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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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He M, Cai JB, Wu X, Tang YB, Wang JY, Mao JQ, Chen JJ, Zhang LF, Guan ZH, Xiong JN, Peng WX, Wang JH, Tao T. Perioperative complication incidence and risk factors for retroperitoneal neuroblastoma in children: analysis of 571 patients. World J Pediatr 2024; 20:250-258. [PMID: 38070095 PMCID: PMC10957663 DOI: 10.1007/s12519-023-00773-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/10/2023] [Indexed: 03/22/2024]
Abstract
BACKGROUND Surgery plays an important role in the treatment of neuroblastoma. Perioperative complications may impact the course of neuroblastoma treatment. To date, comprehensive analyses of complications and risk factors have been lacking. METHODS Patients with retroperitoneal neuroblastoma undergoing tumor resection were retrospectively analyzed between 2014 and 2021. The data collected included clinical characteristics, operative details, operative complications and postoperative outcomes. Risk factors for perioperative complications of retroperitoneal neuroblastoma were analyzed. RESULTS A total of 571 patients were enrolled in this study. Perioperative complications were observed in 255 (44.7%) patients. Lymphatic leakage (28.4%), diarrhea (13.5%), and injury (vascular, nerve and organ; 7.5%) were the most frequent complications. There were three operation-related deaths (0.53%): massive hemorrhage (n = 1), biliary tract perforation (n = 1) and intestinal necrosis (n = 1). The presence of image-defined risk factors (IDRFs) [odds ratio (OR) = 2.09, P < 0.01], high stage of the International Neuroblastoma Risk Group staging system (INRGSS) (OR = 0.454, P = 0.04), retroperitoneal lymph node metastasis (OR = 2.433, P = 0.026), superior mesenteric artery encasement (OR = 3.346, P = 0.003), and inferior mesenteric artery encasement (OR = 2.218, P = 0.019) were identified as independent risk factors for perioperative complications. CONCLUSIONS Despite the high incidence of perioperative complications, the associated mortality rate was quite low. Perioperative complications of retroperitoneal neuroblastoma were associated with IDRFs, INRGSS, retroperitoneal lymph node metastasis and vascular encasement. Patients with high-risk factors should receive more serious attention during surgery but should not discourage the determination to pursue total resection of neuroblastoma. Video Abstract (MP4 94289 KB).
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Affiliation(s)
- Min He
- Pediatric Cancer Research Center, National Clinical Research Center for Child Health, Hangzhou, China
- Department of Surgical Oncology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Cancer Center, Zhejiang University, No. 3333 Binsheng Rode, Hangzhou, China
| | - Jia-Bin Cai
- Pediatric Cancer Research Center, National Clinical Research Center for Child Health, Hangzhou, China
- Department of Surgical Oncology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Cancer Center, Zhejiang University, No. 3333 Binsheng Rode, Hangzhou, China
| | - Xuan Wu
- Pediatric Cancer Research Center, National Clinical Research Center for Child Health, Hangzhou, China
- Department of Surgical Oncology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Cancer Center, Zhejiang University, No. 3333 Binsheng Rode, Hangzhou, China
| | - Yin-Bing Tang
- Pediatric Cancer Research Center, National Clinical Research Center for Child Health, Hangzhou, China
- Department of Surgical Oncology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Cancer Center, Zhejiang University, No. 3333 Binsheng Rode, Hangzhou, China
| | - Jin-Yan Wang
- Pediatric Cancer Research Center, National Clinical Research Center for Child Health, Hangzhou, China
- Department of Surgical Oncology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jun-Qin Mao
- Pediatric Cancer Research Center, National Clinical Research Center for Child Health, Hangzhou, China
- Department of Surgical Oncology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Cancer Center, Zhejiang University, No. 3333 Binsheng Rode, Hangzhou, China
| | - Ji-Jun Chen
- Pediatric Cancer Research Center, National Clinical Research Center for Child Health, Hangzhou, China
- Department of Surgical Oncology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Cancer Center, Zhejiang University, No. 3333 Binsheng Rode, Hangzhou, China
| | - Li-Feng Zhang
- Pediatric Cancer Research Center, National Clinical Research Center for Child Health, Hangzhou, China
- Department of Surgical Oncology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Cancer Center, Zhejiang University, No. 3333 Binsheng Rode, Hangzhou, China
| | - Zhong-Hai Guan
- Pediatric Cancer Research Center, National Clinical Research Center for Child Health, Hangzhou, China
- Department of Surgical Oncology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Cancer Center, Zhejiang University, No. 3333 Binsheng Rode, Hangzhou, China
| | - Jie-Ni Xiong
- Pediatric Cancer Research Center, National Clinical Research Center for Child Health, Hangzhou, China
- Department of Surgical Oncology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Cancer Center, Zhejiang University, No. 3333 Binsheng Rode, Hangzhou, China
| | - Wan-Xin Peng
- Pediatric Cancer Research Center, National Clinical Research Center for Child Health, Hangzhou, China
- Cancer Center, Zhejiang University, No. 3333 Binsheng Rode, Hangzhou, China
| | - Jin-Hu Wang
- Pediatric Cancer Research Center, National Clinical Research Center for Child Health, Hangzhou, China.
- Department of Surgical Oncology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
- Cancer Center, Zhejiang University, No. 3333 Binsheng Rode, Hangzhou, China.
| | - Ting Tao
- Pediatric Cancer Research Center, National Clinical Research Center for Child Health, Hangzhou, China.
- Department of Surgical Oncology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
- Cancer Center, Zhejiang University, No. 3333 Binsheng Rode, Hangzhou, China.
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Saksiri P, Sripornsawan P, Kritsaneepaiboon S, Laochareonsuk W, Choochuen P, Sangkhathat S. Correlation between image-defined risk factors and surgical complications in patients with neuroblastoma: a retrospective study. Pediatr Surg Int 2023; 39:70. [PMID: 36592239 DOI: 10.1007/s00383-022-05361-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/27/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND Image-defined risk factor (IDRF) is a common tool used for neuroblastoma risk group classification. We speculated that anatomical evaluation by IDRF might be correlated with surgical complications and the oncologic outcome. Here, we investigated correlation between IDRF with outcomes of surgery of neuroblastoma patients. METHODS Medical records and computed tomography images of neuroblastoma patients who underwent a surgery at Songklanagarind Hospital between 2002 and 2019 were retrospectively reviewed. IDRFs were analyzed for correlation with surgical complications, overall survival, progression-free survival and local recurrence within 2 years. RESULTS Forty-five patients were enrolled in the study. Sixteen (35%) patients had low IDRF score at diagnosis (score ≤ 5). Other 29 (64%) patients had high IDRF score (score ≥ 6). High IDRF group significantly had higher incidence of organ injury and more intraoperative blood loss. At post-chemotherapy, high IDRF was not only associated with higher operative complications, but also associated with 2-year overall survival and progress-free survival. CONCLUSIONS Neuroblastoma patients whose IDRF score, either at diagnosis or after neoadjuvant therapy, was 6 or higher had increased risk of surgical complication. This evidence prompts pediatric surgeons to prepare more for safe surgery in this group of patients.
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Affiliation(s)
- Poowanon Saksiri
- Division of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Songkhla, Thailand
| | - Pornpan Sripornsawan
- Division of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Songkhla, Thailand
| | - Supika Kritsaneepaiboon
- Division of Radiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Songkhla, Thailand
| | - Wison Laochareonsuk
- Translational Medicine Research Center, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Songkhla, Thailand
| | - Pongsakorn Choochuen
- Translational Medicine Research Center, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Songkhla, Thailand
| | - Surasak Sangkhathat
- Division of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Songkhla, Thailand.
- Translational Medicine Research Center, Faculty of Medicine, Prince of Songkla University, Hat Yai, 90110, Songkhla, Thailand.
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Nucleic acid therapy in pediatric cancer. Pharmacol Res 2022; 184:106441. [PMID: 36096420 DOI: 10.1016/j.phrs.2022.106441] [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: 08/04/2022] [Revised: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 12/24/2022]
Abstract
The overall survival, progress free survival, and life quality of cancer patients have improved due to the advance in minimally invasive surgery, precision radiotherapy, and various combined chemotherapy in the last decade. Furthermore, the discovery of new types of therapeutics, such as immune checkpoint inhibitors and immune cell therapies have facilitated both patients and doctors to fight with cancers. Moreover, in the context of the development in biocompatible and cell type targeting nano-carriers as well as nucleic acid-based drugs for initiating and enhancing the anti-tumor response have come to the age. The treatment paradigms utilization of nucleic acids, including short interfering RNA (siRNA), antisense oligonucleotides (ASO), and messenger RNA (mRNA), can target specific protein expression to achieve the therapeutic effects. Over ten nucleic acid therapeutics have been approved by the FDA and EMA in rare diseases and genetic diseases as well as dozens of registered clinical trails for varies cancers. Though generally less dangerous of pediatric cancers than adult cancers was observed during the past decades, yet pediatric cancers accounted for a significant proportion of child deaths which hurt those family very deeply. Therefore, it is necessary to pay more attention for improving the treatment of pediatric cancer and discovering new nucleic acid therapeutics which may help to improve the therapeutic effect and prognoses in turns to ameliorate the survival period and quality of life for children patient. In this review, we focus on the nucleic acid therapy in pediatric cancers.
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User İR, Ardıçlı B, Çiftçi AÖ, Karnak İ, Tanyel FC, Oğuz B, Haliloğlu M, Kutluk T, Varan A, Ekinci S. Early postoperative complications in pediatric abdominal solid tumor surgery according to Clavian-Dindo classification. Pediatr Surg Int 2022; 38:1303-1310. [PMID: 35821272 DOI: 10.1007/s00383-022-05163-6] [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: 06/19/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Postoperative period after abdominal solid tumor surgery is critical regarding complications. This study aimed to detect incidence and treatment of complications. METHODS Single center retrospective study including years 2010-2019 for early postoperative complications were documented and graded according to Clavian-Dindo classification. RESULTS The overall complication rate was 10% and they were chylous leak (n = 8, 2%), collection in surgical field (n = 8, 2%), acute renal failure (n = 7, 1.7%), hemorrhage (n = 5, 1.3%), intestinal obstruction (n = 4, 1%), surgical site infection (n = 3, 0.7%), thromboembolism (n = 3, 0.7%) and peripheric neuronal event (n = 2, 0.5%). Distribution of complications according to Clavian-Dindo classification was as follows: 2 grade I, 23 grade II, 9 grade IIIb, 5 grade IVa and 1 grade V. While age and percentage of benign or malignant disease were not different in groups with or without complications (p = 0.11, p = 0.24), males had more complications than female patients (p = 0.008). Having more than one surgery aiming tumor resection was associated with increased postoperative complications (p = 0.002). Incidence of complications were highest after extragonadal germ cell tumor (35%) and hepatic tumors (29%). CONCLUSIONS Postoperative complications of abdominal tumor surgery are diverse in children. They are related with prolonged hospital stay and need for medical or surgical interventions. Number of surgeries, organ of origin and tumor type have an influence on risk of complications.
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Affiliation(s)
- İdil Rana User
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Altındağ, Ankara, Turkey.
| | - Burak Ardıçlı
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Altındağ, Ankara, Turkey
| | - Arbay Özden Çiftçi
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Altındağ, Ankara, Turkey
| | - İbrahim Karnak
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Altındağ, Ankara, Turkey
| | - Feridun Cahit Tanyel
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Altındağ, Ankara, Turkey
| | - Berna Oğuz
- Department of Pediatric Radiology, Hacettepe University School of Medicine, Altındağ, Ankara, Turkey
| | - Mithat Haliloğlu
- Department of Pediatric Radiology, Hacettepe University School of Medicine, Altındağ, Ankara, Turkey
| | - Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University School of Medicine, Altındağ, Ankara, Turkey
| | - Ali Varan
- Department of Pediatric Oncology, Hacettepe University School of Medicine, Altındağ, Ankara, Turkey
| | - Saniye Ekinci
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Altındağ, Ankara, Turkey
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Chen Y, Miao L, Lin H, Zhuo Z, He J. The role of m6A modification in pediatric cancer. Biochim Biophys Acta Rev Cancer 2022; 1877:188691. [PMID: 35122883 DOI: 10.1016/j.bbcan.2022.188691] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 02/07/2023]
Abstract
With the development of RNA modification research, the importance of N6-methyladenosine (m6A) in tumors cannot be ignored. m6A promotes the self-renewal of tumor stem cells and the proliferation of tumor cells. It affects post-transcriptional gene expression through epigenetic mechanisms, combining various factors to determine proteins' fate and altering the biological function. This modification process runs through the entire tumors, and genes affected by m6A modification may be the critical targets for cancers breakthroughs. Though generally less dangerous than adult cancer, pediatric cancer accounts for a significant proportion of child deaths. What is more alarming is that the occurrences of adult tumors are highly associated with the poor prognoses of pediatric tumors. Therefore, it is necessary to pay attention to the importance of pediatric cancer and discover new therapeutic targets, which will help improve the therapeutic effect and prognoses of the diseases. We collected and investigated m6A modification in pediatric cancers based on mRNA and non-coding RNA, finding that m6A factors were involved in glioma, hepatoblastoma, nephroblastoma, neuroblastoma, osteosarcoma, medulloblastoma, retinoblastoma, and acute lymphoblastic leukemia. Consequently, we summarized the relationships between the m6A factors and these pediatric cancers.
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Affiliation(s)
- Yongping Chen
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China
| | - Lei Miao
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China
| | - Huiran Lin
- Faculty of Medicine, Macau University of Science and Technology, Macau 999078, China
| | - Zhenjian Zhuo
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China; Laboratory Animal Center, School of Chemical Biology and Biotechnology, Peking University Shenzhen Graduate School, Shenzhen 518055, China.
| | - Jing He
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China.
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Irtan S, Hervieux E, Boutroux H, Becmeur F, Ducou-le-Pointe H, Leverger G, Audry G. Preoperative 3D reconstruction images for paediatric tumours: Advantages and drawbacks. Pediatr Blood Cancer 2021; 68:e28670. [PMID: 32827349 DOI: 10.1002/pbc.28670] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 07/30/2020] [Accepted: 08/08/2020] [Indexed: 01/17/2023]
Abstract
RATIONALE Three-dimensional reconstruction (3DR) of preoperative images may improve the presurgical assessment of tumours prior to removal. We aimed to analyse the advantages and discrepancies of preoperative 3DR in paediatric tumours. METHODS We conducted a prospective observational study from 2016 to 2019, including patients with thoraco-abdominal tumours having predictable surgical risks on preoperative images (encasement of vessels posing vascular risks, ie, neuroblastic and soft tissue tumours or parenchyma preservation of the invaded organ, ie, liver and kidney). A comparison of 2D/3DR and surgical findings was performed. RESULTS Twenty-four patients, with a median age at surgery of 68.2 months (13 days-203 months), were operated on for neuroblastoma (n = 7), renal tumour (n = 7), hepatic tumour (n = 4) and others (n = 6; bone sarcoma of the iliac branch, abdominal lymph nodes of a recurrent testicular germ cell tumour, pseudoinflammatory tumour of the omentum, thoracic lipoblastoma, desmoplastic tumour, solid and pseudopapillar tumour of the pancreas). Reconstruction was of poor quality in two patients with renal tumours because computed tomography (CT) had no excretory phase. Discrepancies between 3DR and surgical findings occurred in two patients, one because of poor assessment of caliceal infiltration by renal nodules and the other because of inadequate reconstruction of renal vein thrombosis. For all the other tumours, 3DR improved the visualisation and precise location of vessels during surgery. CONCLUSION High-quality preoperative images are mandatory to provide the best 3DR. In the majority of cases, 3DR is of significant help during surgery to better identify vascular structures within tumours and preserve parenchyma.
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Affiliation(s)
- Sabine Irtan
- Department of Visceral and Neonatal Paediatric Surgery, Sorbonne Université - APHP.6, Hôpital Armand Trousseau, Paris, France
| | - Erik Hervieux
- Department of Visceral and Neonatal Paediatric Surgery, Sorbonne Université - APHP.6, Hôpital Armand Trousseau, Paris, France
| | - Hélène Boutroux
- Department of Pediatric Hemato-Oncology, Sorbonne Université - APHP.6, Hôpital Armand Trousseau, Paris, France
| | - François Becmeur
- Department of Pediatric Surgery, Hôpitaux Régionaux Universitaires de Strasbourg, Strasbourg, France
| | - Hubert Ducou-le-Pointe
- Department of Pediatric Radiology, Sorbonne Université - APHP.6, Hôpital Armand Trousseau, Paris, France
| | - Guy Leverger
- Department of Pediatric Hemato-Oncology, Sorbonne Université - APHP.6, Hôpital Armand Trousseau, Paris, France
| | - Georges Audry
- Department of Visceral and Neonatal Paediatric Surgery, Sorbonne Université - APHP.6, Hôpital Armand Trousseau, Paris, France
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Abstract
Overall survival (OS) for children with Wilms tumor (WT) currently stands at around 90%. This is markedly improved from the survival rates of around 30% reported in the middle of the last century. This improvement is due to the development of multimodal treatment for this disease, based on the evidence yielded through international collaboration on trials conducted by the Société Internationale d'Oncologie Pédiatrique (SIOP) and the Children’s Oncology Group (COG). In this article, we review some of the current surgical controversies surrounding the management of WT.
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Affiliation(s)
- Karen Milford
- Division of Urology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Keara DeCotiis
- Division of Urology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Armando Lorenzo
- Division of Urology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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Viale M, Vecchio G, Monticone M, Bertone V, Giglio V, Maric I, Cilli M, Bocchini V, Profumo A, Ponzoni M, Emionite L, Rocco M. Fibrin Gels Entrapment of a Poly-Cyclodextrin Nanocarrier as a Doxorubicin Delivery System in an Orthotopic Model of Neuroblastoma: Evaluation of In Vitro Activity and In Vivo Toxicity. Pharm Res 2019; 36:115. [PMID: 31161432 DOI: 10.1007/s11095-019-2636-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 04/28/2019] [Indexed: 01/22/2023]
Abstract
PURPOSE Fibrin gels (FBGs) are potential delivery vehicles for many drugs, and can be easily prepared from purified components. We previously demonstrated their applicability for the release of different doxorubicin (Dox) nanoparticles used clinically or in an experimental stage, such as its inclusion complex with the amino β-cyclodextrin polymer (oCD-NH2/Dox). Here we extend these studies by in vitro and in vivo evaluations. METHODS An in vitro cytotoxicity model consisting of an overlay of a neuroblastoma (NB) cell-containing agar layer above a drug-loaded FBG layer was used. Local toxicity in vivo (histology and blood analysis) was studied in a mouse orthotopic NB model (SHSY5YLuc+ cells implanted into the left adrenal gland). RESULTS In vitro data show that FBGs loaded with oCD-NH2/Dox have a slightly lower cytotoxicity against NB cell lines than those loaded with Dox. Fibrinogen (FG), and Ca2+ concentrations may modify this activity. In vivo data support a lower general and local toxicity for FBGs loaded with oCD-NH2/Dox than those loaded with Dox. CONCLUSION Our results suggest a possible increase of the therapeutic index of Dox when locally administered through FBGs loaded with oCD-NH2/Dox, opening the possibility of using these releasing systems for the treatment of neuroblastoma.
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Affiliation(s)
- Maurizio Viale
- UOC Bioterapie, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy.
| | - Graziella Vecchio
- Dipartimento di Scienze Chimiche, Università di Catania, Viale A. Doria 6, 95125, Catania, Italy
| | - Massimiliano Monticone
- UOC Bioterapie, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Vittorio Bertone
- Lab. Anatomia Comparata e Citologia, Dipartimento Biologia e Biotecnologie, Università di Pavia "L. Spallanzani", Via Ferrata 9, 27100, Pavia, Italy
| | - Valentina Giglio
- Dipartimento di Scienze Chimiche, Università di Catania, Viale A. Doria 6, 95125, Catania, Italy
| | - Irena Maric
- UOC Bioterapie, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Michele Cilli
- UOS Animal Facility, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Vittorio Bocchini
- Segreteria Comitato Etico Regione Liguria, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Aldo Profumo
- UOS Biopolimeri e Proteomica, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Mirco Ponzoni
- Laboratorio di Terapie Sperimentali in Oncologia, Istituto G. Gaslini, Via G. Gaslini 5, 16147, Genoa, Italy
| | - Laura Emionite
- UOS Animal Facility, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Mattia Rocco
- UOS Biopolimeri e Proteomica, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy
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Schmidt A, Warmann SW, Urla C, Schaefer J, Fideler F, Fuchs J. Patient selection and technical aspects for laparoscopic nephrectomy in Wilms tumor. Surg Oncol 2019; 29:14-19. [DOI: 10.1016/j.suronc.2019.02.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/18/2019] [Accepted: 02/11/2019] [Indexed: 12/29/2022]
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11
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Yang N, Chen H, Han H, Shen Y, Gu S, He Y, Guo S. 3D printing and coating to fabricate a hollow bullet-shaped implant with porous surface for controlled cytoxan release. Int J Pharm 2018; 552:91-98. [PMID: 30244147 DOI: 10.1016/j.ijpharm.2018.09.042] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 09/11/2018] [Accepted: 09/17/2018] [Indexed: 12/29/2022]
Abstract
Intratumoral implants have aroused great interests for local chemotherapy of cancer, however, how to efficiently control drug release from implants is still a great challenge. Herein, we designed and prepared a new hollow bullet-shaped implant with porous surface by 3D printing, loaded chemotherapeutic agent cytoxan (CTX) with tetradecyl alcohol or lecithin as matrix and coated it with poly (lactic acid) to obtain a CTX implant, which has a highly tuned drug release property with a drug release time from 4 h to more than 1 month. The drug release from the implant can be easily controlled by changing pore sizes, kinds of matrices, and coating thickness.
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Affiliation(s)
- Ning Yang
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Huanfei Chen
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China; College of Pharmacy and Chemistry, Dali University, Dali, China
| | - Huijie Han
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Yuanyuan Shen
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Song Gu
- Shanghai Children's Medical Center, Department of Surgery, School of Medicine, Shanghai Jiao Tong University, China.
| | - Yong He
- State Key Laboratory of Fluid Power and Mechatronic Systems, School of Mechanical Engineering, Zhejiang University, Hangzhou, China.
| | - Shengrong Guo
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China.
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12
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Manzanares A, Restrepo-Perdomo CA, Botteri G, Castillo-Ecija H, Pascual-Pasto G, Cano F, Garcia-Alvarez L, Monterrubio C, Ruiz B, Vazquez-Carrera M, Suñol M, Mora J, Tornero JA, Sosnik A, Carcaboso AM. Tissue Compatibility of SN-38-Loaded Anticancer Nanofiber Matrices. Adv Healthc Mater 2018; 7:e1800255. [PMID: 29892999 DOI: 10.1002/adhm.201800255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 05/10/2018] [Indexed: 11/08/2022]
Abstract
Delivery of chemotherapy in the surgical bed has shown preclinical activity to control cancer progression upon subtotal resection of pediatric solid tumors, but whether this new treatment is safe for tumor-adjacent healthy tissues remains unknown. Here, Wistar rats are used to study the anatomic and functional impact of electrospun nanofiber matrices eluting SN-38-a potent chemotherapeutic agent-on several body sites where pediatric tumors such as neuroblastoma, Ewing sarcoma, and rhabdomyosarcoma arise. Blank and SN-38-loaded matrices embracing the femoral neurovascular bundle or in direct contact with abdominal viscera (liver, kidney, urinary bladder, intestine, and uterus) are placed. Foreign body tissue reaction to the implants is observed though no histologic damage in any tissue/organ. Skin healing is normal. Tissue reaction is similar for SN-38-loaded and blank matrices, with the exception of the hepatic capsule that is thicker for the former although within the limits consistent with mild foreign body reaction. Tissue and organ function is completely conserved after local treatments, as assessed by the rotarod test (forelimb function), hematologic tests (liver and renal function), and control of clinical signs. Overall, these findings support the clinical translation of SN-38-loaded nanofiber matrices to improve local control strategies of surgically resected tumors.
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Affiliation(s)
- Alejandro Manzanares
- Institut de Recerca Sant Joan de Déu; Barcelona 08950 Spain
- Department of Pediatric Hematology and Oncology; Hospital Sant Joan de Deu; Barcelona 08950 Spain
- Department of Pediatric Surgery; Hospital Universitari Germans Trias i Pujol; Barcelona 08916 Spain
| | - Camilo A. Restrepo-Perdomo
- Institut de Recerca Sant Joan de Déu; Barcelona 08950 Spain
- Department of Pathology; Hospital Sant Joan de Deu; Barcelona 08950 Spain
| | - Gaia Botteri
- Institut de Recerca Sant Joan de Déu; Barcelona 08950 Spain
- Department of Pediatric Hematology and Oncology; Hospital Sant Joan de Deu; Barcelona 08950 Spain
| | - Helena Castillo-Ecija
- Institut de Recerca Sant Joan de Déu; Barcelona 08950 Spain
- Department of Pediatric Hematology and Oncology; Hospital Sant Joan de Deu; Barcelona 08950 Spain
| | - Guillem Pascual-Pasto
- Institut de Recerca Sant Joan de Déu; Barcelona 08950 Spain
- Department of Pediatric Hematology and Oncology; Hospital Sant Joan de Deu; Barcelona 08950 Spain
| | - Francesc Cano
- Institut de Investigació Textil i Cooperació Industrial de Terrassa (INTEXTER); Universitat Politecnica de Catalunya; Barcelona 08222 Spain
| | - Laura Garcia-Alvarez
- Department of Laboratory Medicine; Hospital Sant Joan de Deu; Barcelona 08950 Spain
| | - Carles Monterrubio
- Institut de Recerca Sant Joan de Déu; Barcelona 08950 Spain
- Department of Pediatric Hematology and Oncology; Hospital Sant Joan de Deu; Barcelona 08950 Spain
- Human Oncology & Pathogenesis Program; Memorial Sloan Kettering Cancer Center; NY 10065 USA
| | - Bonaventura Ruiz
- Department of Laboratory Medicine; Hospital Sant Joan de Deu; Barcelona 08950 Spain
| | - Manuel Vazquez-Carrera
- Institut de Recerca Sant Joan de Déu; Barcelona 08950 Spain
- Pharmacology Unit; Department of Pharmacology; Toxicology and Therapeutic Chemistry; Faculty of Pharmacy and Food Sciences; Institut de Biomedicina de la Universitat de Barcelona (IBUB); University of Barcelona; Barcelona 08028 Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM); Instituto de Salud Carlos III; Barcelona 08028 Spain
| | - Mariona Suñol
- Institut de Recerca Sant Joan de Déu; Barcelona 08950 Spain
- Department of Pathology; Hospital Sant Joan de Deu; Barcelona 08950 Spain
| | - Jaume Mora
- Institut de Recerca Sant Joan de Déu; Barcelona 08950 Spain
- Department of Pediatric Hematology and Oncology; Hospital Sant Joan de Deu; Barcelona 08950 Spain
| | - Jose A. Tornero
- Institut de Investigació Textil i Cooperació Industrial de Terrassa (INTEXTER); Universitat Politecnica de Catalunya; Barcelona 08222 Spain
| | - Alejandro Sosnik
- Laboratory of Pharmaceutical Nanomaterials Science; Department of Materials Science and Engineering; Technion-Israel Institute of Technology; Technion City Haifa 3200003 Israel
| | - Angel M. Carcaboso
- Institut de Recerca Sant Joan de Déu; Barcelona 08950 Spain
- Department of Pediatric Hematology and Oncology; Hospital Sant Joan de Deu; Barcelona 08950 Spain
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13
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Nakagawara A, Li Y, Izumi H, Muramori K, Inada H, Nishi M. Neuroblastoma. Jpn J Clin Oncol 2018; 48:214-241. [PMID: 29378002 DOI: 10.1093/jjco/hyx176] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Indexed: 02/07/2023] Open
Abstract
Neuroblastoma is one of the most common solid tumors in children and has a diverse clinical behavior that largely depends on the tumor biology. Neuroblastoma exhibits unique features, such as early age of onset, high frequency of metastatic disease at diagnosis in patients over 1 year of age and the tendency for spontaneous regression of tumors in infants. The high-risk tumors frequently have amplification of the MYCN oncogene as well as segmental chromosome alterations with poor survival. Recent advanced genomic sequencing technology has revealed that mutation of ALK, which is present in ~10% of primary tumors, often causes familial neuroblastoma with germline mutation. However, the frequency of gene mutations is relatively small and other aberrations, such as epigenetic abnormalities, have also been proposed. The risk-stratified therapy was introduced by the Japan Neuroblastoma Study Group (JNBSG), which is now moving to the Neuroblastoma Committee of Japan Children's Cancer Group (JCCG). Several clinical studies have facilitated the reduction of therapy for children with low-risk neuroblastoma disease and the significant improvement of cure rates for patients with intermediate-risk as well as high-risk disease. Therapy for patients with high-risk disease includes intensive induction chemotherapy and myeloablative chemotherapy, followed by the treatment of minimal residual disease using differentiation therapy and immunotherapy. The JCCG aims for better cures and long-term quality of life for children with cancer by facilitating new approaches targeting novel driver proteins, genetic pathways and the tumor microenvironment.
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Affiliation(s)
| | - Yuanyuan Li
- Laboratory of Molecular Biology, Life Science Research Institute, Saga Medical Center Koseikan
| | - Hideki Izumi
- Laboratory of Molecular Biology, Life Science Research Institute, Saga Medical Center Koseikan
| | | | - Hiroko Inada
- Department of Pediatrics, Saga Medical Center Koseikan
| | - Masanori Nishi
- Department of Pediatrics, Saga University, Saga 849-8501, Japan
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14
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Zhong ZY, Shi BJ, Zhou H, Wang WB. CD133 expression and MYCN amplification induce chemoresistance and reduce average survival time in pediatric neuroblastoma. J Int Med Res 2018; 46:1209-1220. [PMID: 29322842 PMCID: PMC5972240 DOI: 10.1177/0300060517732256] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Objectives Neuroblastoma (NB) is the most common pediatric solid tumor derived from the sympathetic nervous system. MYCN is amplified in nearly half of patients with NB, and its association with rapid disease progression and poor outcome is controversial. Characterization of cancer stem cells (CSCs) in NBs has been rarely studied. This study was performed to determine whether MYCN and CD133+ CSCs are associated with chemotherapy resistance and the survival time of patients with NB. Methods Fifty patients with an unequivocal pathological diagnosis of NB were recruited. MYCN expression levels were measured before therapy. CSCs were derived and their multipotency tested by directed differentiation. The patients’ responses to chemotherapy and average survival time were compared among the groups as follows: CD133+, CD133−, MYCN amplification ≥5 times (i.e. MYCN≥5), MYCN<5, CD133+ plus MYCN≥5, and CD133− plus MYCN<5. Results CD133+ CSCs differentiated into neuron-like cells. CD133+ patients had a significantly poorer response to chemotherapy than did CD133− patients. CD133+ plus MYCN≥5 patients had a significantly shorter average survival time than did CD133− plus MYCN<5 patients. Conclusions CD133+ CSCs are chemoresistance. CD133 expression and MYCN amplification can be used together as a prognostic indicator of disease outcome.
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Affiliation(s)
- Zhi-Yong Zhong
- Pediatric Surgery Department, The Second of Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, P.R. China
| | - Bao-Jun Shi
- Pediatric Surgery Department, The Second of Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, P.R. China
| | - Hui Zhou
- Pediatric Surgery Department, The Second of Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, P.R. China
| | - Wen-Bo Wang
- Pediatric Surgery Department, The Second of Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, P.R. China
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15
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Ye JR, Liu L, Zheng F. Long Noncoding RNA Bladder Cancer Associated Transcript 1 Promotes the Proliferation, Migration, and Invasion of Nonsmall Cell Lung Cancer Through Sponging miR-144. DNA Cell Biol 2017; 36:845-852. [PMID: 28885863 DOI: 10.1089/dna.2017.3854] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Ji-Ru Ye
- Department of Respiratory Medicine, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Changzhou, China
| | - Liang Liu
- Department of Thoracic Surgery, The TCM Hospital of Changzhou Affiliated to Nanjing University of TCM, Changzhou, China
| | - Feng Zheng
- Department of Critical Care Medicine, The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Changzhou, China
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16
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Alvi S, Karadaghy O, Manalang M, Weatherly R. Clinical manifestations of neuroblastoma with head and neck involvement in children. Int J Pediatr Otorhinolaryngol 2017; 97:157-162. [PMID: 28483228 DOI: 10.1016/j.ijporl.2017.04.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 04/04/2017] [Accepted: 04/06/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The purpose of our study is to review our 15-year experience with pediatric patients who have been diagnosed with neuroblastoma, and to determine their most frequent head and neck manifestations and symptoms. STUDY DESIGN Retrospective chart review of electronic medical record. SETTING An academic, tertiary care pediatric hospital. SUBJECTS AND METHODS IRB approval from the Office of Research Integrity at Children's Mercy Hospital was obtained. The hospital tumor database was analyzed to identify patients with neuroblastoma, ganglioneuroblastoma, and esthesioneuroblastoma diagnosed between 1997 and 2012. We recorded the various clinical signs and symptoms these patients displayed at their initial presentation, focusing on patients with head and neck involvement. We then determined the relative incidence of these various findings. RESULTS Our review yielded 118 patients diagnosed with neuroblastoma, ganglioneuroblastoma, or esthesioneuroblastoma over our 15 year study period. 7 of the 118 patients were diagnosed with primary tumors of the head and neck. Another 19 patients had metastatic head and neck involvement. For those with primary disease, presence of a neck mass and signs of Horner's syndrome were the most common findings. For metastatic disease, craniofacial bony metastasis was the most frequent finding in our study. CONCLUSIONS Based on our data, there are a handful of findings that occur frequently in pediatric head and neck neuroblastoma. Any persistent neck mass, unexplained Horner's syndrome, or periorbital ecchymosis should be carefully evaluated. This study should serve as an aid for the otolaryngologist to be aware of the possible manifestations of this malignancy in children.
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Affiliation(s)
- Sameer Alvi
- University of Kansas Medical Center, Department of Otolaryngology, Kansas City, KS, USA.
| | - Omar Karadaghy
- University of Missouri, Kansas City School of Medicine, Kansas City, MO, USA
| | - Michelle Manalang
- Children's Mercy Kansas City, Division of Hematology/Oncology/Bone Marrow Transplantation, Kansas City, MO, USA; University of Missouri, Kansas City School of Medicine, Kansas City, MO, USA
| | - Robert Weatherly
- Children's Mercy Kansas City, Department of Otolaryngology, Kansas City, MO, USA; University of Missouri, Kansas City School of Medicine, Kansas City, MO, USA
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