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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; 14:943. [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
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
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