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: | , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
14 August 2022
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| 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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| 520 | |a (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. | ||
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