Tumor size and prognosis in patients with Wilms tumor

• Autor(a) principal: Provenzi,Valentina Oliveira
• Data de Publicação: 2015
• Outros Autores: Rosa,Rafael Fabiano Machado, Rosa,Rosana Cardoso Manique, Roehe,Adriana Vial, Santos,Pedro Paulo Albino dos, Faulhaber,Fabrízia Rennó Sodero, Oliveira,Ceres Andréia Vieira de, Zen,Paulo Ricardo Gazzola
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Revista Paulista de Pediatria (Ed. Português. Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822015000100082
• topic: Wilms tumor; Organ size; Drug therapy; Prognosis; Survival analysis

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.