Portal de Periódicos da CAPES

Pediatric Renal Cell Carcinoma: Single Institution 25-Year Case Series and Initial Experience With Partial Nephrectomy

2006; Lippincott Williams & Wilkins; Volume: 175; Issue: 4 Linguagem: Inglês

10.1016/s0022-5347(05)00671-3

1527-3792

Anthony Cook, Armando J. Lorenzo, João L. Pippi Salle, Manijeh Bakhshi, Lisa Cartwright, Darius Bagi, Walid A. Farhat, Antoine E. Khoury,

Pediatric Urology and Nephrology Studies

No AccessJournal of UrologyAdult urology1 Apr 2006Pediatric Renal Cell Carcinoma: Single Institution 25-Year Case Series and Initial Experience With Partial Nephrectomy Anthony Cook, Armando J. Lorenzo, Joao L. Pippi Salle, Manijeh Bakhshi, Lisa M. Cartwright, Darius Bagi, Walid Farhat, and Antoine Khoury Anthony CookAnthony Cook , Armando J. LorenzoArmando J. Lorenzo , Joao L. Pippi SalleJoao L. Pippi Salle , Manijeh BakhshiManijeh Bakhshi , Lisa M. CartwrightLisa M. Cartwright , Darius BagiDarius Bagi , Walid FarhatWalid Farhat , and Antoine KhouryAntoine Khoury View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)00671-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: RCC represents less than 2% to 6% of pediatric renal tumors. Few reports of long-term outcomes exist. We sought to determine the presentation, treatment and outcome of patients at our institution. Materials and Methods: We retrospectively reviewed the age, mode of presentation, mode of treatment, histological subtype, tumor grade, stage and survival of all patients with RCC from 1980 to 2005. Results: A total of 15 patients were identified. Mean age at presentation was 7.9 years. Symptomatic presentations in nearly 75% of patients included gross hematuria, abdominal pain and polycythemia. The remaining 25% of cases were asymptomatic, and were identified by physical examination or incidentally on imaging. Surgical resection consisted of radical nephrectomy in 10 patients and partial nephrectomy in 5. Pathological analysis revealed papillary RCC in 8 patients and clear cell RCC in 7. Six patients had high stage disease. One patient with stage IV disease died 8 months postoperatively. The remaining 14 patients were alive at a mean followup of 4.9 years. All but 1 patient remain recurrence-free, including all of those who underwent nephron sparing surgery. Conclusions: To our knowledge this single institution series is the first to include children treated with partial nephrectomy. Pediatric patients with RCC tend to be older and more likely to present symptomatically compared to the typical patient with Wilms tumor. Hematuria and abdominal pain were the most common presentations, and papillary RCC was proportionately more common in this series. Our initial experience suggests that equivalent cure rates can be expected from a nephron sparing approach in appropriately selected cases. References 1 : Thirty-year population-based review of childhood renal tumours with an assessment of prognostic features including tumour DNA characteristics. Med Pediatr Oncol1993; 21: 24. Google Scholar 2 : Chemotherapy for advanced renal-cell carcinoma: 1983-1993. Semin Oncol1995; 22: 42. Google Scholar 3 : Nephrectomy and interleukin-2 for metastatic renal-cell carcinoma. N Engl J Med2001; 345: 1711. Google Scholar 4 : Immunotherapy in renal cell carcinoma. Oncology (Williston Park)1999; 13: 801. Google Scholar 5 : Disease outcome in patients with low stage renal cell carcinoma treated with nephron sparing or radical surgery. J Urol1996; 155: 1868. Link, Google Scholar 6 : Management of small unilateral renal cell carcinomas: radical versus nephron-sparing surgery. Urology1995; 45: 34. Google Scholar 7 : Local lymph node involvement does not predict poor outcome in pediatric renal cell carcinoma. Cancer2004; 101: 1575. Google Scholar 8 : Prognostic significance of morphologic parameters in renal cell carcinoma. Am J Surg Pathol1982; 6: 655. Google Scholar 9 : Renal-cell carcinoma in children: a different disorder from its adult counterpart?. Med Pediatr Oncol1998; 31: 153. Google Scholar 10 : Renal cell carcinoma in children. Can J Surg1979; 22: 412. Google Scholar 11 : The role of partial nephrectomy for renal cell carcinoma in contemporary practice. Urol Clin North Am2003; 30: 529. Google Scholar 12 : Nephron sparing surgery for localized renal cell carcinoma: impact of tumor size on patient survival, tumor recurrence and TNM staging. J Urol1999; 162: 1930. Link, Google Scholar 13 : Efficacy of nephron-sparing surgery for renal cell carcinoma: analysis based on the new 1997 tumor-node-metastasis staging system. J Clin Oncol1999; 17: 2868. Google Scholar 14 : Expanding indications for conservative renal surgery in renal cell carcinoma. Urology1994; 43: 160. Google Scholar 15 : Renal cell carcinoma in the solitary kidney: an analysis of complications and outcome after nephron sparing surgery. J Urol2002; 168: 454. Link, Google Scholar 16 : Renal cell carcinoma in children: a clinicopathologic study. J Clin Oncol2003; 21: 530. Google Scholar Division of Urology and Department of Pathology, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada© 2006 by American Urological AssociationFiguresReferencesRelatedDetailsCited byAkhavan A, Richards M, Shnorhavorian M, Goldin A, Gow K and Merguerian P (2018) Renal Cell Carcinoma in Children, Adolescents and Young Adults: A National Cancer Database StudyJournal of Urology, VOL. 193, NO. 4, (1336-1341), Online publication date: 1-Apr-2015. Volume 175Issue 4April 2006Page: 1456-1460 Advertisement Copyright & Permissions© 2006 by American Urological AssociationKeywordscarcinomarenal cellretrospective studieschildrennephrectomyMetricsAuthor Information Anthony Cook More articles by this author Armando J. Lorenzo More articles by this author Joao L. Pippi Salle More articles by this author Manijeh Bakhshi More articles by this author Lisa M. Cartwright More articles by this author Darius Bagi More articles by this author Walid Farhat More articles by this author Antoine Khoury More articles by this author Expand All Advertisement PDF downloadLoading ...