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Duncan C, Sarvode Mothi S, Santiago TC, Coggins JA, Graetz DE, Bishop MW, Mullen EA, Murphy AJ, Green DM, Krasin MJ, Davidoff AM. Response of bilateral Wilms tumor to chemotherapy suggests histologic subtype and guides treatment. J Natl Cancer Inst 2024; 116:1230-1237. [PMID: 38539045 DOI: 10.1093/jnci/djae072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 08/09/2024] Open
Abstract
BACKGROUND Patients with bilateral Wilms tumor initially receive neoadjuvant chemotherapy to shrink the tumors and increase the likelihood of successful nephron-sparing surgery. Biopsy of poorly responding tumors is often done to better understand therapy resistance. The purpose of this retrospective, single-institution study was to determine whether initial chemotherapy response is associated with tumor histology, potentially obviating the need for biopsy or change in chemotherapy. METHODS Patients with synchronous bilateral Wilms tumors who underwent surgery at St Jude Children's Research Hospital from January 2000 to March 2022 were considered for this study. A mixed-effects logistic regression model was used to evaluate the likelihood of the tumor being stromal predominant, as predicted by tumor response to neoadjuvant chemotherapy. RESULTS A total of 68 patients were eligible for this study. Tumors that increased in size had an odds ratio of 19.5 (95% confidence interval [CI] = 2.46 to 155.03) for being stromal predominant vs any other histologic subtype. Age at diagnosis was youngest in patients with stromal-predominant tumors, with a mean age of 18.8 (14.1) months compared with all other histologic subtypes (χ2 = 7.05, P = .07). The predictive value of a tumor growing combined with patient aged younger than 18 months for confirming stromal-predominant histology was 85.7% (95% CI = 57.18% to 93.5%). CONCLUSIONS Tumors that increased in size during neoadjuvant chemotherapy were most frequently stromal-predominant bilateral Wilms tumor, especially in younger patients. Therefore, nephron-sparing surgery, rather than biopsy, or extension or intensification of neoadjuvant chemotherapy, should be considered for bilateral Wilms tumors that increase in volume during neoadjuvant chemotherapy, particularly in patients aged younger than 18 months.
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Affiliation(s)
- Colton Duncan
- Departments of Surgery, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Suraj Sarvode Mothi
- Departments of Biostatistics, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Teresa C Santiago
- Departments of Pathology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Jordan A Coggins
- Departments of Surgery, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Dylan E Graetz
- Departments of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
- Departments of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Michael W Bishop
- Departments of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Elizabeth A Mullen
- Department of Pediatric Hematology/Oncology, Dana-Farber Cancer Institute, Boston Children's Hospital, Boston, MA, USA
| | - Andrew J Murphy
- Departments of Surgery, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Daniel M Green
- Departments of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Matthew J Krasin
- Departments of Radiation Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Andrew M Davidoff
- Departments of Surgery, St Jude Children's Research Hospital, Memphis, TN, USA
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Nagano C, Nozu K. A review of the genetic background in complicated WT1-related disorders. Clin Exp Nephrol 2024:10.1007/s10157-024-02539-x. [PMID: 39002031 DOI: 10.1007/s10157-024-02539-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 07/05/2024] [Indexed: 07/15/2024]
Abstract
The Wilms tumor 1 (WT1) gene was first identified in 1990 as a strong candidate for conferring a predisposition to Wilms tumor. The WT1 protein has four zinc finger structures (DNA binding domain) at the C-terminus, which bind to transcriptional regulatory sequences on DNA, and acts as a transcription factor. WT1 is expressed during kidney development and regulates differentiation, and is also expressed in glomerular epithelial cells after birth to maintain the structure of podocytes. WT1-related disorders are a group of conditions associated with an aberrant or absent copy of the WT1 gene. This group of conditions encompasses a wide phenotypic spectrum that includes Denys-Drash syndrome (DDS), Frasier syndrome (FS), Wilms-aniridia-genitourinary-mental retardation syndrome, and isolated manifestations of nephropathy or Wilms tumor. The genotype-phenotype correlation is becoming clearer: patients with missense variants in DNA binding sites including C2H2 sites manifest DDS and develop early-onset and rapidly developing end-stage kidney disease. A deeper understanding of the genotype-phenotype correlation has also been obtained in DDS, but no such correlation has been observed in FS. The incidence of Wilms tumor is higher in patients with DDS and exon-truncating variants than in those with non-truncating variants. Here, we briefly describe the genetic background of this highly complicated WT1-related disorders.
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Affiliation(s)
- China Nagano
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan.
| | - Kandai Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
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3
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Murphy AJ, Brzezinski J, Renfro LA, Tornwall B, Malek MM, Benedetti DJ, Cost NG, Smith EA, Aldrink J, Romao RLP, Dome JS, Davidoff AM, Treece AL, Parsons LN, Mullen EA, Shamberger RC, Paulino AC, Lo AC, Geller JI, Ehrlich PF. Long-term outcomes and patterns of relapse in patients with bilateral Wilms tumor or bilaterally predisposed unilateral Wilms tumor, a report from the COG AREN0534 study. Int J Cancer 2024. [PMID: 38973574 DOI: 10.1002/ijc.35080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/30/2024] [Accepted: 06/13/2024] [Indexed: 07/09/2024]
Abstract
The objective of this study is to report the long-term timing and patterns of relapse for children enrolled in Children's Oncology Group AREN0534, a multicenter phase III clinical trial conducted from 2009 to 2015. Participants included children with bilateral Wilms tumor (BWT) or unilateral WT with genetic predisposition to develop BWT followed for up to 10 years. Smoothed hazard (risk) functions for event-free survival (EFS) were plotted so that the timing of events could be visualized, both overall and within pre-specified groups. Two hundred and twenty-two children (190 BWT and 32 unilateral WT with BWT predisposition) were followed for a median of 8.6 years. Fifty events were reported, of which 48 were relapse/progression. The overall 8-year EFS was 75% (95% confidence interval: 69%-83%). The highest risk for an EFS event was immediately after diagnosis with a declining rate over 2 years. A second peak of events was observed around 4 years after diagnosis, and a small number of events were reported until the end of the follow-up period. In subset analyses, later increases in risk were more commonly observed in patients with female sex, anaplastic histology, negative lymph nodes or margins, and favorable histology Wilms tumor patients with post-chemotherapy intermediate risk. Among relapses that occurred after 2 years, most were to the kidney. These patterns suggest that late events may be second primary tumors occurring more commonly in females, although more investigation is required. Clinicians may consider observation of patients with BWT beyond 4 years from diagnosis.
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Affiliation(s)
- Andrew J Murphy
- St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Jack Brzezinski
- Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Lindsay A Renfro
- Division of Biostatistics, University of Southern California and Children's Oncology Group, Los Angeles, California, USA
| | - Brett Tornwall
- Division of Biostatistics, University of Southern California and Children's Oncology Group, Los Angeles, California, USA
- Glaukos Corp., San Clemente, California, USA
| | - Marcus M Malek
- Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Daniel J Benedetti
- Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Nicholas G Cost
- The Surgical Oncology Program at the Children's Hospital of Colorado, University of Colorado, Denver, Colorado, USA
| | - Ethan A Smith
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Jennifer Aldrink
- Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Rodrigo L P Romao
- Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Jeffrey S Dome
- Children National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | | | - Amy L Treece
- Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois, USA
| | - Lauren N Parsons
- Department of Pathology, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA
| | - Elizabeth A Mullen
- Boston Children's Hospital and Dana Farber Cancer Institute, Boston, Massachusetts, USA
| | - Robert C Shamberger
- Boston Children's Hospital and Dana Farber Cancer Institute, Boston, Massachusetts, USA
| | | | - Andrea C Lo
- University of British Columbia, Vancouver, British Columbia, Canada
| | - James I Geller
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Peter F Ehrlich
- Section of Pediatric Surgery, CS Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan, USA
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Karam S, Gebreil A, Alksas A, Balaha HM, Khalil A, Ghazal M, Contractor S, El-Baz A. Insights into Personalized Care Strategies for Wilms Tumor: A Narrative Literature Review. Biomedicines 2024; 12:1455. [PMID: 39062028 PMCID: PMC11274555 DOI: 10.3390/biomedicines12071455] [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: 05/02/2024] [Revised: 06/17/2024] [Accepted: 06/26/2024] [Indexed: 07/28/2024] Open
Abstract
Wilms tumor (WT), or nephroblastoma, is the predominant renal malignancy in the pediatric population. This narrative review explores the evolution of personalized care strategies for WT, synthesizing critical developments in molecular diagnostics and treatment approaches to enhance patient-specific outcomes. We surveyed recent literature from the last five years, focusing on high-impact research across major databases such as PubMed, Scopus, and Web of Science. Diagnostic advancements, including liquid biopsies and diffusion-weighted MRI, have improved early detection precision. The prognostic significance of genetic markers, particularly WT1 mutations and miRNA profiles, is discussed. Novel predictive tools integrating genetic and clinical data to anticipate disease trajectory and therapy response are explored. Progressive treatment strategies, particularly immunotherapy and targeted agents such as HIF-2α inhibitors and GD2-targeted immunotherapy, are highlighted for their role in personalized treatment protocols, especially for refractory or recurrent WT. This review underscores the necessity for personalized management supported by genetic insights, with improved survival rates for localized disease exceeding 90%. However, knowledge gaps persist in therapies for high-risk patients and strategies to reduce long-term treatment-related morbidity. In conclusion, this narrative review highlights the need for ongoing research, particularly on the long-term outcomes of emerging therapies and integrating multi-omic data to inform clinical decision-making, paving the way for more individualized treatment pathways.
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Affiliation(s)
- Salma Karam
- Bioengineering Department, University of Louisville, Louisville, KY 40292, USA; (S.K.); (A.G.); (A.A.); (H.M.B.)
| | - Ahmad Gebreil
- Bioengineering Department, University of Louisville, Louisville, KY 40292, USA; (S.K.); (A.G.); (A.A.); (H.M.B.)
| | - Ahmed Alksas
- Bioengineering Department, University of Louisville, Louisville, KY 40292, USA; (S.K.); (A.G.); (A.A.); (H.M.B.)
| | - Hossam Magdy Balaha
- Bioengineering Department, University of Louisville, Louisville, KY 40292, USA; (S.K.); (A.G.); (A.A.); (H.M.B.)
| | - Ashraf Khalil
- College of Technological Innovation, Zayed University, Abu Dhabi 4783, United Arab Emirates;
| | - Mohammed Ghazal
- Electrical, Computer, and Biomedical Engineering Department, Abu Dhabi University, Abu Dhabi 59911, United Arab Emirates;
| | - Sohail Contractor
- Department of Radiology, University of Louisville, Louisville, KY 40202, USA;
| | - Ayman El-Baz
- Bioengineering Department, University of Louisville, Louisville, KY 40292, USA; (S.K.); (A.G.); (A.A.); (H.M.B.)
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Glick RD, Romao RLP, Pachl M, Kotagal M, Buchanan AF, Murphy AJ, Tracy ET, Pio L, Cost NG, Godzinski J, Ehrlich PF. Current surgical approaches to pediatric renal tumors. Pediatr Blood Cancer 2024:e31118. [PMID: 38809413 DOI: 10.1002/pbc.31118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/30/2024]
Abstract
Pediatric renal tumors are among the most common pediatric solid malignancies. Surgical resection is a key component in the multidisciplinary therapy for children with kidney tumors. Therefore, it is imperative that surgeons caring for children with renal tumors fully understand the current standards of care in order to provide appropriate surgical expertise within this multimodal framework. Fortunately, the last 60 years of international, multidisciplinary pediatric cancer cooperative group studies have enabled high rates of cure for these patients. This review will highlight the international surgical approaches to pediatric patients with kidney cancer to help surgeons understand the key differences and similarities between the European (International Society of Pediatric Oncology) and North American (Children's Oncology Group) recommendations.
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Affiliation(s)
- Richard D Glick
- Division of Pediatric Surgery, Cohen Children's Medical Center, Zucker School of Medicine at Northwell/Hofstra, New Hyde Park, New York, USA
| | - Rodrigo L P Romao
- Divisions of Pediatric General Surgery and Pediatric Urology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Max Pachl
- Department of Paediatric Surgery and Urology, Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Meera Kotagal
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Amanda F Buchanan
- Departments of Urology and Pediatrics, University of Kentucky, Lexington, Kentucky, USA
| | - Andrew J Murphy
- Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Elisabeth T Tracy
- Division of Pediatric Surgery, Duke Children's Hospital and Health Center, Durham, North Carolina, USA
| | - Luca Pio
- Paediatric Surgery Unit, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Nicholas G Cost
- Division of Urology, Department of Surgery, University of Colorado School of Medicine and the Surgical Oncology Program at Children's Hospital Colorado, Aurora, Colorado, USA
| | - Jan Godzinski
- Department of Pediatric Surgery, Marciniak Hospital, Wroclaw, Poland
- Department of Pediatric Traumatology and Emergency Medicine, Medical University, Wroclaw, Poland
| | - Peter F Ehrlich
- Section of Pediatric Surgery, University of Michigan Department of Surgery, Ann Arbor, Michigan, USA
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6
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Banerjee A, Babu R, Jayaraman D, Chilukuri S. Preoperative three-dimensional modelling and virtual reality planning aids nephron sparing surgery in a child with bilateral Wilms tumour. BMJ Case Rep 2024; 17:e260600. [PMID: 38642931 PMCID: PMC11033631 DOI: 10.1136/bcr-2024-260600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2024] Open
Abstract
Bilateral Wilms tumour (BWT) is a surgically challenging condition. Virtual reality (VR) reconstruction aids surgeons to foresee the anatomy ahead of Nephron Sparing Surgery (NSS). Three-dimensional (3D) visualisation improves the anatomical orientation of surgeons performing NSS. We herewith report a case of BWT where VR planning and 3D printing were used to aid NSS. Conventional imaging is often found to be inadequate while assessing the tumour-organ-vascular anatomy. Advances like VR and 3D printing help surgeons plan better for complex surgeries like bilateral NSS. Next-generation extended reality tools will likely aid robotic-assisted precision NSS and improve patient outcomes.
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Affiliation(s)
- Avijit Banerjee
- Urology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Ramesh Babu
- Pediatric Urology, Sri Ramachandra University Medical College, Chennai, India
| | - Dhaarani Jayaraman
- Paediatric Hematology and Oncology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, India
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Li T, Zhou J, Wu H, Gao X, Shen Q, Cheng R, Zhang M. Single-cell transcriptomes of kidneys in a 6-month-old boy with Denys-Drash syndrome reveal stromal cell heterogeneity in the tumor microenvironment. Clin Kidney J 2024; 17:sfad277. [PMID: 38223339 PMCID: PMC10784922 DOI: 10.1093/ckj/sfad277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Indexed: 01/16/2024] Open
Abstract
Background Denys-Drash syndrome (DDS) is a rare disease characterized with pseudohermaphroditism, nephroblastoma (also known as Wilms tumor), and diffuse mesangial sclerosis. The therapy for DDS is largely supportive, i.e. surgery and chemotherapy for Wilms tumor and renal replacement therapy. Due to the limited understanding of the pathogenesis, precision therapy for DDS is yet to be explored. We sought to explore the cellular components and interactions in kidney tissues from an infant with DDS. Methods Whole-exome sequencing was performed to examine the mutations associated with DDS. Single-cell RNA sequencing (scRNA-seq) was performed to explore the heterogenicity of kidney tissue samples. Results A 6-month-old infant with bilateral Wilms tumors and genital ambiguity was diagnosed as having DDS. Whole exome sequencing revealed a novel de novo mutation (p.F185fs*118) in exon 1 of WT1. scRNA-seq was performed in tissue samples from bilateral Wilms tumors and the normal kidney from this infant. Fibroblasts, myocytes, epithelial cells, endothelial cells, and mononuclear phagocytes (MPs) ranked at the top of the 31 135 total cells. Fibroblasts and myocytes were dominant in the Wilms tumor samples. In contrast, most epithelial cells and endothelial cells were found in normal kidney tissues. CD44 and TUBA1A were significantly changed in myocyte subclusters, which may contribute to chemotherapy drug resistance. Macrophages intensively interacted with cancerous cells, including fibroblasts, epithelial cells, and myocytes. Conclusions A novel mutation (p.F185fs*118) in exon 1 of WT1 was identified in an infant with DDS. scRNA-Seq revealed the heterogenicity of cellular components in Wilms tumors and kidney tissues, shedding light on the pathogenesis of DDS.
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Affiliation(s)
- Tao Li
- Department of Oncology Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Jiangfeng Zhou
- Department of Oncology Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Haiyan Wu
- Department of Pathology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Xiucheng Gao
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Qiyang Shen
- Department of Pediatric Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Rui Cheng
- Department of Neonatal Medical Center, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Mingshun Zhang
- NHC Key Laboratory of antibody technique, Department of Immunology, Nanjing Medical University, Nanjing, China
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Rastegar B, Andersson N, Petersson A, Karlsson J, Chattopadhyay S, Valind A, Jansson C, Durand G, Romerius P, Jirström K, Holmquist Mengelbier L, Gisselsson D. Resolving the Pathogenesis of Anaplastic Wilms Tumors through Spatial Mapping of Cancer Cell Evolution. Clin Cancer Res 2023; 29:2668-2677. [PMID: 37140929 PMCID: PMC10345961 DOI: 10.1158/1078-0432.ccr-23-0311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/31/2023] [Accepted: 05/02/2023] [Indexed: 05/05/2023]
Abstract
PURPOSE While patients with intermediate-risk (IR) Wilms tumors now have an overall survival (OS) rate of almost 90%, those affected by high-stage tumors with diffuse anaplasia have an OS of only around 50%. We here identify key events in the pathogenesis of diffuse anaplasia by mapping cancer cell evolution over anatomic space in Wilms tumors. EXPERIMENTAL DESIGN We spatially mapped subclonal landscapes in a retrospective cohort of 20 Wilms tumors using high-resolution copy-number profiling and TP53 mutation analysis followed by clonal deconvolution and phylogenetic reconstruction. Tumor whole-mount sections (WMS) were utilized to characterize the distribution of subclones across anatomically distinct tumor compartments. RESULTS Compared with non-diffuse anaplasia Wilms tumors, tumors with diffuse anaplasia showed a significantly higher number of genetically distinct tumor cell subpopulations and more complex phylogenetic trees, including high levels of phylogenetic species richness, divergence, and irregularity. All regions with classical anaplasia showed TP53 alterations. TP53 mutations were frequently followed by saltatory evolution and parallel loss of the remaining wild-type (WT) allele in different regions. Morphologic features of anaplasia increased with copy-number aberration (CNA) burden and regressive features. Compartments demarcated by fibrous septae or necrosis/regression were frequently (73%) associated with the emergence of new clonal CNAs, although clonal sweeps were rare within these compartments. CONCLUSIONS Wilms tumors with diffuse anaplasia display significantly more complex phylogenies compared with non-diffuse anaplasia Wilms tumors, including features of saltatory and parallel evolution. The subclonal landscape of individual tumors was constrained by anatomic compartments, which should be considered when sampling tissue for precision diagnostics.
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Affiliation(s)
- Bahar Rastegar
- Division of Clinical Genetics, Department of Laboratory Medicine, Lund University, Lund, Sweden
- Department of Pediatrics, Skåne University Hospital, Lund, Sweden
| | - Natalie Andersson
- Division of Clinical Genetics, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Alexandra Petersson
- Division of Oncology and Therapeutic Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Jenny Karlsson
- Division of Clinical Genetics, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Subhayan Chattopadhyay
- Division of Clinical Genetics, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Anders Valind
- Division of Clinical Genetics, Department of Laboratory Medicine, Lund University, Lund, Sweden
- Department of Pediatrics, Skåne University Hospital, Lund, Sweden
| | - Caroline Jansson
- Division of Clinical Genetics, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Geoffroy Durand
- Division of Clinical Genetics, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Patrik Romerius
- Department of Pediatrics, Skåne University Hospital, Lund, Sweden
| | - Karin Jirström
- Division of Oncology and Therapeutic Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | | | - David Gisselsson
- Division of Clinical Genetics, Department of Laboratory Medicine, Lund University, Lund, Sweden
- Division of Oncology and Therapeutic Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden
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Csók Á, Micsik T, Magyar Z, Tornóczky T, Kuthi L, Nishi Y, Szirák K, Csóka M, Ottóffy G, Soltész B, Balogh I, Buglyó G. Alterations of miRNA Expression in Diffuse Hyperplastic Perilobar Nephroblastomatosis: Mapping the Way to Understanding Wilms' Tumor Development and Differential Diagnosis. Int J Mol Sci 2023; 24:ijms24108793. [PMID: 37240139 DOI: 10.3390/ijms24108793] [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: 04/18/2023] [Revised: 05/09/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
Wilms' tumor (WT) is the most common renal malignancy in children. In diffuse hyperplastic perilobar nephroblastomatosis (DHPLN), nephrogenic rests result in a bulky enlargement of the kidney, a condition considered as a premalignant state before WT. Despite relevant clinical differences between WT and DHPLN, they are often challenging to distinguish based on histology. Molecular markers would improve differential diagnosis, but none are available at present. In our study, we investigated the potential of microRNAs (miRNAs) as such biomarkers, also aiming to shed light on the chronological order of expression changes. Formalin-fixed, paraffin-embedded (FFPE) samples from four DHPLN cases and adjacent healthy tissues were tested using a PCR array containing primers for 84 miRNAs implicated in genitourinary cancer. Expression in DHPLN was compared to WT data available in dbDEMC. Let-7, miR-135, miR-146a-5p, miR-182-5p, miR-183-5p, miR-20b-3p, miR-29b-3p, miR-195-5p and miR-17-5p showed potential to be used as biomarkers to distinguish WT and DHPLN in cases when traditional differential diagnosis is inconclusive. Our study also revealed miRNAs which may play a role in the initial steps of the pathogenesis (at a precancerous stage) and ones which become deregulated later in WT. More experiments are needed to confirm our observations and find new candidate markers.
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Affiliation(s)
- Ádám Csók
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Tamás Micsik
- Department of Pathology and Experimental Cancer Research, Semmelweis University, 1085 Budapest, Hungary
| | - Zsófia Magyar
- Department of Obstetrics and Gynaecology, Baross Street Division, Semmelweis University, 1088 Budapest, Hungary
| | - Tamás Tornóczky
- Department of Pathology, University of Pécs Medical School and Clinical Center, 7624 Pécs, Hungary
| | - Levente Kuthi
- Department of Pathology, Faculty of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, 6725 Szeged, Hungary
| | - Yumika Nishi
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Krisztina Szirák
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Monika Csóka
- Department of Paediatrics, Semmelweis University, 1094 Budapest, Hungary
| | - Gábor Ottóffy
- Department of Pediatrics, University of Pécs Medical School and Clinical Center, 7623 Pécs, Hungary
| | - Beáta Soltész
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - István Balogh
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- Division of Clinical Genetics, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Gergely Buglyó
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
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10
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Fang Y, Li Z, Song H, Sun N, Zhang W. Treatment of bilateral Wilms' tumor in children: how to improve the application of nephron-sparing surgery. Pediatr Surg Int 2023; 39:145. [PMID: 36856873 DOI: 10.1007/s00383-023-05433-x] [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] [Accepted: 02/20/2023] [Indexed: 03/02/2023]
Abstract
PURPOSE To summarize the experience of nephron-sparing surgery (NSS) for bilateral Wilms tumors (BWT) in children. METHODS This study included children with BWT admitted to our hospital between January 2008 and June 2022. The details of the treatments and outcomes were analyzed. RESULTS In all, 70 patients (39 males and 31 females) were enrolled, including 66 patients with synchronous tumors and 4 patients with metachronous tumors. The median age at diagnosis was 13 (3-75) months. Overall, 59 patients received preoperative chemotherapy and 45.8% (54/118) of the 118 sides of WT achieved a partial response (PR). Of the 70 patients, 48 (68.6%) underwent bilateral NSS and 22 (31.4%) underwent unilateral NSS and contralateral total nephrectomy. The proportion of bilateral NSS in the preoperative chemotherapy group was significantly higher than in the non-chemotherapy group (P = 0.031). Additionally, there were 26, 25, 14, and 5 cases of stage I, stage II, stage III, and stage IV, respectively. Among the 70 children, 16 had a recurrence, and 8 died. The 4 years EFS and OS were 67.9% and 89.3%, respectively. CONCLUSIONS The long-term survival rates of patients with BWT improved. Hence, preoperative chemotherapy should be administered to enhance the use of NSS in BWT.
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Affiliation(s)
- YiWei Fang
- Department of Urology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, No. 56 Nanlishi St, Xicheng District, Beijing, 100045, China
| | - ZhenWu Li
- Department of Urology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, No. 56 Nanlishi St, Xicheng District, Beijing, 100045, China
| | - HongCheng Song
- Department of Urology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, No. 56 Nanlishi St, Xicheng District, Beijing, 100045, China.
| | - Ning Sun
- Department of Urology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, No. 56 Nanlishi St, Xicheng District, Beijing, 100045, China.
| | - WeiPing Zhang
- Department of Urology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, No. 56 Nanlishi St, Xicheng District, Beijing, 100045, China
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11
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Meier CM, Furtwängler R, Mergen M, Welter N, Melchior P, Schenk JP, Vokuhl C, Kager L, Kroiss-Benninger S, Wagenpfeil S, Graf N. Impact of Time to Surgery on Outcome in Wilms Tumor Treated with Preoperative Chemotherapy. Cancers (Basel) 2023; 15:cancers15051494. [PMID: 36900286 PMCID: PMC10001069 DOI: 10.3390/cancers15051494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/23/2023] [Accepted: 02/25/2023] [Indexed: 03/05/2023] Open
Abstract
(1) Background: Wilms tumor (WT) treated preoperatively is cured in over 90% of cases. However, how long preoperative chemotherapy can be given is unknown. (2) Methods: 2561/3030 patients with WT (age < 18 years) treated between 1989 and 2022 according to SIOP-9/GPOH, SIOP-93-01/GPOH, and SIOP-2001/GPOH are retrospectively analyzed to assess the risk of time to surgery (TTS) for relapse-free survival (RFS) and overall survival (OS). (3) Results: TTS was calculated for all surgeries, with the mean being 39 days (38.5 ± 12.5) for unilateral tumors (UWT) and 70 days (69.9 ± 32.7) for bilateral disease (BWT). Relapse occurred in 347 patients, of which 63 (2.5%) were local, 199 (7.8%) were metastatic, and 85 (3.3%) were combined. Moreover, 184 patients (7.2%) died, 152 (5.9%) due to tumor progression. In UWT, recurrences and mortality are independent of TTS. For BWT without metastases at diagnosis, the incidence of recurrence is less than 18% up to 120 days and increases to 29% after 120 days, and to 60% after 150 days. The risk of relapse (Hazard Ratio) adjusted for age, local stage, and histological risk group increases to 2.87 after 120 days (CI 1.19-7.95, p = 0.022) and to 4.62 after 150 days (CI 1.17-18.26, p = 0.029). In metastatic BWT, no influence of TTS is detected. (4) Conclusions: The length of preoperative chemotherapy has no negative impact on RFS or OS in UWT. In BWT without metastatic disease, surgery should be performed before day 120, as the risk of recurrence increases significantly thereafter.
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Affiliation(s)
- Clemens-Magnus Meier
- Department of General Surgery, Visceral, Vascular and Pediatric Surgery, Saarland University Medical Center, 66424 Homburg, Germany
- Correspondence: (C.-M.M.); (N.G.); Tel.: +49-(0)6841-16-22687 (C.-M.M.); +49-(0)6841-16-28411 (N.G.)
| | - Rhoikos Furtwängler
- Department of Pediatric Oncology and Hematology, Saarland University Medical Center, 66424 Homburg, Germany
| | - Marvin Mergen
- Department of Pediatric Oncology and Hematology, Saarland University Medical Center, 66424 Homburg, Germany
| | - Nils Welter
- Department of Pediatric Oncology and Hematology, Saarland University Medical Center, 66424 Homburg, Germany
| | - Patrick Melchior
- Department of Radiation Oncology, Saarland University Medical Center, 66424 Homburg, Germany
| | - Jens-Peter Schenk
- Pediatric Radiology Section, Department for Diagnostic and Interventional Radiology, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Christian Vokuhl
- Institute of Pathology, University Hospital Bonn, 53127 Bonn, Germany
| | - Leo Kager
- St. Anna Children’s Hospital, Department of Pediatrics, Medical University Vienna, 1090 Vienna, Austria
- St. Anna Children’s Cancer Research Institute, 1090 Vienna, Austria
| | | | - Stefan Wagenpfeil
- Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University, Campus Homburg, 66424 Homburg, Germany
| | - Norbert Graf
- Department of Pediatric Oncology and Hematology, Saarland University Medical Center, 66424 Homburg, Germany
- Correspondence: (C.-M.M.); (N.G.); Tel.: +49-(0)6841-16-22687 (C.-M.M.); +49-(0)6841-16-28411 (N.G.)
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12
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Somatic, Genetic and Epigenetic Changes in Nephrogenic Rests and Their Role in the Transformation to Wilms Tumors, a Systematic Review. Cancers (Basel) 2023; 15:cancers15051363. [PMID: 36900155 PMCID: PMC10000075 DOI: 10.3390/cancers15051363] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/13/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE To review somatic genetic changes in nephrogenic rests (NR), which are considered to be precursor lesions of Wilms tumors (WT). METHODS This systematic review is written according to the PRISMA statement. PubMed and EMBASE were systematically searched for articles in the English language studying somatic genetic changes in NR between 1990 and 2022. RESULTS Twenty-three studies were included in this review, describing 221 NR of which 119 were pairs of NR and WT. Single gene studies showed mutations in WT1 and WTX, but not CTNNB1 to occur in both NR and WT. Studies investigating chromosomal changes showed loss of heterozygosity of 11p13 and 11p15 to occur in both NR and WT, but loss of 7p and 16q occurred in WT only. Methylome-based studies found differential methylation patterns between NR, WT, and normal kidney (NK). CONCLUSIONS Over a 30-year time frame, few studies have addressed genetic changes in NR, likely hampered by technical and practical limitations. A limited number of genes and chromosomal regions have been implicated in the early pathogenesis of WT, exemplified by their occurrence in NR, including WT1, WTX, and genes located at 11p15. Further studies of NR and corresponding WT are urgently needed.
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13
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Quarello P, Carli D, Biasoni D, Gerocarni Nappo S, Morosi C, Cotti R, Garelli E, Zucchetti G, Spadea M, Tirtei E, Spreafico F, Fagioli F. Implications of an Underlying Beckwith-Wiedemann Syndrome for Wilms Tumor Treatment Strategies. Cancers (Basel) 2023; 15:cancers15041292. [PMID: 36831633 PMCID: PMC9954715 DOI: 10.3390/cancers15041292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
Beckwith-Wiedemann Syndrome (BWS) is a pediatric overgrowth disorder involving a predisposition to embryonal tumors. Most of the tumors associated with BWS occur in the first 8-10 years of life, and the most common is Wilms tumor (WT). BWS clinical heterogeneity includes subtle overgrowth features or even silent phenotypes, and WT may be the presenting symptom of BWS. WT in BWS individuals exhibit distinct characteristics from those of sporadic WT, and the management of these patients needs a peculiar approach. The most important feature is a higher risk of developing bilateral disease at some time in the course of the illness (synchronous bilateral disease at diagnosis or metachronous recurrence after initial presentation with unilateral disease). Accordingly, neoadjuvant chemotherapy is the recommended approach also for BWS patients with unilateral WT to facilitate nephron-sparing surgical approaches. This review emphasizes the importance of early BWS recognition, particularly if a WT has already occurred, as this will result in an urgent consideration of first-line cancer therapy.
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Affiliation(s)
- Paola Quarello
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
- Correspondence: ; Tel.: +39-011-313-5801
| | - Diana Carli
- Immunogenetics and Transplant Biology Service, Città della Salute e della Scienza University Hospital, 10126 Turin, Italy
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
| | - Davide Biasoni
- Pediatric Surgical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | | | - Carlo Morosi
- Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Roberta Cotti
- Pediatric Radiology, Regina Margherita Children’s Hospital, 10126 Turin, Italy
| | - Emanuela Garelli
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
| | - Giulia Zucchetti
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy
| | - Manuela Spadea
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
| | - Elisa Tirtei
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
| | - Filippo Spreafico
- Pediatric Oncology Unit, Department of Medical Oncology and Hematology, Fondazione IRCCS, Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Franca Fagioli
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
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14
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Smriti V, Baheti AD, Shah S, Qureshi SS, Shetty N, Gala K, Kulkarni S, Raut A, Kamble V, Chinnaswamy G, Prasad M, C. P B, Ramadwar M, Singh S, Shukla A, Panwala H, Sahu A, Siddharth L, Kapadia T. Imaging Recommendations for Diagnosis, Staging, and Management of Pediatric Solid Tumors. Indian J Med Paediatr Oncol 2023. [DOI: 10.1055/s-0042-1759507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
AbstractPaediatric extra-cranial solid tumours are one of the common causes for paediatric malignancies. Lack of appropriate imaging at presentation, staging and for follow-up is a major challenge for paediatric solid tumours. We have reviewed the paediatric solid tumour imaging protocols suggested by the major oncological societies/groups around the world (mainly the SIOP – Society International Pediatric Oncology, and the COG – Children's Oncology Group). We have adapted some of those protocols to develop imaging recommendations for the diagnosis, staging and management of extra-cranial solid tumours based on the treatment protocols followed in India.
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Affiliation(s)
- Vasundhara Smriti
- Department of Radiodiagnosis and Imaging, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Akshay D. Baheti
- Department of Radiodiagnosis and Imaging, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Sneha Shah
- Department of Nuclear Medicine and molecular imaging, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Sajid S. Qureshi
- Division of Pediatric Surgical Oncology, Department of Surgical Oncology, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Nanadan Shetty
- Department of Opthalmology, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Kunal Gala
- Department of Intervention Radiology, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Suyash Kulkarni
- Department of Intervention Radiology, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Abhijit Raut
- Department of Radiodiagnosis, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India
| | - Veenita Kamble
- Department of Radiodiagnosis, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India
| | - Girish Chinnaswamy
- Department of Pediatric Oncology, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Maya Prasad
- Department of Pediatric Oncology, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Badira C. P
- Department of Pediatric Oncology, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Mukta Ramadwar
- Department of Pathology, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Suryaveer Singh
- Department of Radiodiagnosis and Imaging, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Anuradha Shukla
- Department of Radiodiagnosis and Imaging, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Hirenkumar Panwala
- Department of Radiodiagnosis, SRCC Children's Hospital, Mumbai, Maharashtra, India
| | - Arpita Sahu
- Department of Radiodiagnosis and Imaging, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Laskar Siddharth
- Department of Radiation Oncology, Homi Bhabha National Institute, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Tejas Kapadia
- Children's X-ray Department/Academic Unit of Paediatric Radiology, Royal Manchester Children's Hospital, Manchester, United Kingdom
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15
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Bednarek OL, Seemann N, Brzezinski J, Lorenzo A, Fernandez CV, Romao RLP. Outcomes according to treatment using an established protocol in patients with bilateral Wilms' tumor: A national Canadian population-based study. J Pediatr Surg 2023; 58:1014-1017. [PMID: 36797114 DOI: 10.1016/j.jpedsurg.2023.01.016] [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: 12/16/2022] [Accepted: 01/02/2023] [Indexed: 01/19/2023]
Abstract
BACKGROUND Bilateral Wilms tumor (BWT) is a rare entity. The goal of this study is to report outcomes (overall and event-free survival, OS/EFS) of BWT in a large cohort representative of the Canadian population since 2000. We focused on the occurrence of late events (relapse or death beyond 18 months), as well as outcomes of patients treated following the only protocol specifically designed for BWT to date, AREN0534, compared to patients treated following other therapeutic schemes. METHODS Data was obtained for patients diagnosed with BWT between 2001 and 2018 from the Cancer in Young People in Canada (CYP-C) database. Demographics, treatment protocols, and dates for events were collected. Specifically, we examined outcomes of patients treated according to the Children's Oncology Group (COG) protocol AREN0534 since 2009. Survival analysis was performed. RESULTS 57/816 (7%) of patients with Wilms tumor had BWT during the study period. Median age at diagnosis was 2.74 years (IQR 1.37-4.48) and 35 (64%) were female; 8/57 (15%) had metastatic disease. After a median follow-up of 4.8 years (IQR 2.8-5.7 years, range 0.2-18 years), OS and EFS were 86% (CI 73-93%) and 80% (CI 66-89%), respectively. Less than 5 events were recorded after 18 months from diagnosis. Since 2009, patients treated according to the AREN0534 protocol had a statistically significant higher OS compared to patients treated with other protocols. CONCLUSIONS In this large Canadian cohort of patients with BWT, OS and EFS compared favorably to the published literature. Late events were rare. Patients treated according to a disease-specific protocol (AREN0534) had improved overall survival. TYPE OF STUDY Original article. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Olga L Bednarek
- IWK Health Centre, Dalhousie University, Halifax, NS, Canada
| | - Natashia Seemann
- IWK Health Centre, Dalhousie University, Halifax, NS, Canada; Children's Hospital at London Health Sciences Centre, London, ON, Canada
| | - Jack Brzezinski
- The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Armando Lorenzo
- The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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16
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Gao P, Li J, Chen H, Wu W, Liu L, Jiang H, Xu L, Wu C, Fu Q, Liu J, Wang C. Bench surgery with autotransplantation for bilateral Wilms tumor-A feasible technique for renal sinus invasion. Front Surg 2022; 9:1047975. [PMID: 36582965 PMCID: PMC9793901 DOI: 10.3389/fsurg.2022.1047975] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/16/2022] [Indexed: 12/15/2022] Open
Abstract
Purpose Bilateral Wilms tumor (BWT) with renal sinus invasion requires extremely difficult surgical care. This study presents an alternative strategy for tumor removal while at the same time preserving the renal parenchyma. Materials and methods In total, 9 cases of synchronous BWT were admitted to our hospital between May 2016 to Aug 2020. We retrospectively reviewed the clinical data, surgical technique, and functional and oncological outcomes of these cases. Results The 9 cases included 3 males and 6 females, with a median age of 12 months at surgery (range 7-40). A total of 14 kidney units had renal sinus invasion (77.8%), whereas multifocal neoplasms were observed in 7 units (38.9%). The local stage distribution revealed 1 kidney with stage I, 10 kidneys with stage II, and 7 kidneys with stage III. Nephron-sparing surgery was performed on 15 kidney units (83.3%), among which 13 (72.2%) underwent bench surgery with autotransplantation (BS-AT), whereas 2 (11.1%) were subjected to tumor enucleation in vivo. Urinary leakage was the most prevalent postoperative complication. We observed negative margins. During the mean follow-up of 28.4 months, 2 patients (22.2%) succumbed from sepsis and renal failure, respectively, whereas the other 7 (77.8%) survived without recurrence. Survivors experienced an estimated glomerular filtration rate of 81 ± 15.4 ml/(min × 1.73 m2). The endpoint renal volume of 9 renal units receiving BS-AT significantly increased (P = 0.02). Conclusions In summary, the surgical management of bilateral Wilms tumor requires meticulous operative approach and technique. Besides, BS-AT provides a viable alternative to nephron-sparing surgery for BWT patients with renal sinus invasion.
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Affiliation(s)
- Pengfei Gao
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China,Department of Pediatric Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jun Li
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huadong Chen
- Department of Pediatric Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wenrui Wu
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Longshan Liu
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hong Jiang
- Department of Pediatric Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lingling Xu
- Pediatric Intensive Care Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Chenglin Wu
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qian Fu
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Juncheng Liu
- Department of Pediatric Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China,Correspondence: Juncheng Liu Changxi Wang
| | - Changxi Wang
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China,Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China,Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China,Correspondence: Juncheng Liu Changxi Wang
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17
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Gbadamosi H, Mensah YB, Appau AA, Renner LA. A spectrum of findings on computed tomography in paediatric abdominal and pelvic tumours in a Ghanaian teaching hospital. Ghana Med J 2022; 56:295-302. [PMID: 37575625 PMCID: PMC10416291 DOI: 10.4314/gmj.v56i4.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023] Open
Abstract
Objectives To review the Computed Tomography( CT )features of pediatric oncological patients with abdominal and pelvic tumours and correlate these findings with their histopathological diagnosis. Design This was a retrospective cross-sectional facility-based study. Setting This study was conducted in the Pediatric Oncology Unit and Radiology Department of the Korle Bu Teaching Hospital. Participants Fifty-six pediatric oncology patients with contrast-enhanced abdominal and pelvic CT scans. Data Collection The abdominal and pelvic CT scans findings, patient biodata, and histopathology reports of oncology patients over four years were reviewed. Statistical analysis Simple descriptive statistics using frequency distribution, percentages, means, and standard deviation were used to describe the various variables and presented tables. Results The four commonest tumours were nephroblastoma, neuroblastoma, lymphoma, and hepatoblastoma. The mean age at diagnosis was 4.8 years, with a slightly higher male predominance. The majority of the tumours were extremely large at presentation. Overall, the CT - histopathology concordance was 79.2%. Conclusion Abdominal and pelvic CT scans play an important role in the diagnostic workup of pediatric malignancies by ensuring early and accurate diagnosis of these tumours. Funding None declared.
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Affiliation(s)
| | - Yaw B Mensah
- Department of Radiology, University of Ghana Medical School, College of Health Sciences, Accra, Ghana
| | - Andrea A Appau
- Department of Radiology, Korle Bu Teaching Hospital, Accra, Ghana
| | - Lorner A Renner
- Paediatric Oncology Unit, Department of Child Health, University of Ghana Medical School, College of Health Sciences, Accra, Ghana
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18
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Gargallo P, Oltra S, Tasso M, Balaguer J, Yáñez Y, Dolz S, Calabria I, Martínez F, Segura V, Juan-Ribelles A, Llavador M, Castel V, Cañete A, Font de Mora J. Germline variant in Ctcf links mental retardation to Wilms tumor predisposition. Eur J Hum Genet 2022; 30:1288-1291. [PMID: 35459888 PMCID: PMC9626537 DOI: 10.1038/s41431-022-01105-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 04/05/2022] [Accepted: 04/12/2022] [Indexed: 02/04/2023] Open
Abstract
CTCF germline mutations have been related to MRD21. We report the first bilateral Wilms tumor suffered by a MRD21 patient carrying an unreported CTCF missense variant in a zinc finger domain of CTCF protein. We found that germline heterozygous variant I446K became homozygous in the tumor due to a loss of heterozygosity rearrangement affecting the whole q arm on chromosome 16. Our findings propose CTCF I446K variant as a link between MRD21 and Wilms tumor predisposition.
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Affiliation(s)
- Pablo Gargallo
- Clinical and Translational Research in Cancer, La Fe Health Research Institute, Valencia, Spain.
- Oncology Department - Health in Code Group, Paterna, Valencia, Spain.
| | - Silvestre Oltra
- Genetics Unit, La Fe Hospital, Valencia, Spain
- Genetics Department, Valencia University, Valencia, Spain
| | - María Tasso
- Pediatric Oncology Unit, General University Hospital of Alicante, Alicante, Spain
| | - Julia Balaguer
- Clinical and Translational Research in Cancer, La Fe Health Research Institute, Valencia, Spain
- Pediatric Oncology and Hematology Unit, La Fe University Hospital, Valencia, Spain
| | - Yania Yáñez
- Clinical and Translational Research in Cancer, La Fe Health Research Institute, Valencia, Spain
| | - Sandra Dolz
- Clinical and Translational Research in Cancer, La Fe Health Research Institute, Valencia, Spain
| | - Inés Calabria
- Oncology Department - Health in Code Group, Paterna, Valencia, Spain
| | | | - Vanessa Segura
- Clinical and Translational Research in Cancer, La Fe Health Research Institute, Valencia, Spain
| | - Antonio Juan-Ribelles
- Clinical and Translational Research in Cancer, La Fe Health Research Institute, Valencia, Spain
- Pediatric Oncology and Hematology Unit, La Fe University Hospital, Valencia, Spain
| | | | - Victoria Castel
- Clinical and Translational Research in Cancer, La Fe Health Research Institute, Valencia, Spain
| | - Adela Cañete
- Clinical and Translational Research in Cancer, La Fe Health Research Institute, Valencia, Spain
- Pediatric Oncology and Hematology Unit, La Fe University Hospital, Valencia, Spain
| | - Jaime Font de Mora
- Clinical and Translational Research in Cancer, La Fe Health Research Institute, Valencia, Spain
- Laboratory of Cellular and Molecular Biology, La Fe Health Research Institute, Valencia, Spain
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19
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Welter N, Brzezinski J, Treece A, Chintagumpala M, Young MD, Perotti D, Kieran K, Jongmans MCJ, Murphy AJ. The pathophysiology of bilateral and multifocal Wilms tumors: What we can learn from the study of predisposition syndromes. Pediatr Blood Cancer 2022; 70 Suppl 2:e29984. [PMID: 36094328 DOI: 10.1002/pbc.29984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 11/06/2022]
Abstract
Approximately 5% of patients with Wilms tumor present with synchronous bilateral disease. The development of synchronous bilateral Wilms tumor (BWT) is highly suggestive of a genetic or epigenetic predisposition. Patients with known germline predisposition to Wilms tumor (WT1 variants, Beckwith Wiedemann spectrum, TRIM28 variants) have a higher incidence of BWT. This Children's Oncology Group (COG)-International Society for Pediatric Oncology (SIOP-) HARMONICA initiative review for pediatric renal tumors details germline genetic and epigenetic predisposition to BWT development, with an emphasis on alterations in 11p15.5 (ICR1 gain of methylation, paternal uniparental disomy, and postzygotic somatic mosaicism), WT1, TRIM28, and REST. Molecular mechanisms that result in BWT are often also present in multifocal Wilms tumor (multiple separate tumors in one or both kidneys). We identify priority areas for international collaborative research to better understand how predisposing genetic or epigenetic factors associate with response to neoadjuvant chemotherapy, oncologic outcomes, and long-term renal function outcomes.
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Affiliation(s)
- Nils Welter
- Department of Pediatric Oncology and Hematology, Saarland University, Homburg, Germany
| | - Jack Brzezinski
- Department of Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Amy Treece
- Department of Pathology, Children's Hospital Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | | | - Daniela Perotti
- Molecular Bases of Genetic Risk and Genetic Testing Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Kathleen Kieran
- Division of Urology, Seattle Children's Hospital, Seattle, Washington, USA.,Department of Urology, University of Washington, Seattle, Washington, USA
| | - Marjolijn C J Jongmans
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Department of Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Andrew J Murphy
- Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
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20
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Heym KM, Masand PM, Margolin JF. How we approach the diagnosis of a vascular anomaly. Pediatr Blood Cancer 2022; 69 Suppl 3:e29802. [PMID: 35709330 DOI: 10.1002/pbc.29802] [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: 12/17/2021] [Revised: 04/14/2022] [Accepted: 05/08/2022] [Indexed: 11/11/2022]
Abstract
Vascular anomalies represent a diverse group of complex disorders that can cause significant complications, including coagulopathies, pain, and decreased function. The diagnosis of vascular anomalies is often challenging due to heterogeneity of presenting phenotypes and overlapping clinical features with other pediatric conditions. Pediatric hematologists/oncologists (PHO) are uniquely positioned for an essential role in diagnosing, managing, and coordinating the multidisciplinary care required to maximize the quality of life of these patients. Here, we review the diagnostic approach involved in patients with vascular anomalies and utilize cases to highlight the challenges involved, and how PHOs can play a vital part in the care of these patients.
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Affiliation(s)
- Kenneth M Heym
- Department of Hematology/Oncology, Cook Children's Medical Center, Fort Worth, Texas, USA
| | - Prakash M Masand
- Department of Radiology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA
| | - Judith F Margolin
- Department of Pediatrics, Division of Hematology/Oncology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA
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21
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Surgical management and outcomes of intracranial metastatic Wilms' tumor in the pediatric population: a case series. Childs Nerv Syst 2022; 38:1105-1111. [PMID: 35377009 DOI: 10.1007/s00381-022-05502-x] [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: 02/21/2022] [Accepted: 03/15/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Approximately 1 to 2% of patients with Wilms' tumor (WT), or nephroblastoma, will have metastasis to the brain. Due to the rarity of intracranial metastasis, the clinical characteristics, prognosis, and a standardized treatment approach to this occurrence remain poorly understood. Here we review the surgical management and treatment outcome of WT patients with intracranial metastasis at our institution. METHODS A retrospective chart review of patients with WT at the Children's Hospital of Philadelphia was performed from 2007 to 2021. Clinical characteristics, operative details, radiographic studies, pathology, and patient outcomes were collected and analyzed. RESULTS A total of 3 patients with histologically confirmed intracranial metastatic disease from WT were identified with a mean age of 5.7 years (range 3-10 years). 2 of the 3 patients were male. The mean time from diagnosis of primary WT to development of central nervous system metastasis was 15.3 months. Both supratentorial (n = 3) and infratentorial (n = 1) sites of metastasis were observed. Surgical resection was performed, and gross total resection was achieved in all 3 patients. All cases had favorable histology with no anaplasia and received whole-brain irradiation and chemotherapy. Two of 3 patients had a good neurologic function at postoperative follow-up. One patient died from their disease 4 months after resection of the brain metastasis. CONCLUSION In WT patients with limited systemic disease burden, the combination of surgery, chemotherapy, and radiotherapy may play a role in enhancing survival when intracranial metastasis is present, despite the perioperative risk associated with surgery.
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Luo B, Feng S, Li T, Wang J, Qi Z, Zhao Y, Hu B. Transcription factor HOXB2 upregulates NUSAP1 to promote the proliferation, invasion and migration of nephroblastoma cells via the PI3K/Akt signaling pathway. Mol Med Rep 2022; 25:205. [PMID: 35485274 PMCID: PMC9073831 DOI: 10.3892/mmr.2022.12721] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/12/2021] [Indexed: 11/23/2022] Open
Abstract
The transcription factor homeobox protein Hox-B2 (HOXB2) and its downstream factor nucleolar and spindle-associated protein 1 (NUSAP1) play important regulatory roles in cell proliferation, invasion and migration. However, their effects and specific mechanisms in nephroblastoma have not been previously investigated, to the best of our knowledge. Therefore, in the present study, the mRNA and protein expression levels of HOXB2 and NUSAP1 were determined in nephroblastoma cells using reverse transcription-quantitative PCR and western blot analyses, respectively. Furthermore, cell transfection experiments were carried out to knock down NUSAP1 and overexpress HOXB2 in nephroblastoma cell lines. The proliferative, invasive and migratory abilities of nephroblastoma cells were assessed by MTT, EdU, colony formation, wound healing and Transwell assays. In addition, the JASPAR website was used to predict the association between HOXB2 and NUSAP1, which was further verified by dual-luciferase reporter and chromatin immunoprecipitation assays. Finally, the expression levels of the PI3K/Akt signaling pathway-related proteins were measured by western blot analysis. The results showed that the expression of NUSAP1 was abnormally upregulated in nephroblastoma cell lines. However, NUSAP1 silencing attenuated the proliferation, invasion and migration abilities of nephroblastoma cells. The results also suggested that HOXB2 could transcriptionally activate NUSAP1. Therefore, HOXB2 overexpression abrogated the inhibitory effect of NUSAP1 silencing on the proliferation and metastasis of nephroblastoma cells, possibly via the PI3K/Akt signaling pathway. The aforementioned findings indicated that HOXB2 may upregulate NUSAP1 to promote the proliferation, invasion and migration of nephroblastoma cells via the PI3K/Akt signaling pathway.
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Affiliation(s)
- Bo Luo
- Department of Pediatric Surgery, Zigong First People's Hospital, Zigong, Sichuan 643099, P.R. China
| | - Shasha Feng
- Department of Clinical, Chongqing Jiulongpo District Hospital of Traditional Chinese Medicine, Chongqing 400039, P.R. China
| | - Tianliang Li
- Department of Pediatric Surgery, Zigong First People's Hospital, Zigong, Sichuan 643099, P.R. China
| | - Jun Wang
- Department of Pediatric Surgery, Zigong First People's Hospital, Zigong, Sichuan 643099, P.R. China
| | - Zhaoyang Qi
- Department of Pediatric Surgery, Zigong First People's Hospital, Zigong, Sichuan 643099, P.R. China
| | - Yi Zhao
- Department of Pediatric Surgery, Zigong First People's Hospital, Zigong, Sichuan 643099, P.R. China
| | - Bo Hu
- Department of Pediatric Surgery, Zigong First People's Hospital, Zigong, Sichuan 643099, P.R. China
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23
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Steur A, Raymakers-Janssen PAMA, Kneyber MCJ, Dijkstra S, van Woensel JBM, van Waardenburg DA, van de Ven CP, van der Steeg AFW, Wijnen M, Lilien MR, de Krijger RR, van Tinteren H, Littooij AS, Janssens GO, Peek AML, Tytgat GAM, Mavinkurve-Groothuis AM, van Grotel M, van den Heuvel-Eibrink MM, Asperen RMWV. Characteristics and Outcome of Children with Wilms Tumor Requiring Intensive Care Admission in First Line Therapy. Cancers (Basel) 2022; 14:cancers14040943. [PMID: 35205701 PMCID: PMC8870004 DOI: 10.3390/cancers14040943] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/03/2022] [Accepted: 02/08/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Survival of children with Wilms tumor is excellent. However, treatment-related complications may occur, requiring treatment at the pediatric intensive care unit (PICU). The aim of our retrospective study was to assess the frequency, clinical characteristics, and outcome of 175 children with Wilms tumor requiring treatment at the PICU in the Netherlands. Thirty-three patients (almost 20%) required unplanned PICU admission during their disease course. Younger age at diagnosis, intensive chemotherapy regimens, and bilateral tumor surgery were risk factors for these unplanned PICU admissions. Three children required renal replacement therapy, two of which continued dialysis after PICU discharge. Two children died during their PICU stay. During follow up, hypertension and renal dysfunction were frequently observed, which justifies special attention for kidney function and blood pressure monitoring during and after treatment of these children. Abstract Survival rates are excellent for children with Wilms tumor (WT), yet tumor and treatment-related complications may require pediatric intensive care unit (PICU) admission. We assessed the frequency, clinical characteristics, and outcome of children with WT requiring PICU admissions in a multicenter, retrospective study in the Netherlands. Admission reasons of unplanned PICU admissions were described in relation to treatment phase. Unplanned PICU admissions were compared to a control group of no or planned PICU admissions, with regard to patient characteristics and short and long term outcomes. In a multicenter cohort of 175 children with an underlying WT, 50 unplanned PICU admissions were registered in 33 patients. Reasons for admission were diverse and varied per treatment phase. Younger age at diagnosis, intensive chemotherapy regimens, and bilateral tumor surgery were observed in children with unplanned PICU admission versus the other WT patients. Three children required renal replacement therapy, two of which continued dialysis after PICU discharge (both with bilateral disease). Two children died during their PICU stay. During follow-up, hypertension and chronic kidney disease (18.2 vs. 4.2% and 15.2 vs. 0.7%) were more frequently observed in unplanned PICU admitted patients compared to the other patients. No significant differences in cardiac morbidity, relapse, or progression were observed. Almost 20% of children with WT required unplanned PICU admission, with young age and treatment intensity as potential risk factors. Hypertension and renal impairment were frequently observed in these patients, warranting special attention at presentation and during treatment and follow-up.
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Affiliation(s)
- Anouk Steur
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (A.S.); (P.A.M.A.R.-J.); (C.P.v.d.V.); (A.F.W.v.d.S.); (M.W.); (R.R.d.K.); (H.v.T.); (G.O.J.); (A.M.L.P.); (G.A.M.T.); (A.M.M.-G.); (M.v.G.); (M.M.v.d.H.-E.)
| | - Paulien A. M. A. Raymakers-Janssen
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (A.S.); (P.A.M.A.R.-J.); (C.P.v.d.V.); (A.F.W.v.d.S.); (M.W.); (R.R.d.K.); (H.v.T.); (G.O.J.); (A.M.L.P.); (G.A.M.T.); (A.M.M.-G.); (M.v.G.); (M.M.v.d.H.-E.)
- Department of Pediatric Intensive Care, Wilhelmina Children’s Hospital/University Medical Center Utrecht, 3584 EA Utrecht, The Netherlands
| | - Martin C. J. Kneyber
- Division of Pediatric Critical Care Medicine, Beatrix Children’s Hospital/University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (M.C.J.K.); (S.D.)
| | - Sandra Dijkstra
- Division of Pediatric Critical Care Medicine, Beatrix Children’s Hospital/University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (M.C.J.K.); (S.D.)
| | - Job B. M. van Woensel
- Department of Pediatric Intensive Care, Amsterdam University Medical Centers, 1105 AZ Amsterdam, The Netherlands;
| | - Dick A. van Waardenburg
- Department of Pediatric Intensive Care, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands;
| | - Cornelis P. van de Ven
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (A.S.); (P.A.M.A.R.-J.); (C.P.v.d.V.); (A.F.W.v.d.S.); (M.W.); (R.R.d.K.); (H.v.T.); (G.O.J.); (A.M.L.P.); (G.A.M.T.); (A.M.M.-G.); (M.v.G.); (M.M.v.d.H.-E.)
| | - Alida F. W. van der Steeg
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (A.S.); (P.A.M.A.R.-J.); (C.P.v.d.V.); (A.F.W.v.d.S.); (M.W.); (R.R.d.K.); (H.v.T.); (G.O.J.); (A.M.L.P.); (G.A.M.T.); (A.M.M.-G.); (M.v.G.); (M.M.v.d.H.-E.)
| | - Marc Wijnen
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (A.S.); (P.A.M.A.R.-J.); (C.P.v.d.V.); (A.F.W.v.d.S.); (M.W.); (R.R.d.K.); (H.v.T.); (G.O.J.); (A.M.L.P.); (G.A.M.T.); (A.M.M.-G.); (M.v.G.); (M.M.v.d.H.-E.)
| | - Marc R. Lilien
- Department of Pediatric Nephrology, Wilhelmina Children’s Hospital/University Medical Center Utrecht, 3584 EA Utrecht, The Netherlands;
| | - Ronald R. de Krijger
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (A.S.); (P.A.M.A.R.-J.); (C.P.v.d.V.); (A.F.W.v.d.S.); (M.W.); (R.R.d.K.); (H.v.T.); (G.O.J.); (A.M.L.P.); (G.A.M.T.); (A.M.M.-G.); (M.v.G.); (M.M.v.d.H.-E.)
- Department of Pathology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Harm van Tinteren
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (A.S.); (P.A.M.A.R.-J.); (C.P.v.d.V.); (A.F.W.v.d.S.); (M.W.); (R.R.d.K.); (H.v.T.); (G.O.J.); (A.M.L.P.); (G.A.M.T.); (A.M.M.-G.); (M.v.G.); (M.M.v.d.H.-E.)
| | - Annemieke S. Littooij
- Department of Radiology, Wilhelmina Children’s Hospital/University Medical Center Utrecht, 3584 EA Utrecht, The Netherlands;
| | - Geert O. Janssens
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (A.S.); (P.A.M.A.R.-J.); (C.P.v.d.V.); (A.F.W.v.d.S.); (M.W.); (R.R.d.K.); (H.v.T.); (G.O.J.); (A.M.L.P.); (G.A.M.T.); (A.M.M.-G.); (M.v.G.); (M.M.v.d.H.-E.)
| | - Annemarie M. L. Peek
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (A.S.); (P.A.M.A.R.-J.); (C.P.v.d.V.); (A.F.W.v.d.S.); (M.W.); (R.R.d.K.); (H.v.T.); (G.O.J.); (A.M.L.P.); (G.A.M.T.); (A.M.M.-G.); (M.v.G.); (M.M.v.d.H.-E.)
| | - Godelieve A. M. Tytgat
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (A.S.); (P.A.M.A.R.-J.); (C.P.v.d.V.); (A.F.W.v.d.S.); (M.W.); (R.R.d.K.); (H.v.T.); (G.O.J.); (A.M.L.P.); (G.A.M.T.); (A.M.M.-G.); (M.v.G.); (M.M.v.d.H.-E.)
| | - Annelies M. Mavinkurve-Groothuis
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (A.S.); (P.A.M.A.R.-J.); (C.P.v.d.V.); (A.F.W.v.d.S.); (M.W.); (R.R.d.K.); (H.v.T.); (G.O.J.); (A.M.L.P.); (G.A.M.T.); (A.M.M.-G.); (M.v.G.); (M.M.v.d.H.-E.)
| | - Martine van Grotel
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (A.S.); (P.A.M.A.R.-J.); (C.P.v.d.V.); (A.F.W.v.d.S.); (M.W.); (R.R.d.K.); (H.v.T.); (G.O.J.); (A.M.L.P.); (G.A.M.T.); (A.M.M.-G.); (M.v.G.); (M.M.v.d.H.-E.)
| | - Marry M. van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (A.S.); (P.A.M.A.R.-J.); (C.P.v.d.V.); (A.F.W.v.d.S.); (M.W.); (R.R.d.K.); (H.v.T.); (G.O.J.); (A.M.L.P.); (G.A.M.T.); (A.M.M.-G.); (M.v.G.); (M.M.v.d.H.-E.)
| | - Roelie M. Wösten-van Asperen
- Department of Pediatric Intensive Care, Wilhelmina Children’s Hospital/University Medical Center Utrecht, 3584 EA Utrecht, The Netherlands
- Correspondence:
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Guerrero-Villota JC, Manuel F. MF, Dueñas-Ramírez JC, Idrobo AA. Abordaje mínimamente invasivo del tumor de Wilms unilateral: un reporte de caso y revisión de la literatura. REVISTA COLOMBIANA DE CIRUGÍA 2022. [DOI: 10.30944/20117582.921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introducción. El tumor de Wilms es la neoplasia abdominal más común en pacientes pediátricos. En la mayoría de los casos se presenta como una masa unilateral indolora en el abdomen. El objetivo de este artículo fue presentar el caso de una paciente de 4 años con tumor de Wilms unilateral derecho manejado con cirugía mínimamente invasiva en el Hospital Universitario del Valle.
Métodos. Revisión de la historia clínica e imágenes de la paciente, descripción de la técnica quirúrgica y revisión de la literatura del manejo de tumor de Wilms unilateral.
Caso clínico. Paciente femenina de 4 años quien consultó en abril de 2019 por un cuadro clínico de dolor abdominal y sensación de masa en flanco derecho. Se realizó ecografía abdominal donde se encontró imagen nodular heterogénea de contornos definidos en riñón derecho, con riñón izquierdo normal. Se hizo diagnóstico de tumor de Wilms unilateral y se llevó a cirugía mediante abordaje mínimamente invasivo, con buena evolución postoperatoria.
Conclusión. La cirugía es el pilar del manejo, y la nefrectomía mediante abordaje laparoscópico para casos seleccionados, en manos entrenadas, tiene la suficiente eficacia, seguridad y cumplimiento de los principios quirúrgicos y oncológicos que provee la cirugía abierta.
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25
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Theilen TM, Braun Y, Bochennek K, Rolle U, Fiegel HC, Friedmacher F. Multidisciplinary Treatment Strategies for Wilms Tumor: Recent Advances, Technical Innovations and Future Directions. Front Pediatr 2022; 10:852185. [PMID: 35911825 PMCID: PMC9333359 DOI: 10.3389/fped.2022.852185] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/27/2022] [Indexed: 11/13/2022] Open
Abstract
Significant progress has been made in the management of Wilms tumor (WT) in recent years, mostly as a result of collaborative efforts and the implementation of protocol-driven, multimodal therapy. This article offers a comprehensive overview of current multidisciplinary treatment strategies for WT, whilst also addressing recent technical innovations including nephron-sparing surgery (NSS) and minimally invasive approaches. In addition, surgical concepts for the treatment of metastatic disease, advances in tumor imaging technology and potentially prognostic biomarkers will be discussed. Current evidence suggests that, in experienced hands and selected cases, laparoscopic radical nephrectomy and laparoscopic-assisted partial nephrectomy for WT may offer the same outcome as the traditional open approach. While NSS is the standard procedure for bilateral WT, NSS has evolved as an alternative technique in patients with smaller unilateral WT and in cases with imminent renal failure. Metastatic disease of the lung or liver that is associated with WT is preferably treated with a three-drug chemotherapy and local radiation therapy. However, surgical sampling of lung nodules may be advisable in persistent nodules before whole lung irradiation is commenced. Several tumor markers such as loss of heterozygosity of chromosomes 1p/16q, 11p15 and gain of function at 1q are associated with an increased risk of recurrence or a decreased risk of overall survival in patients with WT. In summary, complete resection with tumor-free margins remains the primary surgical aim in WT, while NSS and minimally invasive approaches are only suitable in a subset of patients with smaller WT and low-risk disease. In the future, advances in tumor imaging technology may assist the surgeon in defining surgical resection margins and additional biomarkers may emerge as targets for development of new diagnostic tests and potential therapies.
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Affiliation(s)
- Till-Martin Theilen
- Department of Pediatric Surgery and Pediatric Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Yannick Braun
- Department of Pediatric Surgery and Pediatric Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Konrad Bochennek
- Division of Pediatric Hematology and Pediatric Oncology, Hospital for Children and Adolescents, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Udo Rolle
- Department of Pediatric Surgery and Pediatric Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Henning C Fiegel
- Department of Pediatric Surgery and Pediatric Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - Florian Friedmacher
- Department of Pediatric Surgery and Pediatric Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
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Vujanić G, Đuričić S. Renal tumours of childhood: A review. SCRIPTA MEDICA 2022. [DOI: 10.5937/scriptamed53-38283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Renal tumours of childhood are rare, although they are one of the most common solid tumours in children. They include numerous entities, which have different clinical, histological, molecular biological and prognostic features, so their precise diagnosis and staging are critical for appropriate treatment. The most common is Wilms' tumour (WT) with ~80-85 % of all cases, whereas other entities including mesoblastic nephroma, clear cell sarcoma, rhabdoid tumour, renal cell carcinoma, metanephric tumours and others are very rare (2-4 % each) which explains why they represent a big diagnostic challenge for diagnostic pathologists. They are subclassified into three risk groups - low, intermediate and high - which have different treatments and prognosis. There are two big study groups which have different approaches but remarkable similar outcomes. The International Society of Paediatric Oncology approach (followed in most of the world) is based on preoperative chemotherapy, followed by surgery and further therapy, whereas the Children's Oncology Group approach (followed mainly in the United States and Canada) is based on primary surgery, followed by postoperative treatment.
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27
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van Peer SE, Hol JA, van der Steeg AFW, van Grotel M, Tytgat GAM, Mavinkurve-Groothuis AMC, Janssens GOR, Littooij AS, de Krijger RR, Jongmans MCJ, Lilien MR, Drost J, Kuiper RP, van Tinteren H, Wijnen MHWA, van den Heuvel-Eibrink MM. Bilateral Renal Tumors in Children: The First 5 Years' Experience of National Centralization in The Netherlands and a Narrative Review of the Literature. J Clin Med 2021; 10:jcm10235558. [PMID: 34884260 PMCID: PMC8658527 DOI: 10.3390/jcm10235558] [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] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 02/07/2023] Open
Abstract
Survival of unilateral Wilms tumors (WTs) is exceeding 90%, whereas bilateral WTs have an inferior outcome. We evaluated all Dutch patients with bilateral kidney tumors, treated in the first five years of national centralization and reviewed relevant literature. We identified 24 patients in our center (2015–2020), 23 patients had WT/nephroblastomatosis and one renal cell carcinoma. Patients were treated according to SIOP-RTSG protocols. Chemotherapy response was observed in 26/34 WTs. Nephroblastomatosis lesions were stable (n = 7) or showed response (n = 18). Nephron-sparing surgery was performed in 11/22 patients undergoing surgery (n = 2 kidneys positive margins). Local stage in 20 patients with ≥1 WT revealed stage I (n = 7), II (n = 4) and III (n = 9). Histology was intermediate risk in 15 patients and high risk in 5. Three patients developed a WT in a treated nephroblastomatosis lesion. Two of 24 patients died following toxicity and renal failure, i.e., respectively dialysis-related invasive fungal infection and septic shock. Genetic predisposition was confirmed in 18/24 patients. Our literature review revealed that knowledge is scarce on bilateral renal tumor patients with metastases and that radiotherapy seems important for local stage III patients. Bilateral renal tumors are a therapeutic challenge. We describe management and outcome in a national expert center and summarized available literature, serving as baseline for further improvement of care.
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Affiliation(s)
- Sophie E. van Peer
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (J.A.H.); (A.F.W.v.d.S.); (M.v.G.); (G.A.M.T.); (A.M.C.M.-G.); (G.O.R.J.); (A.S.L.); (R.R.d.K.); (M.C.J.J.); (M.R.L.); (J.D.); (R.P.K.); (H.v.T.); (M.H.W.A.W.); (M.M.v.d.H.-E.)
- Correspondence:
| | - Janna A. Hol
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (J.A.H.); (A.F.W.v.d.S.); (M.v.G.); (G.A.M.T.); (A.M.C.M.-G.); (G.O.R.J.); (A.S.L.); (R.R.d.K.); (M.C.J.J.); (M.R.L.); (J.D.); (R.P.K.); (H.v.T.); (M.H.W.A.W.); (M.M.v.d.H.-E.)
| | - Alida F. W. van der Steeg
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (J.A.H.); (A.F.W.v.d.S.); (M.v.G.); (G.A.M.T.); (A.M.C.M.-G.); (G.O.R.J.); (A.S.L.); (R.R.d.K.); (M.C.J.J.); (M.R.L.); (J.D.); (R.P.K.); (H.v.T.); (M.H.W.A.W.); (M.M.v.d.H.-E.)
| | - Martine van Grotel
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (J.A.H.); (A.F.W.v.d.S.); (M.v.G.); (G.A.M.T.); (A.M.C.M.-G.); (G.O.R.J.); (A.S.L.); (R.R.d.K.); (M.C.J.J.); (M.R.L.); (J.D.); (R.P.K.); (H.v.T.); (M.H.W.A.W.); (M.M.v.d.H.-E.)
| | - Godelieve A. M. Tytgat
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (J.A.H.); (A.F.W.v.d.S.); (M.v.G.); (G.A.M.T.); (A.M.C.M.-G.); (G.O.R.J.); (A.S.L.); (R.R.d.K.); (M.C.J.J.); (M.R.L.); (J.D.); (R.P.K.); (H.v.T.); (M.H.W.A.W.); (M.M.v.d.H.-E.)
| | - Annelies M. C. Mavinkurve-Groothuis
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (J.A.H.); (A.F.W.v.d.S.); (M.v.G.); (G.A.M.T.); (A.M.C.M.-G.); (G.O.R.J.); (A.S.L.); (R.R.d.K.); (M.C.J.J.); (M.R.L.); (J.D.); (R.P.K.); (H.v.T.); (M.H.W.A.W.); (M.M.v.d.H.-E.)
| | - Geert O. R. Janssens
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (J.A.H.); (A.F.W.v.d.S.); (M.v.G.); (G.A.M.T.); (A.M.C.M.-G.); (G.O.R.J.); (A.S.L.); (R.R.d.K.); (M.C.J.J.); (M.R.L.); (J.D.); (R.P.K.); (H.v.T.); (M.H.W.A.W.); (M.M.v.d.H.-E.)
- Department of Radiation Oncology, University Medical Center Utrecht (UMCU), Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Annemieke S. Littooij
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (J.A.H.); (A.F.W.v.d.S.); (M.v.G.); (G.A.M.T.); (A.M.C.M.-G.); (G.O.R.J.); (A.S.L.); (R.R.d.K.); (M.C.J.J.); (M.R.L.); (J.D.); (R.P.K.); (H.v.T.); (M.H.W.A.W.); (M.M.v.d.H.-E.)
- Department of Radiology and Nuclear Medicine, Wilhelmina’s Children Hospital, University Medical Center Utrecht (UMCU), Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Ronald R. de Krijger
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (J.A.H.); (A.F.W.v.d.S.); (M.v.G.); (G.A.M.T.); (A.M.C.M.-G.); (G.O.R.J.); (A.S.L.); (R.R.d.K.); (M.C.J.J.); (M.R.L.); (J.D.); (R.P.K.); (H.v.T.); (M.H.W.A.W.); (M.M.v.d.H.-E.)
- Department of Pathology, University Medical Center Utrecht (UMCU), Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Marjolijn C. J. Jongmans
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (J.A.H.); (A.F.W.v.d.S.); (M.v.G.); (G.A.M.T.); (A.M.C.M.-G.); (G.O.R.J.); (A.S.L.); (R.R.d.K.); (M.C.J.J.); (M.R.L.); (J.D.); (R.P.K.); (H.v.T.); (M.H.W.A.W.); (M.M.v.d.H.-E.)
- Department of Genetics, University Medical Center Utrecht (UMCU), Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Marc R. Lilien
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (J.A.H.); (A.F.W.v.d.S.); (M.v.G.); (G.A.M.T.); (A.M.C.M.-G.); (G.O.R.J.); (A.S.L.); (R.R.d.K.); (M.C.J.J.); (M.R.L.); (J.D.); (R.P.K.); (H.v.T.); (M.H.W.A.W.); (M.M.v.d.H.-E.)
- Department of Pediatric Nephrology, Wilhelmina’s Children Hospital, University Medical Center Utrecht (UMCU), Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Jarno Drost
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (J.A.H.); (A.F.W.v.d.S.); (M.v.G.); (G.A.M.T.); (A.M.C.M.-G.); (G.O.R.J.); (A.S.L.); (R.R.d.K.); (M.C.J.J.); (M.R.L.); (J.D.); (R.P.K.); (H.v.T.); (M.H.W.A.W.); (M.M.v.d.H.-E.)
- Oncode Institute, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands
| | - Roland P. Kuiper
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (J.A.H.); (A.F.W.v.d.S.); (M.v.G.); (G.A.M.T.); (A.M.C.M.-G.); (G.O.R.J.); (A.S.L.); (R.R.d.K.); (M.C.J.J.); (M.R.L.); (J.D.); (R.P.K.); (H.v.T.); (M.H.W.A.W.); (M.M.v.d.H.-E.)
- Department of Genetics, University Medical Center Utrecht (UMCU), Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Harm van Tinteren
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (J.A.H.); (A.F.W.v.d.S.); (M.v.G.); (G.A.M.T.); (A.M.C.M.-G.); (G.O.R.J.); (A.S.L.); (R.R.d.K.); (M.C.J.J.); (M.R.L.); (J.D.); (R.P.K.); (H.v.T.); (M.H.W.A.W.); (M.M.v.d.H.-E.)
| | - Marc H. W. A. Wijnen
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (J.A.H.); (A.F.W.v.d.S.); (M.v.G.); (G.A.M.T.); (A.M.C.M.-G.); (G.O.R.J.); (A.S.L.); (R.R.d.K.); (M.C.J.J.); (M.R.L.); (J.D.); (R.P.K.); (H.v.T.); (M.H.W.A.W.); (M.M.v.d.H.-E.)
| | - Marry M. van den Heuvel-Eibrink
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (J.A.H.); (A.F.W.v.d.S.); (M.v.G.); (G.A.M.T.); (A.M.C.M.-G.); (G.O.R.J.); (A.S.L.); (R.R.d.K.); (M.C.J.J.); (M.R.L.); (J.D.); (R.P.K.); (H.v.T.); (M.H.W.A.W.); (M.M.v.d.H.-E.)
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Spreafico F, Fernandez CV, Brok J, Nakata K, Vujanic G, Geller JI, Gessler M, Maschietto M, Behjati S, Polanco A, Paintsil V, Luna-Fineman S, Pritchard-Jones K. Wilms tumour. Nat Rev Dis Primers 2021; 7:75. [PMID: 34650095 DOI: 10.1038/s41572-021-00308-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/14/2021] [Indexed: 02/08/2023]
Abstract
Wilms tumour (WT) is a childhood embryonal tumour that is paradigmatic of the intersection between disrupted organogenesis and tumorigenesis. Many WT genes play a critical (non-redundant) role in early nephrogenesis. Improving patient outcomes requires advances in understanding and targeting of the multiple genes and cellular control pathways now identified as active in WT development. Decades of clinical and basic research have helped to gradually optimize clinical care. Curative therapy is achievable in 90% of affected children, even those with disseminated disease, yet survival disparities within and between countries exist and deserve commitment to change. Updated epidemiological studies have also provided novel insights into global incidence variations. Introduction of biology-driven approaches to risk stratification and new drug development has been slower in WT than in other childhood tumours. Current prognostic classification for children with WT is grounded in clinical and pathological findings and in dedicated protocols on molecular alterations. Treatment includes conventional cytotoxic chemotherapy and surgery, and radiation therapy in some cases. Advanced imaging to capture tumour composition, optimizing irradiation techniques to reduce target volumes, and evaluation of newer surgical procedures are key areas for future research.
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Affiliation(s)
- Filippo Spreafico
- Department of Medical Oncology and Hematology, Paediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Conrad V Fernandez
- Department of Paediatrics, IWK Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jesper Brok
- Department of Paediatric Haematology and Oncology, Rigshospitalet, Copenhagen, Denmark
| | - Kayo Nakata
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | | | - James I Geller
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Cincinnati, OH, USA
| | - Manfred Gessler
- Theodor-Boveri-Institute, Developmental Biochemistry, and Comprehensive Cancer Center Mainfranken, University of Wuerzburg, Wuerzburg, Germany
| | - Mariana Maschietto
- Research Center, Boldrini Children's Hospital, Genetics and Molecular Biology, Institute of Biology, State University of Campinas, Campinas, SP, Brazil
| | - Sam Behjati
- Wellcome Sanger Institute, Hinxton, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - Angela Polanco
- National Cancer Research Institute Children's Group Consumer Representative, London, UK
| | - Vivian Paintsil
- Department of Child Health, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Sandra Luna-Fineman
- Division of Hematology, Oncology and Bone Marrow Transplantation, Department of Paediatrics, University of Colorado, Aurora, CO, USA
| | - Kathy Pritchard-Jones
- Developmental Biology and Cancer Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
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29
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Liu H, Zhang M, Zhang T, Shi M, Lu W, Yang S, Cui Q, Li Z. Identification of a ferroptosis-related lncRNA signature with prognosis for Wilms tumor. Transl Pediatr 2021; 10:2418-2431. [PMID: 34765465 PMCID: PMC8578763 DOI: 10.21037/tp-21-211] [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: 05/11/2021] [Accepted: 08/05/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Wilms tumor (WT) is a widespread urologic tumor in children. Ferroptosis, on the other hand, is a novel form of cell death associated with tumor development. In this study, we aim to explore the predictability of ferroptosis-related biomarkers in estimating prognosis in WT patients. METHODS To determine a link between ferroptosis-related gene expression and WT prognosis, we first collected RNA sequencing data and clinical information, involving 124 WT and 6 healthy tissue samples, from the TARGET database. Next, we screened the collected information for ferroptosis-related long non-coding RNA using Cox regression analysis, and constructed a signature model, as well as a nomogram, related to prognosis. Finally, we explored a potential link between ferroptosis-related lncRNA and tumor immunity and screened for possible immune checkpoints. RESULTS We constructed a WT prognosis prediction signature containing 12 ferroptosis-related lncRNAs. The area under the curves values, from the ROC curves, predicting overall survival rates at the 1, 3-, and 5-year timepoints were 0.775, 0.867, and 0.891 respectively. Moreover, we generated a nomogram, using clinical features and risk scores, carrying a C-index value of 0.836, which suggested a high predictive value. We also demonstrated significant differences in tumor immunity between low- and high-risk WT patients, particularly in the presence of B cells, NK cells, Th1 cells, Treg cells, inflammation promoting, and type I and II IFN responses. In addition, we showed that immune checkpoints like SIRPA, ICOSLG, LAG3, PVRIG, NECTIN1, and SIRPB2 can serve as potential therapeutic targets for WT. CONCLUSIONS Based on our analyses, we generated a ferroptosis-related lncRNA signature that can both estimate prognosis of WT patients and may provide basis for future WT therapy.
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Affiliation(s)
- Hengchen Liu
- Department of Pediatric Surgery, The Second Hospital Affiliated to Harbin Medical University, Harbin, China
| | - Mingzhao Zhang
- Department of Pediatric Surgery, The Second Hospital Affiliated to Harbin Medical University, Harbin, China
| | - Tingting Zhang
- Department of Pediatric Surgery, The Second Hospital Affiliated to Harbin Medical University, Harbin, China
| | - Manyu Shi
- Department of Pediatric Surgery, The Second Hospital Affiliated to Harbin Medical University, Harbin, China
| | - Wenjun Lu
- Department of Pediatric Surgery, The Second Hospital Affiliated to Harbin Medical University, Harbin, China
| | - Shulong Yang
- Department of Pediatric Surgery, The Second Hospital Affiliated to Harbin Medical University, Harbin, China
| | - Qingbo Cui
- Department of Pediatric Surgery, The Second Hospital Affiliated to Harbin Medical University, Harbin, China
| | - Zhaozhu Li
- Department of Pediatric Surgery, The Second Hospital Affiliated to Harbin Medical University, Harbin, China
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30
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Meng D, Chang X, Ren Q, Xu J, Wang H. Congenital Bilateral Wilms Tumor: A Case Report. Urology 2021; 157:242-245. [PMID: 34450174 DOI: 10.1016/j.urology.2021.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/03/2021] [Accepted: 08/11/2021] [Indexed: 10/20/2022]
Abstract
Compare to congenital mesoblastic nephroma in fetus, congenital wilms tumor is extremely rare. Herein we report a case of congenital bilateral solid masses on antenatal ultrasound. The mass was evaluated by ultrasonography and contrast computed tomography scan in postnatal period, and the patient was undergoing tumor enucleation separately in short period after neoadjuvant chemotherapy. The diagnosis was confirmed by histology analysis for each side, and the treatment was taken according to the International Society of Pediatric Oncology.
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Affiliation(s)
- Deguang Meng
- Baoding Children's Hospital, Baoding, Hebei, PR China
| | - Xiaofeng Chang
- Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, PR China
| | - Qinghua Ren
- Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, PR China
| | - Jiatong Xu
- Pathology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, PR China
| | - Huanmin Wang
- Department of Surgical Oncology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, PR China.
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31
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Balis F, Green DM, Anderson C, Cook S, Dhillon J, Gow K, Hiniker S, Jasty-Rao R, Lin C, Lovvorn H, MacEwan I, Martinez-Agosto J, Mullen E, Murphy ES, Ranalli M, Rhee D, Rokitka D, Tracy EL, Vern-Gross T, Walsh MF, Walz A, Wickiser J, Zapala M, Berardi RA, Hughes M. Wilms Tumor (Nephroblastoma), Version 2.2021, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2021; 19:945-977. [PMID: 34416707 DOI: 10.6004/jnccn.2021.0037] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The NCCN Guidelines for Wilms Tumor focus on the screening, diagnosis, staging, treatment, and management of Wilms tumor (WT, also known as nephroblastoma). WT is the most common primary renal tumor in children. Five-year survival is more than 90% for children with all stages of favorable histology WT who receive appropriate treatment. All patients with WT should be managed by a multidisciplinary team with experience in managing renal tumors; consulting a pediatric oncologist is strongly encouraged. Treatment of WT includes surgery, neoadjuvant or adjuvant chemotherapy, and radiation therapy (RT) if needed. Careful use of available therapies is necessary to maximize cure and minimize long-term toxicities. This article discusses the NCCN Guidelines recommendations for favorable histology WT.
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Affiliation(s)
- Frank Balis
- Abramson Cancer Center at the University of Pennsylvania
| | - Daniel M Green
- St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | | | - Shelly Cook
- University of Wisconsin Carbone Cancer Center
| | | | - Kenneth Gow
- Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | | | | | - Chi Lin
- Fred & Pamela Buffett Cancer Center
| | | | | | | | | | - Erin S Murphy
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | - Mark Ranalli
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | - Daniel Rhee
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | | | | | | | | | - Amy Walz
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | - Matthew Zapala
- UCSF Helen Diller Family Comprehensive Cancer Center; and
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Groenendijk A, Spreafico F, de Krijger RR, Drost J, Brok J, Perotti D, van Tinteren H, Venkatramani R, Godziński J, Rübe C, Geller JI, Graf N, van den Heuvel-Eibrink MM, Mavinkurve-Groothuis AMC. Prognostic Factors for Wilms Tumor Recurrence: A Review of the Literature. Cancers (Basel) 2021; 13:cancers13133142. [PMID: 34201787 PMCID: PMC8268923 DOI: 10.3390/cancers13133142] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/08/2021] [Accepted: 06/18/2021] [Indexed: 01/10/2023] Open
Abstract
Simple Summary A Wilms tumor is a childhood kidney tumor. In high-income countries, 90% of patients with this tumor survive. However, the tumor recurs in 15% of patients. It is important to identify the patients at risk of recurrence in order to adjust treatment in such a way that recurrence may potentially be prevented. However, we are currently unable to determine precisely which patients are at risk of recurrence. Therefore, we present an overview of factors that influence the risk of recurrence, also known as prognostic factors. These factors range from patient-, tumor- and treatment-related characteristics to geographic and socioeconomic factors. In addition to these factors, biological markers, such as genetic alterations, should be studied more intensively as these markers may be able to better identify patients at risk of tumor recurrence. Abstract In high-income countries, the overall survival of children with Wilms tumors (WT) is ~90%. However, overall, 15% of patients experience tumor recurrence. The adverse prognostic factors currently used for risk stratification (advanced stage, high risk histology, and combined loss of heterozygosity at 1p and 16q in chemotherapy-naïve WTs) are present in only one third of these cases, and the significance of these factors is prone to change with advancing knowledge and improved treatment regimens. Therefore, we present a comprehensive, updated overview of the published prognostic variables for WT recurrence, ranging from patient-, tumor- and treatment-related characteristics to geographic and socioeconomic factors. Improved first-line treatment regimens based on clinicopathological characteristics and advancing knowledge on copy number variations unveil the importance of further investigating the significance of biological markers for WT recurrence in international collaborations.
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Affiliation(s)
- Alissa Groenendijk
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (H.v.T.); (M.M.v.d.H.-E.); (A.M.C.M.-G.)
- Correspondence:
| | - Filippo Spreafico
- Department of Medical Oncology and Hematology, Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy;
| | - Ronald R. de Krijger
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (H.v.T.); (M.M.v.d.H.-E.); (A.M.C.M.-G.)
- Department of Pathology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Jarno Drost
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (H.v.T.); (M.M.v.d.H.-E.); (A.M.C.M.-G.)
- Oncode Institute, 3584 CS Utrecht, The Netherlands
| | - Jesper Brok
- Department of Pediatric Oncology and Hematology, Rigshospitalet, 2100 Copenhagen, Denmark;
- Developmental Biology and Cancer Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, London WC1N 1EH, UK
| | - Daniela Perotti
- Molecular Bases of Genetic Risk and Genetic Testing Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy;
| | - Harm van Tinteren
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (H.v.T.); (M.M.v.d.H.-E.); (A.M.C.M.-G.)
| | | | - Jan Godziński
- Department of Pediatric Surgery, Marciniak Hospital, Fieldorfa 2, 54-049 Wroclaw, Poland;
- Department of Pediatric Traumatology and Emergency Medicine, Wroclaw Medical University, Bujwida 44a, 50-345 Wroclaw, Poland
| | - Christian Rübe
- Department of Radiation Oncology, Saarland University Medical Center and Saarland University Faculty of Medicine, D-66421 Homburg, Germany;
| | - James I. Geller
- Division of Oncology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229, USA;
| | - Norbert Graf
- Department of Pediatric Oncology and Hematology, Saarland University Medical Center and Saarland University Faculty of Medicine, D-66421 Homburg, Germany;
| | - Marry M. van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (H.v.T.); (M.M.v.d.H.-E.); (A.M.C.M.-G.)
| | - Annelies M. C. Mavinkurve-Groothuis
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (R.R.d.K.); (J.D.); (H.v.T.); (M.M.v.d.H.-E.); (A.M.C.M.-G.)
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Sereke SG, Sahal AO, Mboizi V, Bongomin F. Synchronous bilateral Wilms' tumor with liver metastasis. BMC Urol 2021; 21:91. [PMID: 34112148 PMCID: PMC8193872 DOI: 10.1186/s12894-021-00859-8] [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: 12/08/2020] [Accepted: 06/07/2021] [Indexed: 11/17/2022] Open
Abstract
Background Wilms’ tumor (nephroblastoma) is mostly unilateral; however, bilateral Wilms’ tumors are seen in about 5–8% of patients. This can be synchronous or metachronous. It is uncommon to get liver metastasis from bilateral Wilms’ tumor. Case presentation An 8-year-old male Ugandan presented with a history of abdominal swelling and flank pains for 1 year. There was no history of hematuria. Both ultrasound and computed tomography of the abdomen demonstrated multiple solid lesions in both kidneys and a huge solid mass in segments V, VI, VII and VIII of the liver. Histological examination of renal biopsy specimen was favorable for chemotherapeutic regimens. However, following a multidisciplinary tumor board consensus, a nephron-sparing surgery was deemed unsuitable, and he was managed conservatively with chemotherapy (adriamycin and vincristine) with a palliative intent. Conclusions Metastatic bilateral Wilms’ tumor has a particularly poor prognosis. There are no clear evidence-based guidelines for the management of this rare presentation. This patient benefited from early palliative care and symptom management.
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Affiliation(s)
- Senai Goitom Sereke
- Department of Radiology and Radiotherapy, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Abdirahman Omar Sahal
- Department of Radiology and Radiotherapy, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Vincent Mboizi
- Department of Radiology and Radiotherapy, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Felix Bongomin
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.,Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
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Thibodeau R, Jafroodifar A, Coelho M, Li HK, Gitto L, Zaccarini DJ, McGrath M. Relapsed Wilms' Tumor Presenting as Metastasis to the Zygoma. Radiol Case Rep 2021; 16:1965-1973. [PMID: 34158876 PMCID: PMC8203567 DOI: 10.1016/j.radcr.2021.05.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 05/04/2021] [Indexed: 11/28/2022] Open
Abstract
Wilms’ tumor accounts for the majority of renal tumors in children. Rarely, Wilms’ tumor may metastasize to the bone. We present a case of a 15-month-old female who presented with severe abdominal distension and signs of cachexia. Abdominal ultrasonography and radiography of the abdomen both demonstrated a large abdominal mass. Follow-up computed tomography of the abdomen revealed a heterogeneous intra-abdominal mass arising from the left kidney which was surrounded by a thin rim of renal parenchyma. Biopsy of the mass revealed findings consistent with Wilms’ tumor. The patient was 14 months status-post nephrectomy and chemoradiation but returned to the clinic with left facial swelling. Magnetic resonance imaging of the face demonstrated a multilobulated, heterogeneously enhancing solitary mass lesion in the left temple centered in the left zygoma with signs of bone breakdown. Despite its rarity, metastatic Wilms’ tumor to bone should be considered in a child presenting with a new focal mass overlying bony-structures.
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Affiliation(s)
- Ryan Thibodeau
- Department of Radiology, SUNY Upstate Medical University, Syracuse, NY
| | - Abtin Jafroodifar
- Department of Radiology, SUNY Upstate Medical University, Syracuse, NY
| | - Marlon Coelho
- Department of Radiology, SUNY Upstate Medical University, Syracuse, NY
| | - Hsin Kwung Li
- Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY
| | - Lorenzo Gitto
- Department of Pathology, SUNY Upstate Medical University, Syracuse, NY
| | | | - Mary McGrath
- Department of Radiology, SUNY Upstate Medical University, Syracuse, NY
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Abstract
PURPOSE OF REVIEW The treatment of Wilms tumor is one of the great achievements in the field of oncology. One of the key success factors has been improved risk stratification, enabling augmentation or reduction of therapy depending on a patient's risk of relapse. This article highlights the evolution of clinical and biological prognostic markers that have been applied in the treatment of Wilms tumor. RECENT FINDINGS Historically, tumor stage and histology were the sole determinants of Wilms tumor treatment. Recent clinical trials conducted by the Children's Oncology Group (COG) and the International Society of Pediatric Oncology (SIOP) Renal Tumor Study Group have expanded the menu of prognostic factors to include histologic and volumetric response to therapy and tumor-specific loss of heterozygosity (LOH) at chromosomes 1p and 16q. Augmentation of therapy has been able to overcome the adverse risk factors. An emerging prognostic marker is chromosome 1q gain, will be incorporated into future clinical trials. SUMMARY The application of new clinical and biological prognostic factors has created unprecedented ability to tailor therapy for Wilms tumor, accompanied with improved outcomes. Current and future trials will continue to enhance precision medicine for Wilms tumor.
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Affiliation(s)
- Marie V. Nelson
- Division of Oncology, Children's National Hospital and the George Washington University School of Medicine and Health Sciences, Washington DC, United States
| | | | - Norbert Graf
- Department of Pediatric Oncology, University Hospital of Saarland, Homburg, Germany
| | - Jeffrey S. Dome
- Division of Oncology, Children's National Hospital and the George Washington University School of Medicine and Health Sciences, Washington DC, United States
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Kratz CP, Jongmans MC, Cavé H, Wimmer K, Behjati S, Guerrini-Rousseau L, Milde T, Pajtler KW, Golmard L, Gauthier-Villars M, Jewell R, Duncan C, Maher ER, Brugieres L, Pritchard-Jones K, Bourdeaut F. Predisposition to cancer in children and adolescents. THE LANCET. CHILD & ADOLESCENT HEALTH 2021; 5:142-154. [PMID: 33484663 DOI: 10.1016/s2352-4642(20)30275-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 08/04/2020] [Accepted: 08/11/2020] [Indexed: 12/18/2022]
Abstract
Childhood malignancies are rarely related to known environmental exposures, and it has become increasingly evident that inherited genetic factors play a substantial causal role. Large-scale sequencing studies have shown that approximately 10% of children with cancer have an underlying cancer predisposition syndrome. The number of recognised cancer predisposition syndromes and cancer predisposition genes are constantly growing. Imaging and laboratory technologies are improving, and knowledge of the range of tumours and risk of malignancy associated with cancer predisposition syndromes is increasing over time. Consequently, surveillance measures need to be constantly adjusted to address these new findings. Management recommendations for individuals with pathogenic germline variants in cancer predisposition genes need to be established through international collaborative studies, addressing issues such as genetic counselling, cancer prevention, cancer surveillance, cancer therapy, psychological support, and social-ethical issues. This Review represents the work by a group of experts from the European Society for Paediatric Oncology (SIOPE) and aims to summarise the current knowledge and define future research needs in this evolving field.
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Affiliation(s)
- Christian P Kratz
- Paediatric Haematology and Oncology, Hannover Medical School, Hannover, Germany
| | - Marjolijn C Jongmans
- Princess Máxima Center for Paediatric Oncology, Utrecht, Netherlands; Department of Genetics, University Medical Center Utrecht, Princess Máxima Center for Paediatric Oncology, Utrecht, Netherlands
| | - Hélène Cavé
- Department of Genetics, Assistance Publique Hôpitaux de Paris-Robert Debre University Hospital, Paris, France; Denis Diderot School of Medicine, University of Paris, Paris, France; Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1131, Institut de Recherche Saint Louis, Paris, France
| | - Katharina Wimmer
- Institute of Human Genetics, Medical University of Innsbruck, Innsbruck, Austria
| | - Sam Behjati
- Wellcome Sanger Institute, Cambridge, UK; Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - Lea Guerrini-Rousseau
- Department of Children and Adolescents Oncology, Gustave Roussy, Villejuif, Paris, France
| | - Till Milde
- Clinical Cooperation Unit Paediatric Oncology, German Cancer Research Center and German Consortium for Translational Cancer Research, Heidelberg, Germany; KiTZ Clinical Trial Unit, Department of Paediatric Haematology and Oncology, Heidelberg University Hospital, Heidelberg, Germany; Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
| | - Kristian W Pajtler
- Clinical Cooperation Unit Paediatric Oncology, German Cancer Research Center and German Consortium for Translational Cancer Research, Heidelberg, Germany; KiTZ Clinical Trial Unit, Department of Paediatric Haematology and Oncology, Heidelberg University Hospital, Heidelberg, Germany; Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
| | - Lisa Golmard
- Department of Genetics, Institut Curie, Paris, France; Paris Sciences Lettres Research University, Paris, France
| | - Marion Gauthier-Villars
- Department of Genetics, Institut Curie, Paris, France; Paris Sciences Lettres Research University, Paris, France
| | - Rosalyn Jewell
- Yorkshire Regional Genetics Service, Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Eamonn R Maher
- Department of Medical Genetics, University of Cambridge, Cambridge, UK; NIHR Cambridge Biomedical Research Centre and Cancer Research UK Cambridge Centre, Cambridge Biomedical Campus, Cambridge, UK
| | - Laurence Brugieres
- Department of Children and Adolescents Oncology, Gustave Roussy, Villejuif, Paris, France
| | - Kathy Pritchard-Jones
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Franck Bourdeaut
- SIREDO Paediatric Cancer Center, Institut Curie, Paris, France; INSERM U830, Laboratory of Translational Research in Paediatric Oncology, Institut Curie, Paris, France; Paris Sciences Lettres Research University, Paris, France.
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McLeod C, Gout AM, Zhou X, Thrasher A, Rahbarinia D, Brady SW, Macias M, Birch K, Finkelstein D, Sunny J, Mudunuri R, Orr BA, Treadway M, Davidson B, Ard TK, Chiao A, Swistak A, Wiggins S, Foy S, Wang J, Sioson E, Wang S, Michael JR, Liu Y, Ma X, Patel A, Edmonson MN, Wilkinson MR, Frantz AM, Chang TC, Tian L, Lei S, Islam SMA, Meyer C, Thangaraj N, Tater P, Kandali V, Ma S, Nguyen T, Serang O, McGuire I, Robison N, Gentry D, Tang X, Palmer LE, Wu G, Suh E, Tanner L, McMurry J, Lear M, Pappo AS, Wang Z, Wilson CL, Cheng Y, Meshinchi S, Alexandrov LB, Weiss MJ, Armstrong GT, Robison LL, Yasui Y, Nichols KE, Ellison DW, Bangur C, Mullighan CG, Baker SJ, Dyer MA, Miller G, Newman S, Rusch M, Daly R, Perry K, Downing JR, Zhang J. St. Jude Cloud: A Pediatric Cancer Genomic Data-Sharing Ecosystem. Cancer Discov 2021; 11:1082-1099. [PMID: 33408242 DOI: 10.1158/2159-8290.cd-20-1230] [Citation(s) in RCA: 101] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/17/2020] [Accepted: 12/14/2020] [Indexed: 02/07/2023]
Abstract
Effective data sharing is key to accelerating research to improve diagnostic precision, treatment efficacy, and long-term survival in pediatric cancer and other childhood catastrophic diseases. We present St. Jude Cloud (https://www.stjude.cloud), a cloud-based data-sharing ecosystem for accessing, analyzing, and visualizing genomic data from >10,000 pediatric patients with cancer and long-term survivors, and >800 pediatric sickle cell patients. Harmonized genomic data totaling 1.25 petabytes are freely available, including 12,104 whole genomes, 7,697 whole exomes, and 2,202 transcriptomes. The resource is expanding rapidly, with regular data uploads from St. Jude's prospective clinical genomics programs. Three interconnected apps within the ecosystem-Genomics Platform, Pediatric Cancer Knowledgebase, and Visualization Community-enable simultaneously performing advanced data analysis in the cloud and enhancing the Pediatric Cancer knowledgebase. We demonstrate the value of the ecosystem through use cases that classify 135 pediatric cancer subtypes by gene expression profiling and map mutational signatures across 35 pediatric cancer subtypes. SIGNIFICANCE: To advance research and treatment of pediatric cancer, we developed St. Jude Cloud, a data-sharing ecosystem for accessing >1.2 petabytes of raw genomic data from >10,000 pediatric patients and survivors, innovative analysis workflows, integrative multiomics visualizations, and a knowledgebase of published data contributed by the global pediatric cancer community.This article is highlighted in the In This Issue feature, p. 995.
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Affiliation(s)
- Clay McLeod
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Alexander M Gout
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Xin Zhou
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Andrew Thrasher
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Delaram Rahbarinia
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Samuel W Brady
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Michael Macias
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Kirby Birch
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - David Finkelstein
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Jobin Sunny
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Rahul Mudunuri
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Brent A Orr
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Madison Treadway
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | | | | | - Arthur Chiao
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Andrew Swistak
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Stephanie Wiggins
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Scott Foy
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Jian Wang
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Edgar Sioson
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Shuoguo Wang
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - J Robert Michael
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Yu Liu
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Xiaotu Ma
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Aman Patel
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Michael N Edmonson
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Mark R Wilkinson
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Andrew M Frantz
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Ti-Cheng Chang
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Liqing Tian
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Shaohua Lei
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - S M Ashiqul Islam
- Department of Cellular and Molecular Medicine and Department of Bioengineering, Moores Cancer Center, University of California, San Diego, La Jolla, California
| | | | | | | | | | | | | | | | - Irina McGuire
- Department of Information Services, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Nedra Robison
- Department of Information Services, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Darrell Gentry
- Department of Information Services, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Xing Tang
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Lance E Palmer
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Gang Wu
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Ed Suh
- Department of Information Services, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Leigh Tanner
- Department of Information Services, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - James McMurry
- Department of Information Services, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Matthew Lear
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Alberto S Pappo
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Zhaoming Wang
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Carmen L Wilson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Yong Cheng
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Soheil Meshinchi
- Fred Hutchinson Cancer Research Center Professor of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Ludmil B Alexandrov
- Department of Cellular and Molecular Medicine and Department of Bioengineering, Moores Cancer Center, University of California, San Diego, La Jolla, California
| | - Mitchell J Weiss
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Yutaka Yasui
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Kim E Nichols
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - David W Ellison
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | | | - Charles G Mullighan
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Suzanne J Baker
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Michael A Dyer
- Department of Developmental Neurobiology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | | | - Scott Newman
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Michael Rusch
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | | | - Keith Perry
- Department of Information Services, St. Jude Children's Research Hospital, Memphis, Tennessee.
| | - James R Downing
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee.
| | - Jinghui Zhang
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee.
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Nakata K, Colombet M, Stiller CA, Pritchard‐Jones K, Steliarova‐Foucher E. Incidence of childhood renal tumours: An international population-based study. Int J Cancer 2020; 147:3313-3327. [PMID: 32902866 PMCID: PMC7689773 DOI: 10.1002/ijc.33147] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/30/2020] [Accepted: 06/02/2020] [Indexed: 12/26/2022]
Abstract
Malignant renal tumours represent 5% of childhood cancers and include types with likely different aetiology: Wilms tumour (WT), rhabdoid renal tumour, kidney sarcomas and renal carcinomas. WT is the most common renal tumour in children, previously shown to vary internationally and with ethnicity. Using the comprehensive database of the International Incidence of Childhood Cancer study (IICC), we analysed global variations and time trends in incidence of renal tumour types in children (age 0-14 years) and adolescents (age 15-19 years). The results were presented by 14 world regions, and five ethnic groups in the US. We included 15 320 renal tumours in children and 800 in adolescents reported to the 163 contributing registries during 2001-2010. In children, age-standardised incidence rate (ASR) of renal tumours was 8.3 per million (95% confidence interval, CI = 8.1, 8.4); it was the highest in North America and Europe (9-10 per million) and the lowest in most Asian regions (4-5 per million). In the US, Blacks had the highest ASR (10.9 per million, 95% CI = 10.2, 11.6) and Asian and Pacific Islanders the lowest (4.4 per million, 95% CI = 3.6, 5.1). In adolescents, age-specific incidence rate of renal tumours was 1.4 per million (95% CI = 1.3, 1.5). WT accounted for over 90% of all renal tumours in each age from 1 to 7 years and the proportion of renal carcinomas increased gradually with age. From 1996 to 2010, incidence remained mostly stable for WT (average annual percent change, AAPC = 0.1) and increased for renal carcinomas in children (AAPC = 3.7) and adolescents (AAPC = 3.2). Our findings warrant further monitoring.
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Affiliation(s)
- Kayo Nakata
- Cancer Control CenterOsaka International Cancer InstituteOsakaJapan
| | - Murielle Colombet
- Section of Cancer SurveillanceInternational Agency for Research on CancerLyonFrance
| | - Charles A. Stiller
- National Cancer Registration and Analysis Service, Public Health EnglandOxfordUK
| | - Kathy Pritchard‐Jones
- Developmental Biology and Cancer Research and Teaching DepartmentUCL Great Ormond Street Institute of Child Health, University College LondonLondonUK
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Mrad C, Coulomb-Lhermine A, Tabone MD, Ulinski T, Audry G, Irtan S. Evaluation of the nephron-sparing surgery formula in Wilms tumors. Pediatr Blood Cancer 2020; 67:e28661. [PMID: 32808461 DOI: 10.1002/pbc.28661] [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: 02/11/2020] [Revised: 07/16/2020] [Accepted: 07/30/2020] [Indexed: 01/30/2023]
Abstract
AIM Definitions of nephron-sparing surgery (NSS) procedures in Wilms tumor (WT) are not clear. The new UMBRELLA protocol offers a formula (NSS(X)-SRM(n)-PRM(n)-RRP(n%)) to better define the different NSS parameters. We aimed to assess the advantages and limits of this new formula. METHODS This retrospective monocentric study included patients operated by NSS for WT from 1975 to 2018. We reviewed the medical records and applied the NSS formula to all included patients. RESULTS Eighty kidneys were operated on 56 patients at a mean age of 19.2 months (4 days-7.5 years), with 49 partial nephrectomies and 31 tumorectomies. The assessment of the surgical resection margins (SRM) showed a doubt in six cases and one tumor breach. An intact pseudocapsule along the resection margin with no renal parenchyma was found in four cases at pathological resection margins (PRM) assessment, whereas a tumor breach was described in seven cases. Among the six patients with a surgical doubt, only one had a pathological stage III. There were no surgical doubts in the seven patients with tumor breach at pathology. At a mean follow-up of eight years (15 days-28.6 years), eight patients had elevated blood pressure levels. Ten had proteinuria. These two parameters were significantly increased in patients with a remaining renal parenchyma (RRP) of less than half of the initial total renal parenchyma. The serum creatinine level was normal for all except two patients. CONCLUSION The new NSS formula described all the crucial elements of NSS. RRP seemed essential for the evaluation of long-term renal function.
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Affiliation(s)
- Chaima Mrad
- Pediatric Surgery Department, Sorbonnes Universités, Hôpital Trousseau, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Aurore Coulomb-Lhermine
- Pathology Department, Sorbonnes Universités, Hôpital Trousseau, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Marie-Dominique Tabone
- Pediatric Oncology Department, Hôpital Trousseau, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Tim Ulinski
- Pediatric Nephrology Department, Sorbonnes Universités, Hôpital Trousseau, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Georges Audry
- Pediatric Surgery Department, Sorbonnes Universités, Hôpital Trousseau, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Sabine Irtan
- Pediatric Surgery Department, Sorbonnes Universités, Hôpital Trousseau, Assistance Publique Hôpitaux de Paris, Paris, France
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Li L, Zhang X, Liu N, Chen X, Peng C. LINC00473: A novel oncogenic long noncoding RNA in human cancers. J Cell Physiol 2020; 236:4174-4183. [PMID: 33222224 DOI: 10.1002/jcp.30176] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 12/15/2022]
Abstract
Long noncoding RNAs (lncRNAs) have been found to play essential roles in the occurrence and development of multiple human cancers. Accumulating evidence has shown that LINC00473, an oncogenic lncRNA, is upregulated in various human malignancies and related to poor clinical outcomes. Besides, LINC00473 overexpression can promote cell proliferation, migration, and invasion through multiple potential mechanisms, indicating that it may serve as a novel prognostic biomarker and therapeutic target for human cancers. Here, we reviewed the biological functions, molecular mechanisms, and clinical implications of LINC00473 in human cancers.
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Affiliation(s)
- Lingfeng Li
- The Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Changsha, Hunan, China.,Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Xiangya Clinical Research Center for Cancer ImmunoTherapy, Central South University, Changsha, Hunan, China
| | - Xu Zhang
- The Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Changsha, Hunan, China.,Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Xiangya Clinical Research Center for Cancer ImmunoTherapy, Central South University, Changsha, Hunan, China
| | - Nian Liu
- The Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Changsha, Hunan, China.,Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Xiangya Clinical Research Center for Cancer ImmunoTherapy, Central South University, Changsha, Hunan, China
| | - Xiang Chen
- The Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Changsha, Hunan, China.,Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Xiangya Clinical Research Center for Cancer ImmunoTherapy, Central South University, Changsha, Hunan, China
| | - Cong Peng
- The Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Changsha, Hunan, China.,Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Xiangya Clinical Research Center for Cancer ImmunoTherapy, Central South University, Changsha, Hunan, China
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Dual-Phase 99mTc-MIBI SPECT/CT in the Characterization of Enhancing Solid Renal Tumors: A Single-Institution Study of 147 Cases. Clin Nucl Med 2020; 45:765-770. [PMID: 32701813 DOI: 10.1097/rlu.0000000000003212] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE The aim of this study was to investigate the value of dual-phase Tc-MIBI SPECT/CT in the differential diagnosis between benign and malignant enhancing solid renal tumors. PATIENTS AND METHODS Totally, 180 patients were imaged with dual-phase Tc-MIBI SPECT/CT, which was performed 30 minutes and 90 minutes after Tc-MIBI administration. Among them, 147 patients with 148 histologically proved solid renal tumors met the selection criteria and were included for the final analysis. Relative quantification was performed by measuring the radioactive uptake ratio of tumor to the normal renal parenchymal background for both early and delayed images. RESULTS Benign renal tumors (4 renal oncocytomas and 8 lipid-poor angiomyolipomas) demonstrated a significantly higher early relative uptake value (ERUV) and delayed relative uptake value (DRUV) than malignant renal tumors (n = 136; both P < 0.0001). The ERUV cutoff value of 0.53 helped to differentiate benign from malignant renal tumors, with sensitivity of 100%, specificity of 94.8%, and accuracy of 95.3% for the diagnosis of benign renal tumors. The DRUV cutoff value of 0.50 helped to differentiate benign from malignant renal tumors, with sensitivity of 100%, specificity of 96.3%, and accuracy of 96.6% for the diagnosis of benign renal tumors. There was no statistically significant difference between the efficacy of ERUV and DRUV in the differential diagnosis between benign and malignant renal tumors (P = 0.5). The efficacies of ERUV and DRUV were all significantly higher than the retention index (both P < 0.0001). CONCLUSIONS Both early and delayed phase Tc-MIBI SPECT/CT are helpful for distinguishing benign renal oncocytoma and lipid-poor angiomyolipoma from malignant renal tumors, and the delayed phase imaging tends to show higher diagnostic accuracy.
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Liu EK, Suson KD. Syndromic Wilms tumor: a review of predisposing conditions, surveillance and treatment. Transl Androl Urol 2020; 9:2370-2381. [PMID: 33209710 PMCID: PMC7658145 DOI: 10.21037/tau.2020.03.27] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Predisposing syndromes associated with an increased risk of Wilms tumor (WT) are responsible for 9–17% of all cases of the malignancy. Due to an earlier age at WT diagnosis and an increased incidence of bilateral and metachronous disease, management of syndromic WT warrants a distinct approach from that of non-syndromic WT. This review of English-language manuscripts about WT focuses on the most common syndromes, surveillance protocols and current treatment strategies. Highlighted syndromes include those associated with WT1, such as WAGR (Wilms-Aniridia-Genitourinary-mental Retardation), Denys-Drash syndrome (DDS), and Frasier syndrome, 11p15 defects, such as Beckwith-Wiedemann syndrome (BWS), among others. General surveillance guidelines include screening renal or abdominal ultrasound every 3–4 months until the age of 5 or 7, depending on the syndrome. Further, some of the predisposing conditions also increase the risk of other malignancies, such as gonadoblastoma and hepatoblastoma. With promising results for nephron-sparing surgery in bilateral non-syndromic WT, there are increasing reports and recommendations to pursue nephron-sparing for these patients who are at greater risk of bilateral, metachronous lesions. In addition to the loss of renal parenchyma from malignancy, many patients are at risk of developing renal insufficiency as part of their syndrome. Although there may be some increase in the complication rate, recurrence free survival seems equivalent. Some conditions require specialized approaches to adjuvant therapy, as their syndrome may make them especially susceptible to side effects.
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Affiliation(s)
- Esther K Liu
- Detroit Medical Center Urology, Detroit, MI, USA
| | - Kristina D Suson
- Pediatric Urology, Children's Hospital of Michigan, Detroit, MI, USA
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43
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Davis JT, Wagner LM. Imaging of childhood urologic cancers: current approaches and new advances. Transl Androl Urol 2020; 9:2348-2357. [PMID: 33209708 PMCID: PMC7658153 DOI: 10.21037/tau-19-839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Urologic tumors make up approximately 10% of all pediatric cancers, and include a variety of different histologies and imaging considerations. In this review, we discuss standard radiologic approaches for children with tumors arising in the genitourinary system, and identify important ways in which imaging affects the differential diagnosis, preoperative planning, and staging of these tumors. In addition, we provide an update on strategies to reduce the time of imaging, which may obviate the need for sedation in younger patients. Efforts to reduce a patient’s overall radiation exposure and subsequent risk of second malignancy are also detailed, including recent work on surveillance imaging following completion of therapy. Finally, we highlight new techniques such as radiomics that are now being investigated for patients with these malignancies.
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Affiliation(s)
- Joseph T Davis
- Department of Radiology, Duke University Medical Center, Durham, NC, USA
| | - Lars M Wagner
- Division of Pediatric Hematology/Oncology, Duke University Medical Center, Durham, NC, USA
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Dzhuma K, Ducou Le Pointe H, Coulomb A, Tabone MD, Bergeron C, Audry G, Irtan S. Wilms tumors and their precursors: Radiological diagnosis versus histology. Pediatr Blood Cancer 2020; 67:e28414. [PMID: 32568441 DOI: 10.1002/pbc.28414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 04/29/2020] [Indexed: 01/27/2023]
Abstract
The radiological distinction of Wilms tumor (WT) nodules from nephrogenic rests (NR) in patients with multifocal unilateral WT or bilateral disease is challenging. The study aims to compare the radiology assessment of kidney nodules with their final histology in 48 patients. The final histology of 118 nodules corresponded to the initial radiological diagnosis while 40 (25%) nodules were misdiagnosed, 20 being initially diagnosed WT on imaging were proved to be NR at histology. The size of nodules at diagnosis might help to distinguish WT from NR before surgery. Homogeneity did not seem to be a key feature.
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Affiliation(s)
- Kristina Dzhuma
- Department of Visceral Pediatric Surgery, APHP Hôpital Armand Trousseau, Paris, France
| | | | - Aurore Coulomb
- Department of Anatomy and Cytology Pathologic, APHP Hôpital Armand Trousseau, Paris, France.,Centre de Recherche St Antoine Inserm UMRS 938, UPMC Univ Paris 06, Sorbonne Université, Paris, France
| | | | - Christophe Bergeron
- Pediatric Hemato-Oncology Unit, Institut d'hématologie et d'Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - Georges Audry
- Department of Visceral Pediatric Surgery, APHP Hôpital Armand Trousseau, Paris, France.,Centre de Recherche St Antoine Inserm UMRS 938, UPMC Univ Paris 06, Sorbonne Université, Paris, France
| | - Sabine Irtan
- Department of Visceral Pediatric Surgery, APHP Hôpital Armand Trousseau, Paris, France.,Centre de Recherche St Antoine Inserm UMRS 938, UPMC Univ Paris 06, Sorbonne Université, Paris, France
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45
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Zong S, Zhao J, Liu L. miR-30d Induced Apoptosis by Targeting Sox4 to Inhibit the Proliferation, Invasion and Migration of Nephroblastoma. Onco Targets Ther 2020; 13:7177-7188. [PMID: 32821117 PMCID: PMC7419636 DOI: 10.2147/ott.s251714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/15/2020] [Indexed: 01/10/2023] Open
Abstract
Background Wilms tumor (WT) is an embryonic malignant tumor, and its related mechanism is still unclear. microRNA (miR), as a short-chain non-coding RNA, has low expression in various tumors. In this study, WT differential miR was screened by multi-chip in GEO database and its mechanism was explored to provide potential therapeutic targets and ideas for clinic. Methods We logged into GEO database and downloaded GSE57370 and GSE48137 chip matrix files to analyze potential differences in miR. TargetScan, miRDB, miRTarBase and starBase were applied to predict the target genes of miR with significant differences. qRT-PCR was applied to determine the expression of miR-30d and Sox4 in WT tissue and cell line (G401). The interaction of miR-30d with Sox4 was confirmed by qRT-PCR, Western blot and luciferase assay, respectively. CCK-8, Transwell and flow cytometry were applied to determine the proliferation, invasion, migration and apoptosis of cells. Results We found that miR-30d was low expressed in two chips. qRT-PCR showed that miR-30d was down-regulated and SOX4 was up-regulated in WT tissues and cells. The online target gene prediction software showed there was a targeted binding site between Sox4 and miR-30d. Sox4 was negatively controlled by miR-30d. Subsequent studies found that over-expression of miR-30d inhibited the proliferation, invasion, migration and induced apoptosis of C64 and WiT49 cells. In addition, Sox4 could reverse the proliferation, invasion and migration of C64 and WiT49 induced by miR-30d and induce apoptosis. Conclusion miR-30d is poorly expressed in WT and can induce apoptosis and inhibit proliferation, invasion and migration by mediating Sox4.
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Affiliation(s)
- Shi Zong
- Department of Urology Surgery, China-Japan Union Hospital of Jilin University, Changchun 130000, Jilin, People's Republic of China
| | - Jia Zhao
- Department of Anesthesia, China-Japan Union Hospital of Jilin University, Changchun 130000, Jilin, People's Republic of China
| | - Ling Liu
- Department of Pediatrics, China-Japan Union Hospital of Jilin University, Changchun 130000, Jilin, People's Republic of China
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Bruce G, Chaudhury S, Reynolds B. Bilateral primary renal diffuse large B-cell lymphoma: a rare presentation of paediatric renal disease mimicking juvenile nephronophthisis. BMJ Case Rep 2020; 13:13/7/e234810. [PMID: 32675115 DOI: 10.1136/bcr-2020-234810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 12-year-old boy presented with a prolonged history of headache, fatigue and hypertension. Initial investigations were consistent with presumed non-oliguric end-stage renal disease, leading to a provisional diagnosis of juvenile nephronophthisis. Subsequent imaging demonstrated bilaterally enlarged kidneys without cystic change. Mutation analysis was negative for nephronophthisis, causing diagnostic uncertainty which prompted renal biopsy. Histology revealed a primary renal diffuse large B-cell lymphoma which was highly responsive to chemotherapy, including the anti-CD20 monoclonal agent, rituximab. Renal function improved during lymphoma treatment, with residual chronic kidney disease stage 3a once chemotherapy was completed. Atypical diagnostic features should always prompt re-evaluation of a patient. In this case, the delayed malignancy diagnosis did not have an adverse effect on patient survival or morbidity. The outcome for primary renal lymphoma (PRL) has improved markedly following the introduction of rituximab.
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Affiliation(s)
- Gordon Bruce
- Department of Paediatrics, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Shahzya Chaudhury
- Department of Paediatrics, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Ben Reynolds
- Department of Paediatrics, NHS Greater Glasgow and Clyde, Glasgow, UK
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47
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Fiala EM, Ortiz MV, Kennedy JA, Glodzik D, Fleischut MH, Duffy KA, Hathaway ER, Heaton T, Gerstle JT, Steinherz P, Shukla N, McNeer N, Tkachuk K, Bouvier N, Cadoo K, Carlo MI, Latham A, Dubard Gault M, Joseph V, Kemel Y, Kentsis A, Stadler Z, La Quaglia M, Papaemmanuil E, Friedman D, Ganguly A, Kung A, Offit K, Kalish JM, Walsh MF. 11p15.5 epimutations in children with Wilms tumor and hepatoblastoma detected in peripheral blood. Cancer 2020; 126:3114-3121. [PMID: 32320050 PMCID: PMC7383476 DOI: 10.1002/cncr.32907] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 02/18/2020] [Accepted: 03/17/2020] [Indexed: 01/14/2023]
Abstract
Background Constitutional or somatic mosaic epimutations are increasingly recognized as a mechanism of gene dysregulation resulting in cancer susceptibility. Beckwith‐Wiedemann syndrome is the cancer predisposition syndrome most commonly associated with epimutation and is extremely variable in its phenotypic presentation, which can include isolated tumors. Because to the authors' knowledge large‐scale germline DNA sequencing studies have not included methylation analysis, the percentage of pediatric cancer predisposition that is due to epimutations is unknown. Methods Germline methylation testing at the 11p15.5 locus was performed in blood for 24 consecutive patients presenting with hepatoblastoma (3 patients) or Wilms tumor (21 patients). Results Six individuals with Wilms tumor and 1 patient with hepatoblastoma were found to have low‐level gain of methylation at imprinting control 1, and a child with hepatoblastoma was found to have loss of methylation at imprinting control 2. The loss of methylation at imprinting control 2 was found to be maternally inherited, despite not being associated with any detectable genomic alteration. Conclusions Overall, 33% of patients (8 of 24 patients) with Wilms tumor or hepatoblastoma were found to have an epigenetic susceptibility that was detectable in the blood. It is interesting to note that low‐level gain of methylation at imprinting control 1 predominantly was detected in females with bilateral Wilms tumors. Further studies in larger cohorts are needed to determine the efficacy of testing all patients with Wilms tumor or hepatoblastoma for 11p15.5 epimutations in the blood as part of DNA analysis because this hallmark of predisposition will not be detected by sequencing‐based approaches and detecting a cancer predisposition may modify treatment. In the current study, all patients presenting with Wilms tumor or hepatoblastoma undergo 11p15.5 methylation analysis. Approximately one‐third are found to have an epimutation at this locus that is detectable in peripheral blood.
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Affiliation(s)
- Elise M Fiala
- Division of Clinical Genetics, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michael V Ortiz
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Jennifer A Kennedy
- Division of Clinical Genetics, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Dominik Glodzik
- Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Megan Harlan Fleischut
- Division of Clinical Genetics, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kelly A Duffy
- Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Evan R Hathaway
- Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Todd Heaton
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York.,Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Justin T Gerstle
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York.,Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Peter Steinherz
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Neerav Shukla
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Nicole McNeer
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kaitlyn Tkachuk
- Division of Clinical Genetics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nancy Bouvier
- Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Karen Cadoo
- Division of Clinical Genetics, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Maria I Carlo
- Division of Clinical Genetics, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Alicia Latham
- Division of Clinical Genetics, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York.,Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.,Division of Long Term Follow-Up, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marianne Dubard Gault
- Division of Clinical Genetics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Vijai Joseph
- Division of Clinical Genetics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Yelena Kemel
- Division of Clinical Genetics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Alex Kentsis
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York.,Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Zsofia Stadler
- Division of Clinical Genetics, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michael La Quaglia
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York.,Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Elli Papaemmanuil
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Danielle Friedman
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York.,Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.,Division of Long Term Follow-Up, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Arupa Ganguly
- Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Andrew Kung
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Kenneth Offit
- Division of Clinical Genetics, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jennifer M Kalish
- Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michael F Walsh
- Division of Clinical Genetics, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
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Watson T, Oostveen M, Rogers H, Pritchard-Jones K, Olsen Ø. The role of imaging in the initial investigation of paediatric renal tumours. THE LANCET CHILD & ADOLESCENT HEALTH 2020; 4:232-241. [PMID: 32007136 DOI: 10.1016/s2352-4642(19)30340-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/10/2019] [Accepted: 10/11/2019] [Indexed: 12/15/2022]
Abstract
Imaging has a key role in the assessment of paediatric renal tumours, especially when the initial treatment approach is to proceed to standard chemotherapy without histological confirmation. In Europe, according to the International Society of Paediatric Oncology guidelines, core needle biopsy is not routinely done unless the child is older than 10 years. Between age 6 months and 9 years, the child is treated with a standard regimen of preoperative chemotherapy unless there are concerns about non-Wilms' tumour pathology. Atypical imaging findings could therefore stratify a child into a different treatment protocol, and can prompt the need for pretreatment histology. This review details the latest protocols and techniques used in the assessment of paediatric renal tumours. Important imaging findings are discussed, especially the features that might prompt the need for a pretreatment biopsy. Local radiology practices vary, but both MRI and CT are widely used as routine imaging tests for the assessment of paediatric renal tumours in Europe. Advances in imaging technology and MRI sequences are facilitating the development of new techniques, which might increase the utility of imaging in terms of predicting tumour histology and clinical behaviour. Several of these new imaging techniques are outlined here.
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Affiliation(s)
- Tom Watson
- Department of Paediatric Radiology, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
| | - Minou Oostveen
- Department of Paediatric Haematology and Oncology, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Harriet Rogers
- Centre for Medical Imaging, University College London, London, UK
| | - Kathy Pritchard-Jones
- Department of Paediatric Haematology and Oncology, Great Ormond Street Hospital NHS Foundation Trust, London, UK; UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Øystein Olsen
- Department of Paediatric Radiology, Great Ormond Street Hospital NHS Foundation Trust, London, UK
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49
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Prognostic Factors and Nomograms to Predict Overall and Cancer-Specific Survival for Children with Wilms' Tumor. DISEASE MARKERS 2019; 2019:1092769. [PMID: 31871495 PMCID: PMC6913163 DOI: 10.1155/2019/1092769] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 11/08/2019] [Indexed: 12/27/2022]
Abstract
Objective This study is aimed at constructing and verifying nomograms that forecast overall survival (OS) and cancer-specific survival (CSS) of children with Wilms' tumor (WT). Patients and methods Clinical information of 1613 WT patients who were under 18 years old between 1988 and 2010 was collected from the Surveillance, Epidemiology, and End Results (SEER) database. Using these data, we performed univariate as well as multivariate Cox's regression analyses to determine independent prognostic factors for WT. Then, nomograms to predict 3- and 5-year OS and CSS rates were constructed based on the identified prognostic factors. The nomograms were validated externally and internally. The nomograms' reliability was evaluated utilizing receiver operating characteristic (ROC) curves and concordance indices (C-indices). Results 1613 WT patients under 18 were involved in the study and randomly divided into the training (n = 1210) and validation (n = 403) cohorts. Age at diagnosis, tumor laterality, tumor size, tumor stage, and use of surgery were determined as independent prognostic factors for OS and CSS in WT and were further applied to construct prognostic nomograms. The C-index and area under the receiver operating characteristic curve (AUC) revealed the great performance of our nomograms. Internal and external calibration plots also showed excellent agreement between actual survival and nomogram prediction. Conclusion Precise and convenient nomograms were developed for forecasting OS and CSS of children with WT. These nomograms were able to offer accurate and individualized prognosis and assisted clinicians in performing suitable therapy.
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50
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Servaes SE, Hoffer FA, Smith EA, Khanna G. Imaging of Wilms tumor: an update. Pediatr Radiol 2019; 49:1441-1452. [PMID: 31620845 DOI: 10.1007/s00247-019-04423-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 03/29/2019] [Accepted: 04/29/2019] [Indexed: 12/15/2022]
Abstract
Wilms tumor is the most common pediatric renal tumor, accounting for approximately 7% of all childhood cancers. Imaging plays an important role in the detection, staging, post-therapy evaluation and surveillance of Wilms tumor. Wilms tumor can be detected during surveillance of a known cancer predisposition or after a child presents with symptoms. In this manuscript we describe an evidence-based approach to the initial evaluation of Wilms tumor using current guidelines from the Children's Oncology Group (COG). We illustrate the COG staging system for pediatric renal tumors and highlight key imaging findings that are critical for surgical management. We also discuss the controversies regarding detection and significance of <5-mm pulmonary nodules at initial staging. And finally, we present some thoughts regarding surveillance of Wilms tumor, where overall survival has now approached 90%.
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Affiliation(s)
- Sabah E Servaes
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Fredric A Hoffer
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Ethan A Smith
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Geetika Khanna
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway, Campus Box 8131, St. Louis, MO, 63110, USA.
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