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Vena cava thrombus in patients with wilms tumor

(1) Background: Vena cava thrombus (VCT) is rare in Wilms tumor (WT) (4-10%). The aim of this study is to identify factors for an outcome to improve treatment for better survival. (2) Methods: 148/3015 patients with WT (aged < 18 years) and VCT, prospectively enrolled over a period of 32 years (1...

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Main Authors: Meier, Clemens-Magnus (Author) , Furtwängler, Rhoikos (Author) , Schweinitz, Dietrich von (Author) , Stein, Raimund (Author) , Welter, Nils (Author) , Wagenpfeil, Stefan (Author) , Kager, Leo (Author) , Schenk, Jens-Peter (Author) , Vokuhl, Christian Oliver (Author) , Melchior, Patrick (Author) , Fuchs, Jörg (Author) , Graf, Norbert (Author)
Format: Article (Journal)
Language:English
Published: 14 August 2022
In: Cancers
Year: 2022, Volume: 14, Issue: 16, Pages: 1-11
ISSN:2072-6694
DOI:10.3390/cancers14163924
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3390/cancers14163924
Verlag, kostenfrei, Volltext: https://www.mdpi.com/2072-6694/14/16/3924
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Author Notes:Clemens-Magnus Meier, Rhoikos Furtwängler, Dietrich von Schweinitz, Raimund Stein, Nils Welter, Stefan Wagenpfeil, Leo Kager, Jens-Peter Schenk, Christian Vokuhl, Patrick Melchior, Jörg Fuchs and Norbert Graf
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Summary:(1) Background: Vena cava thrombus (VCT) is rare in Wilms tumor (WT) (4-10%). The aim of this study is to identify factors for an outcome to improve treatment for better survival. (2) Methods: 148/3015 patients with WT (aged < 18 years) and VCT, prospectively enrolled over a period of 32 years (1989-2020) by the German Society for Pediatric Oncology and Hematology (SIOP-9/GPOH, SIOP-93-01/GPOH and SIOP-2001/GPOH), are retrospectively analyzed to describe clinical features, response to preoperative chemotherapy (PC) (142 patients) and surgical interventions and to evaluate risk factors for overall survival (OS). (3) Results: 14 VCT regressed completely with PC and another 12 in parts. The thrombus was completely removed in 111 (85.4%), incompletely in 16 (12.3%), and not removed in 3 (2.3%). The type of removal is unknown in four patients. Patients without VCT have a significantly (p < 0.001) better OS (97.8%) than those with VCT (90.1%). OS after complete resection is (89.9%), after incomplete (93.8%) and with no resection (100%). Patients with anaplasia or stage IV without complete remission (CR) after PC had a significantly worse OS compared to the remaining patients with VCT (77.1% vs. 94.4%; p = 0.002). (4) Conclusions: As a result of our study, two risk factors for poor outcomes in WT patients with VCT emerge: diffuse anaplasia and metastatic disease, especially those with non-CR after PC.
Item Description:Der Artikel ist Teil des Special Issue: New insights in pediatric surgical oncology
Gesehen am 15.09.2022
Physical Description:Online Resource
ISSN:2072-6694
DOI:10.3390/cancers14163924

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