The Survival Rate and Late Effects of Treatment for Wilms Tumor.
- Author:
Keon Hee YOO
1
;
Myung Hyun LEE
;
Hee Young SHIN
Author Information
1. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Wilms tumor;
Survival rate;
Late effects
- MeSH:
Blood Pressure;
Follow-Up Studies;
Hematuria;
Hepatitis;
Humans;
Hypertension;
Nephrectomy;
Prognosis;
Proteinuria;
Quality of Life;
Radiotherapy;
Survival Rate*;
Urea;
Wilms Tumor*
- From:Korean Journal of Pediatric Hematology-Oncology
1998;5(1):98-105
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Wilms tumor, the most common primary malignant renal tumor of childhood, has relatively good prognosis among solid tumors occurring in childhood because of the improved operation skill, proper selection of chemotherapeutic agents, and combined radiotherapy on the primary and distant metastatic sites after nephrectomy. However, successful therapy has been associated with long-term toxicity occurring years or decades later. So it is important to identify and understand the possible late effects of treatment for Wilms tumor. METHODS: We reviewed 73 cases of Wilms tumor who were diagnosed and treated from Mar., 1983 to Nov., 1996 and calculated the survival rate. In addition, 42 cases were investigated to see the late effects of treatment for Wilms tumor since Feb., 1993, especially with predesigned indices such as blood pressure, blood urea nitrogen(BUN), serum creatinine(S-Cr), 24 hour urine protein/creatinine(24 HU Pr/Cr), 24 hour urine microalbumin(24 HU MA), 24 hour urine beta2-microglobulin/creatinine(24 HU beta2-MG/Cr). RESULTS: Overall survival rate of Wilms tumor was 86% in 5 years. There was significant difference in survival between stage I, II, III group and stage IV, V group(90% vs 72%, P=0.032), and survival rate of favorable histology group was higher than that of unfavorable histology group(92% vs 73%, P=0.043). Of the 42 cases in our study of late effects, no patient has presented significant late sequelae causing morbidity, and there were one case of transient hypertension, three cases of microalbuminuria, three cases of proteinuria, one case of asymptomatic microscopic hematuria, one case of radiation hepatitis and two cases of nut-cracker syndrome. No abnormality was noted in BUN, S-Cr, or 24 HU beta2-MG/Cr. CONCLUSION: Wilms tumor in our center have an excellent prognosis and no significant late sequelae that might affect long-term morbidity were found. But thorough and further longer follow-up is mandatory to understand the possible late effects fully, so that cope with properly and improve the quality of life.
