery, Division of Neurosurgery, University of Alabama, Birmingham, Birmingham, Alabama, United States of America
| | - G. Yancey Gillespie
- Department of Surgery, Division of Neurosurgery, University of Alabama, Birmingham, Birmingham, Alabama, United States of America
| | - Gregory K. Friedman
- Department of Pediatrics, Division of Hematology/Oncology, University of Alabama, Birmingham, Birmingham, Alabama, United States of America
| | - Elizabeth A. Beierle
- Department of Surgery, Division of Pediatric Surgery, University of Alabama, Birmingham, Birmingham, Alabama, United States of America
- * E-mail:
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Megison ML, Gillory LA, Stewart JE, Nabers HC, Mrozcek-Musulman E, Beierle EA. FAK inhibition abrogates the malignant phenotype in aggressive pediatric renal tumors. Mol Cancer Res 2014; 12:514-26. [PMID: 24464916 DOI: 10.1158/1541-7786.mcr-13-0505] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
UNLABELLED Despite the tremendous advances in the treatment of childhood kidney tumors, there remain subsets of pediatric renal tumors that continue to pose a therapeutic challenge, mainly malignant rhabdoid kidney tumors and nonosseous renal Ewing sarcoma. Children with advanced, metastatic, or relapsed disease have a poor disease-free survival rate. Focal adhesion kinase (FAK) is a nonreceptor tyrosine kinase that is important in many facets of tumor development and progression. FAK has been found in other pediatric solid tumors and in adult renal cellular carcinoma, leading to the hypothesis that FAK contributes to pediatric kidney tumors and would affect cellular survival. In the current study, FAK was present and phosphorylated in pediatric kidney tumor specimens. Moreover, the effects of FAK inhibition upon G401 and SK-NEP-1 cell lines were examined using a number of parallel approaches to block FAK, including RNA interference and small-molecule FAK inhibitors. FAK inhibition resulted in decreased cellular survival, invasion and migration, and increased apoptosis. Furthermore, small-molecule inhibition of FAK led to decreased SK-NEP-1 xenograft growth in vivo. These data deepen the knowledge of the tumorigenic process in pediatric renal tumors, and provide desperately needed therapeutic strategies and targets for these rare, but difficult to treat, malignancies. IMPLICATIONS This study provides a fundamental understanding of tumorigenesis in difficult to treat renal tumors and provides an impetus for new avenues of research and potential for novel, targeted therapies.
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Affiliation(s)
- Michael L Megison
- University of Alabama at Birmingham, 1600 7th Avenue South, Lowder, Room 300, Birmingham, AL 35233.
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Allan BJ, Wang B, Davis JS, Parikh PP, Perez EA, Neville HL, Sola JE. A review of 218 pediatric cases of hepatocellular carcinoma. J Pediatr Surg 2014; 49:166-71; discussion 171. [PMID: 24439603 DOI: 10.1016/j.jpedsurg.2013.09.050] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 09/30/2013] [Indexed: 11/27/2022]
Abstract
PURPOSE This study evaluates the incidence trends and clinical outcomes of children with hepatocellular carcinoma (HCC) and assesses factors predictive of patient survival. METHODS The Surveillance, Epidemiology, and End Results registry was queried from 1973 to 2009 for all patients between ages 0 and 19 with primary HCC. Demographics, tumor histology, surgical intervention, and patient survival were collected. RESULTS Overall, 218 patients were identified. The annual age-adjusted incidence was 0.05 cases per 100,000 in 2009. Fibrolamellar subtype tumors were exclusive to children >5years old and exhibited greater survival compared to non-fibrolamellar subtype (57% vs. 28%, respectively, p=0.002). Tumor extirpation for patients with resectable disease significantly improved overall survival at 5years compared to no surgery (60% vs. 0%, respectively, p<0.0001). Overall 5-, 10- and 20-year survival for the entire cohort was 24%, 23%, and 8%, respectively. Independent prognostic factors of lower mortality according to multivariate analysis were surgical resection (hazard ratio (HR)=0.18), non-Hispanic ethnicity (HR=0.52), and local disease at presentation (HR=0.46). CONCLUSION Over the past four decades, the incidence of HCC has remained relatively stable. Children of Hispanic ethnicity have high mortality rates. However, HCC resection for curative intent significantly improves outcomes.
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Affiliation(s)
- Bassan J Allan
- Department of Surgery, Division of Pediatric Surgery, DeWitt-Daughtry Family, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Bo Wang
- Department of Surgery, Division of Pediatric Surgery, DeWitt-Daughtry Family, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - James S Davis
- Department of Surgery, Division of Pediatric Surgery, DeWitt-Daughtry Family, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Punam P Parikh
- Department of Surgery, Division of Pediatric Surgery, DeWitt-Daughtry Family, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Eduardo A Perez
- Department of Surgery, Division of Pediatric Surgery, DeWitt-Daughtry Family, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Holly L Neville
- Department of Surgery, Division of Pediatric Surgery, DeWitt-Daughtry Family, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Juan E Sola
- Department of Surgery, Division of Pediatric Surgery, DeWitt-Daughtry Family, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
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Allan BJ, Parikh PP, Diaz S, Perez EA, Neville HL, Sola JE. Predictors of survival and incidence of hepatoblastoma in the paediatric population. HPB (Oxford) 2013; 15:741-6. [PMID: 23600968 PMCID: PMC3791112 DOI: 10.1111/hpb.12112] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 03/17/2013] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This study evaluates current trends in incidence, clinical outcomes and factors predictive of survival in children with hepatoblastoma (HB). METHODS The Surveillance, Epidemiology and End Results (SEER) database was queried for the period 1973-2009 for all patients aged <20 years with HB. RESULTS A total of 606 patients were identified. The age-adjusted incidence was 0.13 patients per 100 000 in 2009. An annual percentage change of 2.18% (95% confidence interval (CI) 1.10-3.27; P < 0.05) was seen over the study period. Overall survival rates at 5, 10 and 20 years were 63%, 61% and 59%, respectively. Ten-year survival rates significantly improved in patients with resectable disease who underwent operative treatment in comparison with those with non-resectable HB (86% versus 39%; P < 0.0001). Multivariate analysis showed surgical treatment (hazard ratio (HR) = 0.23, 95% CI 0.17-0.31; P < 0.0001), Hispanic ethnicity (HR = 0.61, 95% CI 0.43-0.89; P = 0.01), local disease at presentation (HR = 0.43, 95% CI 0.29-0.63; P < 0.0001) and age < 5 years (HR = 0.63, 95% CI 0.41-0.95; P < 0.03) to be independent prognostic factors of survival. CONCLUSIONS The incidence of paediatric HB has increased over time. Hepatoblastoma is almost exclusively seen in children aged < 5 years. When HB presents after the age of 5 years, the prognosis is most unfavourable. Tumour extirpation markedly improves survival in paediatric patients with local disease.
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Affiliation(s)
- Bassan J Allan
- Division of General Surgery, University of Miami Miller School of MedicineMiami, FL, USA
| | - Punam P Parikh
- Division of General Surgery, University of Miami Miller School of MedicineMiami, FL, USA
| | - Sofia Diaz
- Division of General Surgery, University of Miami Miller School of MedicineMiami, FL, USA
| | - Eduardo A Perez
- Division of Paediatric Surgery, DeWitt-Daughtry Family Department of Surgery, University of Miami Miller School of MedicineMiami, FL, USA
| | - Holly L Neville
- Division of Paediatric Surgery, DeWitt-Daughtry Family Department of Surgery, University of Miami Miller School of MedicineMiami, FL, USA
| | - Juan E Sola
- Division of Paediatric Surgery, DeWitt-Daughtry Family Department of Surgery, University of Miami Miller School of MedicineMiami, FL, USA
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Kerl K, Holsten T, Frühwald MC. Rhabdoid tumors: clinical approaches and molecular targets for innovative therapy. Pediatr Hematol Oncol 2013; 30:587-604. [PMID: 23848359 DOI: 10.3109/08880018.2013.791737] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Rhabdoid tumors are rare but highly aggressive tumors with a predilection for infants and young children. The majority of these tumors harbor biallelic mutations in SMARCB1/INI1/hSNF5. Rather rare cases with mutations in other SWI/SNF core members such as BRG1 are on record. Rhabdoid tumors have only recently been registered and treated according to specifically designed treatment recommendations and in the framework of clinical trials. Within the last decade, prognosis has improved significantly but at least 50% of patients still relapse and subsequently almost inevitably succumb to their disease. This review summarizes past and current clinical approaches and presents an overview of the rationales for targeted therapy with potential for future clinical treatment trials for rhabdoid tumors.
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Affiliation(s)
- Kornelius Kerl
- Institute of Molecular Tumor Biology (IMTB), Westfalian Wilhelms University (WWU), M¨unster, Germany, Robert-Koch Strasse 43, 48149M¨unster, Germany
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Allan BJ, Thorson CM, Davis JS, Van Haren RM, Parikh PP, Perez EA, Lew JI, Sola JE. An analysis of 73 cases of pediatric malignant tumors of the thymus. J Surg Res 2013; 184:397-403. [DOI: 10.1016/j.jss.2013.03.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 03/01/2013] [Accepted: 03/07/2013] [Indexed: 11/29/2022]
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Short SS, Zmora O, Hunter CJ, Wang L, Siegel S, Ford HR. Large clear cell sarcoma of the kidney mistaken as Wilms' tumor. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2013. [DOI: 10.1016/j.epsc.2013.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Heck JE, Lombardi CA, Cockburn M, Meyers TJ, Wilhelm M, Ritz B. Epidemiology of rhabdoid tumors of early childhood. Pediatr Blood Cancer 2013; 60:77-81. [PMID: 22434719 PMCID: PMC3399923 DOI: 10.1002/pbc.24141] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 02/23/2012] [Indexed: 01/29/2023]
Abstract
BACKGROUND Rhabdoid tumors are a rare and aggressive cancer subtype which is usually diagnosed in early childhood. Little is known about their etiology. The purpose of this study was to describe the epidemiology of rhabdoid tumors and examine their relation to perinatal characteristics. METHODS We identified 44 atypical teratoid/rhabdoid tumors (AT/RT) of the central nervous system (CNS) and 61 rhabdoid sarcomas (renal and extra-renal non-CNS tumors) from California Cancer Registry records of diagnoses 1988-2007 among children <6 years of age. We randomly selected 208,178 controls from California birthrolls. Multivariable logistic regression was used to examine associations between rhabdoid tumors and perinatal characteristics. RESULTS After adjustment for demographic characteristics, low birthweight (<2,500 g) strongly increased risk for developing both rhabdoid sarcomas (OR = 2.43, 95% CI 1.09, 5.41) and AT/RT (OR = 2.99, 95% CI 1.31, 6.84). Both preterm delivery (<37 weeks gestation, OR = 2.63, 95% CI 1.34, 5.17) and late term delivery (>42 weeks, OR = 3.66, 95% CI 1.54, 8.71) also increased risk of rhabdoid sarcomas. Rhabdoid sarcoma cases (OR = 3.08, 95% CI 1.11, 8.55) and AT/RT cases (OR = 3.16, 95% CI 1.23, 8.13) also were more likely to be multiple births. CONCLUSION The excess of twin pregnancies may suggest an association with infertility treatments. This is the first population-based epidemiologic study to examine these rare tumors.
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Affiliation(s)
- Julia E Heck
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA.
| | - Christina A Lombardi
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA
| | - Myles Cockburn
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Travis J Meyers
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA
| | - Michelle Wilhelm
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA
| | - Beate Ritz
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA
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Wang J, Shehata BM, Langness SM, Davis GK, Cheng L, Osunkoya AO. Clear cell, papillary and chromophobe renal cell carcinoma in patients younger than 20 years old: a clinicopathologic study with follow-up. J Pediatr Urol 2012; 8:531-4. [PMID: 22018933 DOI: 10.1016/j.jpurol.2011.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Accepted: 09/25/2011] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To perform a clinicopathologic study with follow-up on this rare subset of tumors in the pediatric population. PATIENTS AND METHODS A search was made through the surgical pathology files of two academic institutions for cases of non-translocation associated renal cell carcinoma in patients younger than 20 years old from 1995 to 2011. RESULTS 12 cases were identified from 350 pediatric patients with renal tumors (prevalence = 3.4%). The mean age at diagnosis was 11 years (range 1-18 years). The average tumor size was 7.3 cm (range 3.0-15.0 cm). Pathological staging analysis revealed 7/12 (58%) pT1 tumors, 3/12 (25%) pT2 tumors, and 2/12 (17%) pT3 tumors. Lymph node metastasis was present in 3/12 (25%) patients. The majority of tumors 9/12 (75%) were Fuhrman nuclear grade 2, while 3/12 (25%) cases were Fuhrman nuclear grade 3. Tumor necrosis was identified in 5/12 (42%) tumors, and angiolymphatic invasion was identified in 4/12 (33%) tumors; 1 patient developed lung metastasis. CONCLUSIONS Pathologic parameters typically associated with poor outcome in adults, including metastasis/high tumor stage, high Fuhrman nuclear grade, angiolymphatic invasion, and tumor necrosis, did not lead to death in any of the patients in our series.
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Affiliation(s)
- Jason Wang
- Department of Pathology, Emory University School of Medicine, Atlanta, GA 30322, USA
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Abstract
BACKGROUND Pediatric non-Wilms' renal tumors (NWRT) are poorly understood owing to their heterogeneity and relative rarity. This study aimed at auditing the outcome of the management of NWRT in a tertiary hospital in the Third World. METHODS Records of all patients (n = 68) treated for NWRT over a 32-year period (1978-2010) were reviewed retrospectively. RESULTS The major histological groups included clear cell sarcoma of the kidney (CCSK) (33.8%), mesoblastic nephroma (17.6%), cystic partially differentiated nephroblastoma (CPDN) (17.6%), intrarenal neuroblastoma (8.8%), malignant rhabdoid tumor (MRT) (7.4%), and renal cell carcinoma (RCC) (5.9%). Sixteen (69.7%) patients with CCSK and 11 (91.7%) with CPDN were aged 1-4 years. Ten (83.3%) patients with mesoblastic nephroma were aged <1 year and three (60.0%) with RCC were aged 10-14 years. Ten (43.5%) patients with CCSK and four (80.0%) with RCC had metastases at diagnosis. The sensitivity of a pretreatment Tru-Cut biopsy was 100% for MRT. All the patients with CCSK, mesoblastic nephroma, CPDN, and RCC had radical nephrectomy. Only eight (34.8%) patients with CCSK received radiotherapy. The overall 1-10-year survival rates were 52.2%, 91.7%, 75.0%, 40.0% and 0.0% for CCSK, mesoblastic nephroma, CPDN, RCC, and MRT, respectively. The overall 1-10-year survival for the entire cohort was 51.5%. CONCLUSIONS The demography and clinical presentation of pediatric NWRT, which comprises 13.6% of pediatric renal tumors in the Third World, were similar to those in the Developed World. The overall 1-10-year survival for pediatric NWRT was low.
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Affiliation(s)
- Peter W Saula
- Department of Paediatric Surgery, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Private Bag 7, Congella 4013, South Africa.
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Cloutier J, Aziz A, Inman B, Bolduc S. Bilateral renal cell carcinoma in a child. Urology 2012; 80:430-3. [PMID: 22386253 DOI: 10.1016/j.urology.2012.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Revised: 12/31/2011] [Accepted: 01/09/2012] [Indexed: 10/28/2022]
Abstract
Renal cell carcinoma is a rare renal tumor in the pediatric population with an incidence of 0.1-0.3%. We report on the first case of bilateral renal clear cell carcinoma that was treated by partial nephrectomies. We performed a complete genetic evaluation to exclude a family inheritance and we looked at the deletions associated with the possible histologic subtypes of renal cell carcinoma. The patient had no evidence of recurrence after 80-month follow-up and her renal function remained normal.
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Affiliation(s)
- Jonathan Cloutier
- Division of Urology, Centre Hospitalier Universitaire de Québec (CHUQ), Université Laval, Quebec, Canada
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O'Meara E, Stack D, Lee CH, Garvin AJ, Morris T, Argani P, Han JS, Karlsson J, Gisselson D, Leuschner I, Gessler M, Graf N, Fletcher JA, O'Sullivan MJ. Characterization of the chromosomal translocation t(10;17)(q22;p13) in clear cell sarcoma of kidney. J Pathol 2012; 227:72-80. [DOI: 10.1002/path.3985] [Citation(s) in RCA: 110] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Revised: 12/22/2011] [Accepted: 12/22/2011] [Indexed: 01/06/2023]
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McFadden DW, Souba WW. The Journal of Surgical Research Editorial Board – 2011. J Surg Res 2011. [DOI: 10.1016/j.jss.2011.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Clear cell renal sarcoma is a rare tumor and comprises 4% of primary pediatric malignant renal tumors. It is known as an aggressive tumor with poor prognosis. Clinically and radiographically, it resembles Wilms tumor. We present a case of a child with an abdominal mass that was diagnosed as clear cell sarcoma of her right kidney.
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Affiliation(s)
- Arie Franco
- Department of Radiology, Georgia Health Sciences University, Augusta, GA 30912, USA.
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