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  • Title: Relapse of unilateral favorable histology Wilms' tumor: significant clinicopathological factors.
    Author: Aoba T, Urushihara N, Fukumoto K, Furuta S, Fukuzawa H, Mitsunaga M, Watanabe K, Yamoto M, Miyake H, Koyama M, Iwabuchi H, Koike J, Tatsunami S, Wakisaka M, Kitagawa H.
    Journal: J Pediatr Surg; 2012 Dec; 47(12):2210-5. PubMed ID: 23217878.
    Abstract:
    PURPOSE: To evaluate the clinicopathological features that indicate relapse and suggest a new risk based therapeutic strategy for unilateral Favorable Histology Wilms Tumor (FH-WT). MATERIALS & METHODS: Thirty-three patients with unilateral WT were treated in two institutions between 1986 and 2010. Twenty-eight patients with FH-WT received primary nephrectomy according to the National Wilms' Tumor Study (NWTS) or the Japanese Wilms' Tumor Study (JWiTS) protocol. Retrospective analyses of the non-relapsed group (n=23) and the relapsed group (n=5) compared age, gender, tumor laterality, tumor weight, initial tumor stage, known histological subtype, chemotherapy (2 or 3 drugs), and any irradiation delivered. Stages and histological subtypes of the tumors were re-evaluated according to the Japanese staging system. RESULTS: Five of the twenty-eight tumors relapsed, and one patient died. The initial staging (P=0.029) and the histological subtype (P=0.003) were the only factors indicating relapse. Nine of the twenty-three tumors were histologically classified as blastemal predominant subtype (BPT-WT). Five relapsed. CONCLUSION: According to the basic Japanese therapeutic strategy, all patients underwent a primary nephrectomy before chemotherapy. This study suggests that the histological subtype pre-treatment "BPT-WT" should be included as a strong indicator of poor prognosis. Such patients should be treated as a high-risk group.
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