临床小儿外科杂志2024，Vol.23Issue(4)：372-376,5.DOI:10.3760/cma.j.cn101785-202304039-013
单侧肾母细胞瘤新辅助化疗后保留肾单位手术的初步疗效分析
Preliminary analysis of nephron sparing surgery for unilateral Wilms tumor after neoadjuvant chemo-therapy
摘要
Abstract
Objective To explore the preliminary therapeutic efficacy of nephron sparing surgery(NSS)for unilateral Wilms tumor after neoadjuvant chemotherapy.Methods From January 2014 to December 2020,retrospective analysis was conducted for the relevant clinical data of 7 children hospitalized with unilateral Wilms tumer(uWT)receiving neoadjuvant chemotherapy and undergoing NSS.Clinical parameters of tumor re-currence,renal function,and survival rate were recorded.And treatment outcomes were compared with matched cases of radical nephrectomy(RN)during the same period.Results There were 4 boys and 3 girls with an onset age of(38.86±18.23)(16-55)month.There was no tumor-related syndrome or hemihypertrophy.Re-nal tumor was located at pole(n=1)and center(n=6).After neoadjuvant chemotherapy,tumor shrank by(66.4％±18.6％)(53.3％-93.9％).One child with a pole renal tumor underwent partial nephrectomy(PN)while the remainders tumor enucleation(TE).Postoperative pathological examination indicated that mi-croscopic tumor margins were positive(n=2).According to SIOP staging,the stages were Ⅱ(n=4)and Ⅲ(n=3).During a follow-up period of(38.42±10.17)(27-64)month,no case became lost or died.There were tumor-free survival(n=6)and 1 tumor-bearing survival(n=1).Two cases had tumor recurrence after NSS surgery.No statistically significant difference existed in recurrence rate(28.6％)and 5-year survival rate(100％)after NSS as compared with recurrence rate(13.3％)and 5-year survival rate(86.9％)of RN in the same period.Conclusions For uWT,proper preoperative evaluations and neoadjuvant chemotherapy may boost the proportion of NSS surgery and achieve similar therapeutic outcomes as RN.关键词
Wilms瘤/外科手术/放化疗,辅助/治疗结果Key words
Wilms Tumor/Surgical Procedures,Operative/Chemoradiotherapy,Adjuvant/Treatment Outcome引用本文复制引用
姚伟,宋治莹,杨家健,李凯,沈剑,董岿然..单侧肾母细胞瘤新辅助化疗后保留肾单位手术的初步疗效分析[J].临床小儿外科杂志,2024,23(4):372-376,5.基金项目
唐仲英基金会(ZSBK0070) （ZSBK0070）
厦门市小儿外科疾病重点实验室开放课题(CHP-2023-XKL-009) Cyrus Tang Foundation(ZSBK0070) （CHP-2023-XKL-009）
Xiamen Key Laboratory of Pediatric Comprehen-sive Surgical Diseases(CHP-2023-XKL-009) （CHP-2023-XKL-009）
