Outcomes of event-free survival in patients with Wilms tumor undergoing preoperative chemotherapy. Analysis of lymph-node yield in a single-center cohort.

摘要: Summary Introduction The clinical value of lymph node sampling in Wilms tumor (WT) lies its ability to accurately determine (LN) involvement. LN yield (LNY) is used as a valuable tool measure retrieval, and minimum 6 LNs one the current recommendations. In patients who are managed with SIOP strategy, preoperative chemotherapy decreases retrieval during surgery resulting lower LNY values. Purpose To mean analyze survival outcomes WT underwent at single center. Methods We performed retrospective chart review all between months 12 years age unilateral 2010 2018. Patients bilateral or without were excluded. Collected data included: demographics, volume, histopathology, number collected (LNY), presence absence retrieved LNs, disease stage according these results. Kaplan Meier curves calculated estimate 5-year event-free (EFS) overall (OS). Results 95 median follow-up 25 included study. A total 19 laparoscopic surgery. Mean for entire cohort was 3.26 (95% CI, 2.4–3.6; SD, 3.62). Six (6.3%) had least positive LN. estimated OS 89.3% 82.1%–96.5%). EFS 79.8 74.8%–84.8%). Recurrence rate 20% (n: 19). Four (4.2%) developed local recurrence 15 (15.7%) pulmonary recurrence. initial that relapsed 4.16 2.2–5.8; SD: 4.18), which higher than did not relapse (LNY: 3; 95% 2.33–3.67; 3.39). No recurrences deaths occurred group. Discussion identification (i.e. threshold) minimize risk harboring occult metastatic has been proposed standardize surgical procedure. Preliminary results this study suggest limited acceptable possible scenario treated protocol. Systematic reduce false negatives still strongly recommended. Conclusion Our presented relatively low compared standard EFS, however, remained acceptable. Multivariate analysis would be necessary actual role an isolated prognostic factor WT.