Title: Wilms' Tumor in Children: An Experience of SIOP Protocol from Tertiary Centre
Authors: Anirban Chatterjee, Malay Kumar Sinha, Suman Sarkar,Bidhan Chandra Roy,Risavdeb Patra
DOI: http://dx.doi.org/10.18535/jmscr/v3i9.21
Abstract
Background: Wilms’ tumor is the commonest renal .tumor. Survival depends on stage and biologic behavior and economic settings. International Society of Pediatric Oncology (SIOP) has laid down protocol for developing country.
Methods:Prospective observational study. aged 1-12 year with wilms’ tumor department of Pediatrics IPGMER, Kolkata .fromFebruary 2009- August 2012.. All cases are managed according to SIOP 2001protocol. Follow-up for 2 to 4 years Prognosis is noted in terms of local recurrence or metastasis and overall survival.
Results:Out of 8 children male 5 and female 3with age of presentation ranging from 3-12 year (median-5 year). Abdominal lump is the main clinical presentation along with hematuria in 2 and hypertension in 1 child. Clinically and histologically 6 of the children was on stage 1 and 2 were on stage 2. . Out of 8 children, 1 child died soon after nephrectomy due to postoperative complications. Remaining 7 children are disease free till date with no evidence of local recurrence or metastasis.
Conclusions: SIOP protocol can be used in management of pediatric Wilms' tumor Stage I and II with excellent prognosis in our settings. However more studies are needed to bring SIOP protocol in treatment of Wilms tumor in India or develop own protocol for our country.
References
Willetts IE. Jessop and the Wilms’ tumor. J Pediatr Surg2003;38:1496–1498.
Kalapurakal JA, Dome JS, Perlman EJ et al. Management of Wilms’ tumour: current practice and future goals. Lancet Oncol2004;5:37–46.
Vujanic GM, Sandstedt B, Harms D et al. Revised International Society of Paediatric Oncology (SIOP) working classification of renal tumors of childhood. Med Pediatr Oncol2002;38:79–82.
Green DM, Breslow NE, Beckwith JB et al. Treatment with nephrectomy only for small, stage I/favorable histology Wilms’ tumor: a report from the National Wilms’ Tumor Study Group. J Clin Oncol2001;19:3719–3724.
Bhatnagar S. J Indian Assoc Pediatr Surg. 2009 14(1): 6–14.
Israels T. , Moreira C., Scanlan T. SIOP PODC: Clinical Guidelines for the Management of Children With Wilms Tumour in a Low Income Setting. Pediatr Blood Cancer: DOI 10.1002/pbc.24321
Arora RS, Pizer B , Eden T. Understanding Refusal and Abandonment in the Treatment of Childhood Cancer.Indian Pediatr 2010;47: 1005-1010
Bhalodia J N, Patel M M. Profile of Pediatric Malignancy: A three year Study. National Journal of Community Medicine.2011; 2 (1) : 24-27
Rathi A.K., Kumar S., Ashu A., Singh K. and Bahadur A.K. Epidemiology of pediatric tumors at a teriary care centre. Indian J Med Paediatr Oncol. 2007; 28(2): 33-5
Gurney J.G., Severson R., Devis S, Robinson L.L. Incidence of cancer in children in United States. Cancer 1995; 75(8): 2186-95
Breslow N, Olshan A, Beckwith JB, Green DMEpidemiology of Wilms tumor.Med Pediatr Oncol. 1993;21(3):172-81.
Gupta DK, Sharma S, Agarwala S, Carachi R. Saga of Wilms' tumor: Lessons learnt from the past. J Indian Assoc Pediatr Surg [serial online] 2005 [cited 2015 Aug 28];10:217-28
Tongaonkar HB, Qureshi SS, Purna A. Kurkure PA, et al. Wilms' tumor: An update.Indi an J Urol . 2007 OctDec; 23(4): 458–466.
Graf N, Tournade MF, de Kraker J. The role of preoperative chemotherapy in the management of Wilms’ tumor. The SIOP studies. International Society of Pediatric Oncology. Urol Clin North Am 2000;27:443–454.
Israels T, Borgstein E, Pidini D, et al. Management of children with a Wilms tumour in Malawi, subSaharan Africa. J Pediatr Hematol Oncol 2012; DOI:10.1097/MPH.0b013e3182580921
Moreira C, Nachef MN, Ziamati S, et al. Treatment of nephroblastoma in Africa: Results of the first French African pediatric oncology group (GFAOP) study. Pediatr Blood Cancer 2012;58:37–42.
Abuidris DO, Elimam ME, Nugud FM, et al. Wilms tumour in Sudan. Pediatr Blood Cancer 2008;50:1135–1137.
Israels T. Wilms tumor in Africa: Challenges to cure. Pediatr Blood Cancer 2012;58:3–4.
Wilde JC, Lameris W, van Hasselt EH, et al. Challenges and outcome of Wilms’ tumour management in a resource-constrained setting. Afr J Paediatr Surg 2010;7:159–162.
De Campo JF. Ultrasound of Wilms’ tumor. Pediatr Radiol 1986;16:21–24.
Lowe LH, Isuani BH, Heller RM, et al. Pediatric renal masses: Wilms tumor and beyond. Radiographics 2000;20:1585–1603
Tournade MF, Com-Nougue C, de Kraker J et al. Optimal duration of preoperative therapy in unilateral and nonmetastatic Wilms’ tumor in children older than 6 months: results of the Ninth International Society of Pediatric Oncology Wilms’ Tumor Trial and Study. J Clin Oncol 2001;19:488–500.