Tamanho tumoral e prognóstico em pacientes portadores de tumor de Wilms

Abstract

OBJECTIVE: Investigate the relationship of the tumor volume after preoperative chemotherapy (TVAPQ) and before preoperative chemotherapy (TVBPQ) with overall survival at two and at five years, and lifetime. METHODS: Our sample consisted of consecutive patients evaluated in the period from 1989 to 2009 in an Onco-Hematology Service. Clinical, histological and volumetric data were collected from the medical records. For analysis, chi-square, Kaplan-Meier, log-rank and Cox regression tests were used. RESULTS: The sample consisted of 32 patients, 53.1% were male with a median age at diagnosis of 43 months. There was a significant association between TVAPQ>500mL and the difference between the TVBPQ and TVAPQ (p=0.015) and histologic types of risk (p=0.008). It was also verified an association between the difference between the TVBPQ and TVAPQ and the predominant stromal tumor (p=0.037). When assessing the TVAPQ of all patients, without a cutoff, there was an association of the variable with lifetime (p=0.013), i.e., for each increase of 10mL in TVAPQ there was an average increase of 2% in the risk of death. CONCLUSIONS: Although our results indicate that the TVAPQ could be considered alone as a predictor of poor prognosis regardless of the cutoff suggested in the literature, more studies are needed to replace the histology and staging by tumor size as best prognostic variable.

Prognostic Factors and Nomograms to Predict Overall and Cancer-Specific Survival for Children with Wilms’ Tumor

“…As for tumor size, our study demonstrated that it was an independent prognostic factor and the risk increased as the tumor became larger. Other scholars drew a similar conclusion, and it was estimated that the risk of death increased by 2% if the tumor volume after preoperative chemotherapy increased by 10 ml [33].…”

Repercussões Na Vida De Cuidadores De Crianças E Adolescentes Com Doença Oncológica

“…O estágio do câncer e o tipo de tecido lesionado pelo tumor serão definidores para recidiva e a mortalidade. Os pontos desfavoráveis mais relevantes são estadiamentos avançados e a má formação de uma célula ou tecido, principalmente quando a quimioterapia não alcança mais o recurso almejado (3) .…”

Relação Entre Queixa Proctológica E Diagnóstico De Pacientes Referenciados a Um Ambulatório Universitário

“…Uma ressecção renal parcial só é permitida em casos precisamente designados, como na presença de desvantagens de desenvolvimento no outro rim, doenças geneticamente predispostas nas quais o risco de desenvolvimento de nefroblastoma é alto e em pacientes que só tem um rim. No geral não é recomendada a cirurgia poupadora de néfrons em pacientes com nefroblastoma unilateral sem a presença dos critérios acima mencionados (PROVENZI et al, 2015;HUSZNO et al, 2013). Entre as investigações realizadas na confirmação da presença de massa intrarenal primária a ultrassonografia abdominal ainda é a mais utilizada, além disso é usada para avaliar a extensão do tumor e o envolvimento do rim contralateral.…”