Long-term Outcome in Pediatric Renal Tumor Survivors

Abstract

Medical records of 30 children with renal tumor diagnosed at Siriraj Hospital during 1996 to 2007 were reviewed. Mean age at diagnosis was 36 months; male to female ratio was 1.7:1. Clinical manifestations included abdominal mass (96.7%), hypertension (40.0%), abdominal pain (36.7%), hematuria (26.7%), postrenal obstruction (16.7%), and proteinuria (13.3%). Eight patients had Denys-Drash malformations, WAGR, Dandy-Walker malformation, or genitourinary anomalies. Twenty-seven patients (90%) had Wilms tumor. Sixteen patients were stage 3 or more at diagnosis. Rhabdoid tumor was found in 3 patients. All patients received chemotherapy, 13 patients also received radiation therapy. Acute complications included febrile neutropenia (44.4%), hypokalemia (37.0%), hyponatremia (29.6%), Fanconi syndrome (11.1%), urinary tract Infection (10.0%), and acute renal failure (7.4%). Mean follow-up time was 57.2 months. Ten patients died from progressive disease. Five-year patient survival was 69.7%. Two patients had chronic kidney disease. One of these had Denys-Drash malformations. Both patients received ifosfamide-carboplatin-etoposide protocol and abdominal radiation. Antihypertensive medications were needed in 9 patients for a mean duration of 164 days. None had persistent proteinuria or hematuria. No difference was found among mean estimated glomerular filtration rate at diagnosis, 1 year after treatment, and at last follow-up. Long-term follow-up, especially renal function, is recommended.

Effectiveness of Nephron Sparing Surgery and Radical Nephrectomy in the Management of Unilateral Wilms Tumor: A Meta-Analysis

“…Thereafter, upon excluding the duplicates and applying the inclusion criteria, a total of 20 studies were retained. Thirteen of the included studies were retrospective cohort studies (12,15,(34)(35)(36)(37)(38)(39)(40)(41)(42)(43), whereas seven of the included studies were prospective cohort studies (44)(45)(46)(47)(48)(49)(50). Qualitative and quantitative data were then extracted from all the studies and summarized in Table 1.…”

“…The survival rate was compared in six studies. Here, 10 studies reported the survival rate of children operated with radical nephrectomy ( 12 , 37 – 40 , 43 – 45 , 47 , 50 ), whereas six studies reported the outcome after nephron sparing surgery ( 12 , 37 – 39 , 47 , 50 ). A mean survival rate of 90.6 ± 8.7% was reported in 4,623 children operated with radical nephrectomy during a mean follow-up of 5.9 ± 3.5 years.…”

“…Mean relapse rate was reported in 10 studies. Here, eight studies reported the survival rate of children operated with radical nephrectomy (35,37,38,40,44,45,47,50), whereas two studies reported the outcome after nephron sparing surgery (38,47). A mean relapse rate of 8 ± 8.8% was reported in 2,940 children operated with radical nephrectomy during a mean follow-up of 4.4 ± 3.4 years, whereas a mean relapse rate of 2 ± 2.8% was reported in 97 children operated with nephron sparing surgery during a mean follow-up of 3.6 ± 0.8 years.…”

Long noncoding RNA TUG1 promotes renal cell carcinoma cell proliferation, migration and invasion by downregulating microRNA‑196a

“…At present, a number of studies have reported that the abnormal expression of proteins is involved in regulating various RCC cell pathological processes, including proliferation, migration and invasion (22,23). Simultaneously, studies have detected noncoding RNAs in RCC cell genomes, which are considered to be important elements in modifying protein expression (5,22,23). Therefore, analyzing noncoding RNAs may be an effective way to examine novel potential biomarkers and their molecular mechanisms in the development of RCC.…”

“…Long noncoding RNA (lncRNA) is a class of noncoding transcribed RNA molecules with >200 bases. Emerging evidence has demonstrated that lncRNAs appear to be associated with a number of malignancies, and act as tumor oncogenes or suppressors, which regulate gene expression through regulation of transcription, post-transcription, genomic imprinting and chromatin modification (5)(6)(7). MicroRNAs (miRs) are a class of small noncoding RNAs of 17-22 nucleotides in length (8).…”