scholarly journals Long-term Outcome in Children with Wilms’ Tumor; Experience of a Single Center for Two Decades

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Leily Mohajerzadeh ◽  
Ahmad Khaleghnejad ◽  
Mohsen Rouzrokh ◽  
Shahin Shamsian ◽  
Javad Ghoroubi ◽  
...  

Background: Wilms’ tumor (nephroblastoma) is the major renal cancer in children. Objectives: The aim of this study was to assess the individuality of Wilms’ tumor and the consequences of management attained in our referral subspecialty center. Methods: In this study, we composed the data of children with Wilms’ tumor in 2 decades; 55 cases between 1992 and 2002 and 49 patients between 2006 and 2016 were diagnosed with Wilms’ tumor. Demographic characters, a form of presentation, tumor stage, related underlying disease, histopathology consequences, type of management, and the survival rates were assessed. Results: In the first decade, 24 patients were females and 31 were males (M/F = 1.2); in the other groups, 30 were females and 19 were males (M/F = 0.61). The mean age was 45.2 months at the time of diagnosis for the first group and the mean age was 36 months for the other group. In the first decade, the surgical stage after the operation was as follows: stage I (32.7%), stage II (16.36%), stage III (38.1%), stage IV (9%), and stage V (1.8%) who did not operate. In second decade, 49 patients were as follows: stage I (14.3%), stage II (40.8%), stage III (24.5%), stage IV (10.2%), and stage V (10.2%). In 54.5% of the first group, histology was favorable, and in 43.6% of the first group, histology was unfavorable; in the second group, 95.4% were the favorable type. The patients were managed based on protocols of the National Wilms’ Tumor Study. In the first decade, relapse-free was 71% and 4-year survival rates were estimated at 86%, and in the second decade, pulmonary metastasis was observed at 28.6%, liver metastasis in 2.3%, recurrence in 5%, and 4-year survival rates were estimated at 90%. Conclusions: This study demonstrated development in the management of children with Wilms’ tumor in recent 20 years, with comparable relapse-free and survival rates to the National Wilms’ Tumor study. But with more adjustment in treatment protocols, the superior outcome will be attainable.

1995 ◽  
Vol 13 (1) ◽  
pp. 124-133 ◽  
Author(s):  
J Pritchard ◽  
J Imeson ◽  
J Barnes ◽  
S Cotterill ◽  
D Gough ◽  
...  

PURPOSE The first United Kingdom Children's Cancer Study Group (UKCCSG) Wilms' Tumor Trial (UKW1) applied treatment regimens stratified by stage and histology in accordance with National Wilms' Tumor Study (NWTS) criteria, seeking to reduce treatment of low-stage, favorable-histology (FH) tumors without impairing survival and to improve prognosis of stage III and IV (FH) and unfavorable-histology (UH) tumors with more intensive chemotherapy. PATIENTS AND METHODS Three hundred eighty-four consecutively diagnosed patients with Wilms' tumor were recruited from the 20 UKCCSG centers and Oslo, Norway, between January 1980 and June 1986. The regimen for stage I patients was vincristine (Vcr) only, while stage II patients received Vcr and dactinomycin (Act-D). Stage III patients received three-drug therapy and stage IV and UH patients four-drug regimens. Act-D was given as pulsed doses of 1.5 mg/m2 every 3 or every 6 weeks. No lung irradiation was used in stage IV patients. No randomized comparisons were attempted. End points were survival and event-free survival (EFS). RESULTS Survival at 6 years in FH patients was 96% for stage I, 93% for stage II, 83% for stage III, 65% for stage IV, and 50% for UH patients of all stages. CONCLUSION Vcr alone is as effective for stage I FH tumors as the two-drug regimen used in the NWTS and International Society of Pediatric Oncology (SIOP) studies. Fractionation of Act-D is unnecessary. The poorer results for stage IV FH and UH patients compared with the NWTS may be due to treatment differences, such as the use of lung irradiation for stage IV FH patients in NWTS3, and/or to case selection bias.


2018 ◽  
Vol 84 (4) ◽  
pp. 565-569 ◽  
Author(s):  
Yasumitsu Hirano ◽  
Masakazu Hattori ◽  
Kenji Douden ◽  
Chikashi Hiranuma ◽  
Yasuo Hashizume ◽  
...  

Single-incision laparoscopic surgery (SILS) has been developed with the aim to further reduce the invasiveness of conventional laparoscopy. Our experiences with more than 300 consecutive patients with SILS for colon cancer are reviewed, and its outcomes are evaluated to determine the midterm clinical and oncologic safety of SILS for colon cancer in a community hospital. A single surgeon's consecutive experience of SILS for colon cancer is presented. Three hundred and eight patients were treated with the SILS procedure for colon cancer between December 2010 and March 2015. Data were analyzed according to intention to treat. Of these 308 patients, 19 (6.2%) were converted to laparotomy. Intraoperative injury occurred in five patients. Postoperative complications occurred in 19 patients (6.2%). The 2-year relapse-free survival rates of patients with Stage I, Stage II, and Stage III were 97.8, 92.2, and 80.4 per cent, respectively, and the 2-year overall survival rates of patients with Stage I, Stage II, Stage III, and Stage IV were 100, 95.7, 93.0, and 74.4 per cent, respectively. Our initial experiences showed that SILS colectomy for cancer can be performed safely and with good short-term oncologic outcomes by a skilled surgeon.


2018 ◽  
Vol 48 (4) ◽  
Author(s):  
Simone Carvalho dos Santos Cunha ◽  
Katia Barão Corgozinho ◽  
Franciele Basso Fernandes Silva ◽  
Kassia Valéria Gomes Coelho da Silva ◽  
Ana Maria Reis Ferreira

ABSTRACT: Our retrospective study evaluated the survival of 24 dogs with unresectable malignant melanoma treated with radiation therapy. Fifteen dogs were treated with radiation therapy (RT) and chemotherapy (CT), five with surgery followed by RT and CT, three with palliative RT, and one with electrochemotherapy associated with RT. All dogs were treated with an orthovoltage Stabilipan I. The protocol used was three or four weekly fractions of 8 Gy. Carboplatin was administered every 21 days, a total of four times. Five percent of dogs were classified as having stage I melanoma, 17% as stage II, 50% as stage III, and 17% as stage IV. Sixty-four percent had a partial response to treatment, 29% achieved complete remission, and 7% remained in a stable disease state. The mean survival time was 390 days for stage I, 286 days for stage II, 159 days for stage III, and 90 days for stage IV. We concluded that radiation therapy can be considered a viable alternative for the palliative treatment of canine oral melanoma.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15645-15645
Author(s):  
N. Radhakrishnan ◽  
R. Roy ◽  
A. Thomas ◽  
B. Mehrotra ◽  
U. Iqbal

15645 Background: Penile cancer is a rare malignancy in the Western world with limited published data. We conducted a review of patient (pt.) records diagnosed with penile cancer at our instituition to evaluate the patterns of treatment, responses, recurrences and long term outcomes. Methods: IRB approval was obtained for this retrospective analysis. Tumor registry data was analysed for all adult patients diagnosed with penile cancers between 1995 and 2005. Patient characteristics including age, disease stage, histology, grade, ethnicity, treatment modalities and outcomes were recorded. Results: 24 pts were identified. Median age: 68 years (range: 38 - 86), Stage distribution: Stage 0 (n=7, 29%), Stage I: n =8 (33.%) ; Stage II: n= 4 (17%); Stage III: n = 1 (4%), Stage IV: n=4 (16.7%); ethnicity: Caucasian:17, African-American: n=3; Hispanic: n=1;and South Asian: n=6; Histology: squamous (sq.): n = 21(88%), sq. with sarcomatoid features: n=1(4%), small cell ca: n = 1, (4%); poorly diff. ca: n = 1 (4%). Grades 1,2,3 in each stage respectively : stage I: ( n= 4, 2, 1), stage II: (n = 0,1,2), stage III: (1,0,0), stage IV: (n = 1,2,1). Treatment and Outcome: All pts with stage 0 disease were treated with excision biopsy. 3 of 7 (40%) recurred but are disease free after re-excision. All pts with Stage I disease were treated with partial penectomy. Two of 8 (25%) recurred, of which one pt died of his disease. All pts with stage II were treated with surgery (penectomy) and CT. One pt was additionally treated with RT to the groin. Except for this pt all stage II pts recurred and died due to recurrent disease. The pt with stage III disease was treated with a partial penectomy and CT and remains disease free without recurrence. All pts with stage IV disease were treated with CT, 3 were also treated with RT , but all died of metastatic disease. Median OS: Stage 0: 70+ mo, (20–150 ); Stage I: 69 mo (11–133); Stage II: 25 mo(12–84); Stage III: 25 mo; Stage IV: 7 mo ( 7- 23); Conclusions: Pts with early stage 0 and I disease have a high local recurrence rate (33%) but are curable with surgical salvage. Stages II, III and IV pts have high recurrence rates and poor prognoses despite treatment with penectomy and CT. Future trials should address the benefit of adjuvant chemo/RT in patients with intermediate stage (II & III) disease. No significant financial relationships to disclose.


2014 ◽  
Vol 32 (1) ◽  
pp. 5-8
Author(s):  
M Mazumder ◽  
A Islam ◽  
N Farooq ◽  
M Zaman

Introduction: Wilms’ tumor is the most common primary malignant renal tumor of childhood. It is important to pick up the children with wilms’ tumor earlier as early stages has excellent outcomes after treatment. Objective : To find out the common clinical presentations and pathological profile of Wilms’ tumor in children. Methods and Materials : A hospital based prospective study done with twenty diagnosed patients of Wilms tumour enrolled from department of Pediatric haemato-oncology, BSMMU, Dhaka in the period between January to December 2008. Results- The peak incidence of Wilms’ tumor was in 1 to 5 years age group (80%,n=16). Median age at presentation was 49 months with male: female ratio 1.8:1.The most common presentation was abdominal swelling (80%,n=16),followed by flank mass (75%,n=15), abdominal pain (55%,n=11), haematuria (15%,n=3), hypertension (10%,n=2). Thirteen raised from right kidney, ratio of right to left involvement 1.8:1. Histologically 13(65%) patients had triphasic histology having blastemal, stromal and epithelial elements, 7(35%) was biphasic having blastema and epithelia. All had favourable histological pattern. Most patients presented in stage III (55%,n=11) followed by stage II (25%,n=5), Stage IV(10%,n=2), Stage I(10%,n=2). No bilateral presentation. Conclusions : Most of the patients of Wilms’ tumor presented within 1 to 5 years of age(80%) with abdominal distension(80%) and flank mass(75%), few associated with haematuria(15%) and hypertension(10%). Histologically all were favourable and maximum presented in stage III (55%) followed by stage II(25%). DOI: http://dx.doi.org/10.3329/jbcps.v32i1.21015 J Bangladesh Coll Phys Surg 2014; 32: 5-8


2018 ◽  
Vol 8 (2) ◽  
pp. 14-21
Author(s):  
Syaifurrahman Hidayat ◽  
Laylatul Hasanah ◽  
Dewi Herlina Susantin
Keyword(s):  
Stage Iv ◽  
T Test ◽  
Stage I ◽  
Stage Ii ◽  

Daun salam (syzygiumpolyanthum) merupakan salah satu dari jenis terapi herbal yang digunakan untuk berbagai penyakit salah satunya yaitu untuk menangani penyakit hipertensi,untuk menurunkan hipertensi dibutuhkan 10 lembar daun salam dan 300 ml air lalu direbus hingga mendidih dan menyusut menjadi 200 ml dan dikonsumsi sebanyak 2 kali sehari pada pagi dan sore hari, masing-masing 100 ml. Penelitian ini bertujuan untuk mengetahui pengaruh air rebusan daun salam dalam menurunkan tekanan darah pada lansia di wilayah kerja UPT Puskesmas Guluk-Guluk. Penelitian ini menggunakan desain penelitian eksperimen Pre post test design, dimana pada rancangan ini berupaya mengungkapkan hubungan sebab akibat dengan cara melibatkan kelompok eksperimental, dengan sampel sebanyak 30 0rang Pengumpulan data menggunakan observasi tekanan darah langsung dan wawancara ke responden.  Hasil penelitian menunjukkan bahwa sebelum diberikan perlakuan pada responden sebagian besar berada pada stage III sebanyak 22 orang (73,3 %), lalu sebagian kecil berada pada stage IV dengan 2 orang (6,7 %). Setelah dilakukan penelitian menunujukkan sesudah diberikan perlakuan pada responden sebagian besar menempati stage II sebanyak 28 orang (93,3 %), sebagian kecil berada pada stage I hanya 2 orang (6,7 %). Hasil uji T test paried dan uji T test didapatkan nilai signifikan 0.000 yang nilainya lebih kecil dari taraf kesalahan α 0.05. sehingga H0 ditolak dan H1 diterima yang berarti ada pengaruh air rebusan daun salam terhadap penurunan tekanan darah pada lansia yang menderita hipertensi di wilayah kerja UPT Puskesmas Guluk-Guluk Kecamatan Guluk-Guluk. Daun salam mempunyai kandungan kimia seperti minyak atsiri, sitrat, euganol, tannin serta flavanoid yang dipercaya mampu untuk menurunkan tekanan darah, mekanisme kerja dari daun salam ini yaitu merangsang sekresi cairan empedu sehingga lemak akan keluar bersamaan dengan usus yang kemudian mengurangi gumpalan lemak yang mengendap dalam pembuluh darah sehingga aliran darah menjadi lancar dan tekanan darah akan normal.


Author(s):  
Viktor Dmytryk ◽  
Tetiana Luhovska ◽  
Pavel Yakovlev ◽  
Olexiy Savchuk ◽  
Ludmila Ostapchenko ◽  
...  

Bladder Cancer (BC) is a common disease worldwide. Chronic inflammation is one of the key mechanisms for the development of BC. This study enrolled 40 patients. Preoperative plasma levels of IL-1β, IL-4, IL-6, IL-10, IL-12β, TNF-α and IFN-γ were determined by ELISA. In our study, we observed diverse changes in the levels of cytokines in patients with BC Stage I, II, III and IV. The levels of IL-1β was increased for stage I, stage II, and stage III. The level of TNF-α was increased for stage II, stage III, stage IV. The levels of IL-4, IL-6, IL-10 and IL-12β were increased in patients with stage III and IV only. The levels of IFN- γ declined for stage II, stage III and stage IV with the lowest levels in patients with Stage IV. In our study, we investigated alteration in levels of Th-1 and Th-2-like cytokine profile, but some deficiency in Th1- status discovered in patients with BC.


2000 ◽  
Vol 18 (14) ◽  
pp. 2665-2675 ◽  
Author(s):  
Jorge A. Ortega ◽  
Edwin C. Douglass ◽  
James H. Feusner ◽  
Marleta Reynolds ◽  
John J. Quinn ◽  
...  

PURPOSE: Previous studies demonstrated that chemotherapy with either cisplatin, vincristine, and fluorouracil (regimen A) or cisplatin and continuous infusion doxorubicin (regimen B) improved survival in children with hepatoblastoma. The current trial is a randomized comparison of these two regimens. PATIENTS AND METHODS: Patients (N = 182) were enrolled onto study between August 1989 and December 1992. After initial surgery, patients with stage I–unfavorable histology (UH; n = 43), stage II (n = 7), stage III (n = 83), and stage IV (n = 40) hepatoblastoma were randomized to receive regimen A (n = 92) or regimen B (n = 81). Patients with stage I–favorable histology (FH; n = 9) were treated with four cycles of doxorubicin alone. RESULTS: There were no events among patients with stage I-FH disease. Five-year event-free survival (EFS) estimates were 57% (SD = 5%) and 69% (SD = 5%) for patients on regimens A and B, respectively (P = .09) with a relative risk of 1.54 (95% confidence interval, 0.93 to 2.5) for regimen A versus B. Toxicities were more frequent on regimen B. Patients with stage I-UH, stage II, stage III, or stage IV disease had 5-year EFS estimates of 91% (SD = 4%), 100%, 64% (SD = 5%), and 25% (SD = 7%), respectively. Outcome was similar for either regimen within disease stages. At postinduction surgery I, patients with stage III or IV disease who were found to be tumor-free had no events; those who had complete resections achieved a 5-year EFS of 83% (SD = 6%); other patients with stage III or IV disease had worse outcome. CONCLUSION: Treatment outcome was not significantly different between regimen A and regimen B. Excellent outcome was achieved for patients with stage I-UH and stage II hepatoblastoma and for subsets of patients with stage III disease. New treatment strategies are needed for the majority of patients with advanced-stage hepatoblastoma.


1970 ◽  
Vol 118 (4) ◽  
pp. 667-676 ◽  
Author(s):  
W. M. Waites ◽  
D. Kay ◽  
I. W. Dawes ◽  
D. A. Wood ◽  
S. C. Warren ◽  
...  

A comparison was made of morphological changes and successive, mainly biochemical, marker events for sporulation in 14 asporogenous mutants. The morphological and biochemical sequences are linked so that arrested development in one is accompanied by corresponding effects in the other. Thus mutants that fail to produce both protease and antibiotic do not progress beyond stage 0, formation of alkaline phosphatase appears to be associated with the transition from stage II to stage III and glucose dehydrogenase with that from stage III to stage IV. Stage II mutants may produce `pygmy' cells or other bizarre cell-division forms. The biochemical sequence is dependent in the sense that if the occurrence of any one event is blocked that of all the succeeding events is also blocked. This has implications for biochemical models that have been proposed to explain the temporal sequence observed in spore development.


2012 ◽  
Vol 518-523 ◽  
pp. 5813-5816
Author(s):  
Liang Chen ◽  
Zheng Qing Wang ◽  
Yan Shi Xie ◽  
Wei Huang

In this paper, factor analysis are used to study the early Paleogene paleoenvironmental evolution from the Sanshui Basin, and main conclusions can be obtained as follows: stage I (89.0-73.0m), relatively dry and relatively low temperatures; stage II (73.0-52.5m), warm and humidity of the climate and environment; stage III (52.5-22.5m), the ancient climate conditions change quickly, showing the alternating warm and humidity and dry; stage IV (22.5-0m), prevailing warm and moist climatic conditions.


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