Clinical, epidemiological and therapeutic profile of pediatric Wilms tumor in Costa Rica
DOI:
https://doi.org/10.51481/amc.v62i3.1074Keywords:
Wilms tumor, pediatrics, clinical, epidemiology, treatment, radiotherapyAbstract
Background: Wilms tumor is the most frequent malignant renal tumor in pediatrics. Therapeutic management follows the oncological principle of curing the disease through surgery, chemotherapy, radiotherapy. It seeks to minimize the toxicity of treatments. The objective of the study was to describe the clinical, epidemiological and, therapeutic characteristics of patients diagnosed with Wilms tumor, treated at the Oncology Unit of the National Children's Hospital ""Dr. Carlos Sáenz Herrera"" Caja Costarricense de Seguro Social, during the period from January 2009 to December 2016.
Methods: It is a descriptive, observational, retrospective study of one series of cases. The population analyzed were 42 pediatric patients with Wilms tumor for seven years. Medical records were revised retrospectively to collect data about all cases. The statistical analysis used qualitative variables and quantitative variables to descriptive and inferential techniques, and for survival analysis, KaplanMeier survival curves were used.
Results: During a study period, a total of 42 patients diagnosed with Wilms tumor were studied. 59.5% were women. The prevalence is higher in children 2 years old or younger (66.7%). 95.2% of the patients presented favorable histology; and when discriminated by sex, 100.0% of unfavorable histology were women. The most common surgery was nephrectomy. All patients received chemotherapy and 38.1% radiotherapy. The main acute side effect of radiotherapy was vomiting. The estimated overall survival was 85.6% at 3 years, and 79.9% at 5 years and the disease-free survival was the same as 78.8% at 3 and 5 years.
Conclusions: Wilms tumor exhibited low frequency in pediatric patients, in both sexes however bad histology most affected women. The patient received a combination of therapy with surgery, chemotherapy and, radiotherapy; his interventions have success and pediatric patients have longer overall survival and free disease progression survival at 5 years, like results of other average income countries.
Downloads
References
Szychot E, Apps J, Jones KP. Wilms tumor: biology, diagnosis and treatment. Transl Pediatr. 2014;3:12-24.
Halperin C, Tarbell K. Irradiación en oncología pediátrica. 5ta ed. Philadelphia: Lippincott Williams y Wilkins, 2016.
Pizzo PA, Poplack DG. Principles and Practice of Pediatric Oncology. 7th ed. Philadelphia: Lippincott Williams & Wilkins. 2015.
Deng C, Dai R, Li X, Liu F. Genetic variation frequencies in Wilm´s tumor: A meta-analysis and systematic review. Cancer Sci. 2016;107:690-699.
Dome JS, Graf N, Geller JI, Fernandez CV, Mullen EA, Spreafico F, et al. Advances in Wilms tumor treatment and biology: Progress through international collaboration. J Clin Oncol. 2015;33:2999-3007.
Davidoff AM. Wilms tumor. Adv Pediatr. 2012;59:247- 267.
Breslow N, Olshan A, Beckwith JB, Green DM. Epidemiology of Wilms tumor. Med Pediatr Oncol. 1993;21:172-181.
Quirós M, Gamboa AY. Tumor de Wilms en niños de Costa Rica. Acta Méd. Costarric. 2018;60:15-20.
Guruprasad B, Rohan B, Kavitha S, Madhumathi DS, Lokanath D, Appaji, L. Wilms' Tumor: Single centre retrospective study from South India. Indian J Surg Oncol. 2013;4:301-304.
Erginel B, Vural S, Akin M, Karadag C, Sever N, Abdullah et al. Wilms Tumor: A 24-year retrospective study from a single center. J Pediatr Hematol Oncol. 2014;31:409-414.
Gunderson L, Tepper J. Clinical Radiation Oncology. 4th ed. Philadelphia: Elsevier. 2016.
Perlman EJ. Pediatric renal tumors: practical updates for the pathologist. Pediatr Dev Pathol. 2005; 8:320-338.
Breslow NE, Collins AJ, Ritchey ML, Grigoriev YA, Peterson SM, Green DM. End stage renal disease in patients with Wilms tumor: results from the National Wilms Tumor Study Group and the United States Renal Data System. J Urol. 2005;174:1972-1975.
Kieran K, Anderson JR, Dome JS, Ehrlich PF, Ritchey ML, Shamberger RC, et al. Lymph node involvement in Wilms tumor: results from National Wilms Tumor Studies 4 and 5. J Pediatr Surg. 2012;47:700-706.
Madero L, Lassaletta A, Sevilla J. Hematología y Oncología Pediátricas. 3ra ed. Madrid: Ergon. 2015.
Keebsabai S, Jurairut T, Achar S. Long-Term outcome in pediatric renal tumor survivors: experience of a single center. J Pediatr Hematol Oncol. 2013;35:610613.
Chung H, Agrawal A, Swift P. Management of Acute Radiation Side Effects. In: Feusner, Hastings, Agrawal, ed. Supportive Care in Pediatric Oncology: A Practical Evidence-Based Approach. Berlin: Springer; 2015:203-217.
Smith MA, Altekruse SF, Adamson PC, Reaman GH, Seibel NL. Declining childhood and adolescent cancer mortality. Cancer. 2014;120:2497-2506.
Downloads
Published
Issue
Section
License
Copyright (c) 2020 Acta Médica Costarricense
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Los autores que publican en la revista Acta Médica Costarricense pueden distribuir, copiar, remezclar, retocar, leer, descargar, imprimir, buscar y crear a partir de su obra de modo no comercial, indicando los créditos a la revista y sus autores y compartir su obra en las mismas condiciones. Para ello se aplica la licencia Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional(CC BY-NC-SA 4.0)
