Tumor size and prognosis in patients with Wilms tumor

Valentina Oliveira Provenzi Rafael Fabiano Machado Rosa Rosana Cardoso Manique Rosa Adriana Vial Roehe Pedro Paulo Albino dos Santos Fabrízia Rennó Sodero Faulhaber Ceres Andréia Vieira de Oliveira Paulo Ricardo Gazzola Zen About the authors

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.

Wilms tumor; Organ size; Drug therapy; Prognosis; Survival analysis


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