Successful Treatment of Renal Vein and Vena Caval Extension of Nephroblastoma by Preoperative Chemotherapy

Kogan, Stanley J.; Marans, Hillel Y.; Santorineau, M.; Schneider, Keith M.; Reda, Edward F.; Levitt, Selwyn B.

doi:10.1016/s0022-5347(17)44852-x

Cited by 24 publications

(9 citation statements)

References 12 publications

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“…Preoperative chemotherapy has not been extensively used in the management of intravascular nephroblastoma [9]. Our experience with these patients indicated that it can successfully eradicate all of the tumor thrombus including thrombus extending as far as the right atrium.…”

Section: Discussionmentioning

confidence: 97%

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Successful management of inferior vena cava and right atrial nephroblastoma tumor thrombus with preoperative chemotherapy

Oberholzer

Falkson

Jager

1992

Med. Pediatr. Oncol.

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Involvement of inferior vena cava (IVC) by tumor thrombus occurs in up to 10% of patients with nephroblastoma. Right atrial involvement by tumor thrombus is much less frequent. Four patients presenting with advanced nephroblastoma were diagnosed as having IVC involvement with tumor thrombus. Two of these patients had in addition thrombus extending up to the right atrium. All 4 patients were treated with preoperative chemotherapy (vincristine, actinomycin D, 4-epi-Adriamycin). Nephrectomy was subsequently performed without undue difficulty on all 4 patients. The intravascular tumor thrombus had completely cleared in all 4 patients and most of the primary renal tumor was necrotic. The results obtained with preoperative chemotherapy as given to these patients mediates strongly against difficult surgery being undertaken as primary treatment for such patients.

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Section: Discussionmentioning

confidence: 97%

“…There are few reports in the literature of chemotherapy being used to manage intravascular nephroblastoma [9,12]. We use preoperative chemotherapy in the management of nephroblastoma, because of a very high incidence of inoperable tumors.…”

Section: Introductionmentioning

confidence: 99%

Successful management of inferior vena cava and right atrial nephroblastoma tumor thrombus with preoperative chemotherapy

Oberholzer

Falkson

Jager

1992

Med. Pediatr. Oncol.

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“…[181920] However, the toxicity of conventional systemic chemotherapy affords limited effectiveness and frequently compromises the quality of life for patients. In this context, it should be noticed that targeted or localized drug delivery should be the major goal of chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Clinico-immunological response to intratumoral versus intravenous neoadjuvant chemotherapy in advanced pediatric solid malignancies

Kumar

Pandey

et al. 2013

Indian Journal of Medical and Paediatric Oncology

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Background:There is minimal literature on the use of intralesional chemotherapy in the pediatric age group. We undertook this present study to evaluate the two modalities (intratumoral and intravenous) of giving chemotherapy in terms of toxicity of chemotherapy, hematological parameters, efficacy of chemotherapy in reduction in volume of the tumor as well as resectability of tumor with special emphasis on immunological parameters.Materials and Methods:Advanced cases of Wilms’ tumor and Neuroblastoma were included in the study. Intratumoral chemotherapy was given through 25 G spinal needle under aseptic precautions and ultrasound guidance in the same dose as in systemic chemotherapy. Intravenous group was given chemotherapy in the usual way. Reassessment was carried out after every course of chemotherapy.Results:Group A included 16 cases of Wilms’ tumor and 6 cases of neuroblastoma. In group B, there were 14 cases of Wilms’ tumor and 8 of neuroblastoma. Vomiting, diarrhea, mucositis, and thrombophlebitis were more common in the intravenous group (P<0.05). The fall in Immunoglobulin A, Immunogloblulin G, Immunoglobulin M, and T-cell rosetting was more common in the intravenous group (P<0.05). Seventy percent of patients had completely resectable tumor at the end of 6 doses of intratumoral chemotherapy as compared to 50% resectability in the intravenous group (P<0.05).Conclusion:Intratumoral chemotherapy, besides causing less of the adverse effects and increasing the resecability rate, also causes less suppression of the immune system. This may be offered as an alternative safe and effective modality of treatment for advanced solid tumors.

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“…Preoperative imaging detects renal vein involve ment in only a few patients, but intracaval thrombus There are reports that preoperative chemotherapy and radiation therapy can be successful in shrinking intravascular tumor extension before surgery [17][18][19], This therapy has produced extensive shrinkage of large tumor extensions into the IVC, simplifying later removal of the renal mass. In one report, a patient with renal vein thrombus was treated with preoperative chemotherapy because of bilateral disease, but the extrarenai thrombus resolved entirely [17], One publication, however, de scribes increased difficulty in removing the thrombus because of dense adherence to the vein wall after preop erative chemotherapy [20], None of the patients in our study received preoperative chemotherapy. Patients who have undergone preoperative chemotherapy are ex cluded from randomization in the NWTS, and therefore any patients with intracaval extension who received pre operative chemotherapy were excluded from this re view.…”

Section: 5mentioning

confidence: 99%

Renal Vein Involvement with Nephroblastoma: A Report of the National Wilms’ Tumor Study-3

Ml¹,

Hb²,

Aa³

et al. 1990

Eur Urol

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Successful Treatment of Renal Vein and Vena Caval Extension of Nephroblastoma by Preoperative Chemotherapy

Cited by 24 publications

References 12 publications

Successful management of inferior vena cava and right atrial nephroblastoma tumor thrombus with preoperative chemotherapy

Successful management of inferior vena cava and right atrial nephroblastoma tumor thrombus with preoperative chemotherapy

Clinico-immunological response to intratumoral versus intravenous neoadjuvant chemotherapy in advanced pediatric solid malignancies

Renal Vein Involvement with Nephroblastoma: A Report of the National Wilms’ Tumor Study-3

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