Clinical effect of multicenter multidisciplinary treatment in children with renal malignant tumors
YIN Ze-Xi1, HE Xiang-Ling1, HE Jun2, TIAN Xin1, ZHU Cheng-Guang1, CHEN Ke-Ke1, ZOU Run-Ying1, YOU Ya-Lan1, JIANG Xin-Ping3, TANG Wen-Fang1, ZENG Min-Hui1, HUANG Zhi-Jun1, YAO An-Qi1
Department of Hematology and Oncology, First Affiliated Hospital of Hunan Normal University/Children's Medical Center of Hunan Provincial People's Hospital, Changsha 410005, China
Abstract Objective To study the long-term clinical effect of multicenter multidisciplinary treatment (MDT) in children with renal malignant tumors. Methods A retrospective analysis was performed on the medical data of 55 children with renal malignant tumors who were diagnosed and treated with MDT in 3 hospitals in Hunan Province from January 2015 to January 2020, with GD-WT-2010 and CCCG-WT-2016 for treatment regimens. A Kaplan-Meier survival analysis was used to analyze the survival of the children. Results Of the 55 children, 10 had stage I tumor, 14 had stage Ⅱ tumor, 22 had stage Ⅲ tumor, 7 had stage IV tumor, and 2 had stage V tumor. As for pathological type, 47 had FH type and 8 had UFH type. All children underwent complete tumor resection. Of the 55 children, 14 (25%) received preoperative chemotherapy. All children, except 1 child with renal cell carcinoma, received postoperative chemotherapy. Among the 31 children with indication for radiotherapy, 21 (68%) received postoperative radiotherapy. One child died of postoperative metastasis. The incidence rate of FH-type myelosuppression was 94.4%, and the incidence rate of UFH-type myelosuppression was 100%. The median follow-up time was 21 months and the median survival time was 26 months for all children, with an overall survival rate of 98% and an event-free survival rate of 95%. Conclusions Multicenter MDT has the advantages of high success rate of operation and good therapeutic effect of chemotherapy in the treatment of children with renal malignant tumors, with myelosuppression as the most common side effects, and radiotherapy is safe and effective with few adverse events. Therefore, MDT has good feasibility, safety, and economy.
YIN Ze-Xi,HE Xiang-Ling,HE Jun et al. Clinical effect of multicenter multidisciplinary treatment in children with renal malignant tumors[J]. CJCP, 2021, 23(2): 169-173.
YIN Ze-Xi,HE Xiang-Ling,HE Jun et al. Clinical effect of multicenter multidisciplinary treatment in children with renal malignant tumors[J]. CJCP, 2021, 23(2): 169-173.
Oostveen RM, Pritchard-Jones K. Pharmacotherapeutic management of Wilms tumor:an update[J]. Paediatr Drugs, 2019, 21(1):1-13.
[2]
Steliarova-Foucher E, Colombet M, Ries LAG, et al. International incidence of childhood cancer, 2001-10:a population-based registry study[J]. Lancet Oncol, 2017, 18(6):719-731.
[3]
Brok J, Treger TD, Gooskens SL, et al. Biology and treatment of renal tumours in childhood[J]. Eur J Cancer, 2016, 68:179-195.
Perlman EJ. Pediatric renal tumors:practical updates for the pathologist[J]. Pediatr Dev Pathol, 2005, 8(3):320-338.
[8]
Ljungberg B, Albiges L, Abu-Ghanem Y, et al. European Association of Urology guidelines on renal cell carcinoma:the 2019 update[J]. Eur Urol, 2019, 75(5):799-810.
[9]
Janssen MWW, Linxweiler J, Philipps I, et al. Kidney autotransplantation after nephrectomy and work bench surgery as an ultimate approach to nephron-sparing surgery[J]. World J Surg Oncol, 2018, 16(1):35.
[10]
Blanc T, Pio L, Clermidi P, et al. Robotic-assisted laparoscopic management of renal tumors in children:preliminary results[J]. Pediatr Blood Cancer, 2019, 66(S3):e27867.
[11]
Kieran K, Ehrlich PF. Current surgical standards of care in Wilms tumor[J]. Urol Oncol, 2016, 34(1):13-23.
