UNASSIGNED: To analyze various clinicopathological parameters that effect outcomes in treatment naïve and post chemotherapy Wilms tumor specimens.
UNASSIGNED: This was a retrospective observational study.
UNASSIGNED: All patients diagnosed with Wilms tumor between 2012 and 2018 at our institute will be included with their clinical findings, laboratory reports, and radiological findings. The patients will be categorized into two groups based on treatment protocol (Society of Pediatric Oncology (SIOP) or the National Wilms Tumor Study Group/Children\'s Oncology Group (COG) guidelines) used. Details of Grossing and reporting protocols used for the in pre treatment and post treatment specimens will be analyzed. Follow-up till December 2020 will be analyzed.
UNASSIGNED: Chi-square and Fisher\'s exact tests were used for statistical analysis.
UNASSIGNED: A total of 36 patients with the diagnosis of Wilms tumor were included in the present study. The mean age of presentation was 3.9 ± 0.7 years, and males were more common than females. Most of them presented as abdominal mass and few with isolated hematuria. Twenty-six (72%) patients were treated under SIOP protocol with preoperative neoadjuvant chemotherapy. Ten patients underwent upfront surgery as per COG protocol. In SIOP group patients, the mean tumor size was 9.3cm. Forty percent (n = 10) we mixed histological type followed by blastemal type constituting (32%, n = 8). Regressive and epithelial histological types constituted 16% (n = 4) and 12% (n = 3), respectively. In the SIOP group 72% (n = 19) had no anaplasia and 28% (n = 7) had anaplasia. Fifty seven percent (n = 15) cases were Stage I, followed by 26.9% n = 7) and 11.5% (n = 3) being Stage II and Stage III, respectively. Ten patients underwent upfront surgery as per COG protocol. The mean tumor size among this group was 8 cm ranging from 7 cm to 11 cm. Eight (80%) cases had favorable histology and two cases showed focal anaplasia. Heterologous differentiation is seen in 3 (70%). Out of the 10 cases, one case was Stage I, six were Stage 2, one was Stage III, and two were clinical Stage IV. None of the cases showed either vessel or lymph node metastasis. All the patients received adjuvant chemotherapy postsurgery and were followed up till December 2020 for (at least 3 years). Of 25 patients in the SIOP group, 18 (72%) had complete remission with no radiological evidence of residual disease. Of the 10 patients in the COG group, 6 (70%) had complete remission.
UNASSIGNED: Histopathological evaluation of Wilms tumor is a critical aspect in the management of Wilms tumor, as tumor characteristics are different in the tumors treated under SIOP and COG protocols, which will ultimately affect the prognostic risk stratification. This necessitates the knowledge of the important grossing and reporting of these tumors under the two protocols.
■分析影响初治和化疗后肾母细胞瘤标本治疗结果的各种临床病理参数。
■这是一项回顾性观察性研究。
■2012年至2018年在我们研究所诊断为Wilms肿瘤的所有患者都将纳入其临床发现,实验室报告,和放射学发现。根据使用的治疗方案(儿科肿瘤学会(SIOP)或国家威尔姆斯肿瘤研究组/儿童肿瘤研究组(COG)指南)将患者分为两组。将分析用于治疗前和治疗后标本的Grosing和报告方案的详细信息。将对2020年12月之前的后续行动进行分析。
■卡方和Fisher精确检验用于统计分析。
■本研究共纳入36例诊断为Wilms肿瘤的患者。演示的平均年龄为3.9±0.7岁,男性比女性更常见。大多数表现为腹部肿块,少数表现为孤立性血尿。26例(72%)患者在SIOP方案下接受术前新辅助化疗。10例患者按照COG方案进行了前期手术。在SIOP组患者中,平均肿瘤大小为9.3cm.40%(n=10)我们混合了组织学类型,其次是囊胚型(32%,n=8)。回归和上皮组织学类型占16%(n=4)和12%(n=3),分别。在SIOP组中,72%(n=19)无间变,而28%(n=7)有间变。57%(n=15)的病例为I期,其次是26.9%n=7)和11.5%(n=3)为II期和III期,分别。10例患者按照COG方案进行了前期手术。该组中的平均肿瘤大小为8cm,范围为7cm至11cm。8例(80%)具有良好的组织学,2例显示局灶性发育不良。异源分化见3(70%)。在这10个案例中,一个案例是第一阶段,六个是第二阶段,一个是第三阶段,两个是临床IV期。所有病例均未出现血管或淋巴结转移。所有患者术后均接受辅助化疗,随访至2020年12月(至少3年)。在SIOP组的25名患者中,18(72%)完全缓解,没有放射学证据表明残留疾病。在COG组的10名患者中,6人(70%)完全缓解。
■Wilms肿瘤的组织病理学评估是治疗Wilms肿瘤的关键方面,由于在SIOP和COG方案下治疗的肿瘤的肿瘤特征不同,最终会影响预后风险分层。这就需要了解两种方案下这些肿瘤的重要收入和报告。