Factors impacting survival in children with renal cell carcinoma

Abstract

Purpose Renal cell carcinoma (RCC) is an uncommon tumor in the pediatric population. We examined a large national cancer database to determine outcomes for children with RCC and to identify variables affecting long-term survival. Methods The National Cancer Data Base (NCDB) was queried for patients age 0 to 17 years diagnosed with RCC from 1998–2011. Patient demographics, tumor stage and characteristics, management, and outcomes were evaluated. Results A total of 304 children met inclusion criteria. Overall, 39% of children had stage I disease, 16% stage II, 33% stage III, and 12% stage IV. One-year and five-year survival for all children was 87% and 70%, respectively. Eighty-six percent of patients underwent surgical resection. In comparison to children who underwent complete nephrectomy, patients undergoing partial nephrectomy had smaller tumors and were of lower clinical stages. Survival following partial resection was 100% at one and five years. Age and gender had no significant impact on survival. Survival was negatively impacted by increasing tumor size (P < 0.001), positive nodal status (P = 0.001), and higher pathologic stage (P < 0.001). Conclusion Children with renal cell carcinoma who undergo surgical resection have excellent one-year and five-year survival. Overall survival is significantly affected by pathologic stage, tumor size, and nodal status.

Indications and results of diagnostic biopsy in pediatric renal tumors: A retrospective analysis of 317 patients with critical review of SIOP guidelines

“…Due to an overlap of phenotypical features between the various histological tumor types, tumor volume cannot on its own discriminate between WT and CCSK, both being large masses at diagnosis. Nevertheless, apart from screening in genetically predisposed patients, WT are rapidly growing tumors and are therefore usually very large at diagnosis, [37][38][39][40][41] whereas carcinomas and MRTK commonly presented as smaller masses in our series. Therefore, one objective of this study was to assess if the tumor volume could be used as a potential additional criterion for the indication of a biopsy at diagnosis.…”

Carcinoma renal con translocación xp11.2 en una infante

“…Indolfi P. et al realizaron un análisis retrospectivo de 41 pacientes, entre niños y adolescentes, con el cual demostraron que los pacientes con CCR tienen, en promedio, una tasa de sobrevida global de 63%, con tasas de sobrevida determinadas por el estadio clínico. Además, señalaron que entre los estadios I y IV hay una tasa de sobrevida de 92,4%, 84,6%, 72,7% y 13,9%, respectivamente (11) .…”

Distinguishing pediatric and adolescent renal cell carcinoma from other renal malignancies

“…In addition, technical challenges may increase the risk of positive margins and tumor spillage, which may alter prognosis and necessitate further chemotherapy . Data addressing this issue are sparse; however, retrospective series suggest that oncologic outcomes of NSS for pediatric RCC are comparable to radical nephrectomy . These studies suggest that NSS may be a reasonable option for a select population of pediatric RCC; however, this is still debated and would benefit from long‐term prospective trials.…”