Clinical and prognostic characteristics of bilateral Wilms tumor: a multi-center institutional retrospective cohort study experience from China

被引：0

作者：

Shen Yang ^{[1
]}

Jing-Hao Yan ^{[1
]}

Jin-Hu Wang ^{[2
]}

Hong Qin ^{[1
]}

Wei Yang ^{[1
]}

Kui-Ran Dong ^{[3
]}

Jun-Cheng Liu ^{[4
]}

Min Xu ^{[5
]}

Yi-Zhuo Zhang ^{[6
]}

Jian-Guo Zhang ^{[7
]}

Ye-Ming Wu ^{[8
]}

Qiang Zhao ^{[9
]}

Shan Wang ^{[10
]}

Jing-Fu Wang ^{[11
]}

Jian Chang ^{[12
]}

Rong-De Wu ^{[13
]}

Xiang-Ling He ^{[14
]}

Tao Li ^{[15
]}

Yan Su ^{[16
]}

Ju Gao ^{[17
]}

Hui Li ^{[18
]}

Xiao-Mei Yang ^{[19
]}

Xiao-Juan Wu ^{[20
]}

De-Guang Meng ^{[21
]}

Paul D. Losty ^{[24
]}

Chan Hon Chui ^{[25
]}

Xiao-Feng Chang ^{[1
]}

Hong-Cheng Song ^{[22
]}

Huan-Min Wang ^{[1
]}

机构：

[1] Department of Surgical Oncology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing

[2] Department of Surgical Oncology, Children’s Hospital Zhejiang University School of Medicine, Hangzhou

[3] Department of Pediatric Surgery, Children’s Hospital of Fudan University, National Center for Children’s Health, Shanghai

[4] Department of Pediatric Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou

[5] Department of General Surgery, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, National Center for Children’s Health, Shanghai

[6] Department of Pediatric Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou

[7] Department of Pediatric Surgery, Inner Mongolia Maternal and Child Health Care Hospital, Hohhot

[8] Department of Pediatric Surgery, Xinhua Hospital Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai

[9] Department of Children’s Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin Cancer Clinical Research Center, Tianjin

[10] Department of Surgical Oncology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing

[11] Department of Pediatric Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan

[12] Department of Pediatric Oncology, Children’s Medical Center, the First Hospital of Jilin University, Changchun

[13] Department of Pediatric Surgery, Shandong Provincial Hospital, Jinan

[14] Department of Pediatric Hematology and Oncology, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha

[15] Department of Oncology Surgery, Children’s Hospital of Nanjing Medical University, Nanjing

[16] Department of Medical Oncology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing

[17] Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu

[18] Department of Oncology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Huazhong University of Science and Technology, Wuhan

[19] Department of Hematology and Oncology, Children’s Hospital Affiliated to Shandong University, Jinan Children’s Hospital, Jinan

[20] Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan

[21] Department of Surgical Oncology, Baoding Hospital of Beijing Children’s Hospital, Baoding

[22] Department of Urology Surgery, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing

[23] MOE Key Laboratory of Major Diseases in Children, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing

[24] Institute of Systems Molecular and Integrative Biology, University of Liverpool, Liverpool

[25] Surgery Center for Children, Mount Elizabeth Hospital, Singapore

来源：

World Journal of Pediatrics | 2025年 / 21卷 / 4期

关键词：

Bilateral Wilms tumor; Neoadjuvant chemotherapy; Nephron-sparing surgery; Prognostic factors;

D O I：

10.1007/s12519-025-00895-6

中图分类号：

学科分类号：

摘要：

Background: This multi-center analysis of data from China reviews the management and long-term outcomes of patients with bilateral Wilms tumors (BWT), and explores prognostic risk factors. Methods: We retrospectively analyzed a cohort of pediatric patients with synchronous BWT treated at 18 pediatric oncology centers in China between 2006 and 2023. The overall survival (OS) and event-free survival (EFS) rates were calculated using Kaplan–Meier methodology. Prognostic risk factors were determined using univariable and multivariable analysis. Results: A total of 167 patients with BWT and a median age at diagnosis of 13 months (range 0–78 months) were included in the study. Neoadjuvant chemotherapy was administered to 149 index cases; tumor biopsy was performed before initiating chemotherapy in 70 patients. One hundred and three children underwent bilateral nephron-sparing surgery (NSS) and two hundred fifty-two of the three hundred one kidneys underwent NSS. The four-year OS and EFS rates in the study cohort were 86.5% and 77.8%. After a median follow-up of 50 months, four patients developed renal failure requiring dialysis and a single patient received a kidney transplant 26 months postoperatively. Conclusions: Regarding prognostic factors, the results of the multifactor analysis indicate that distant metastasis and positive surgical margins have negative impacts on OS and distant metastasis had a negative effect on EFS. Distant metastasis and positive surgical margins affect the long-term prognosis of BWT. 1QNvutR1ca4Y5v-Jz6WysKVideo Abstract (MP4 19393 KB). © Children's Hospital, Zhejiang University School of Medicine 2025.

引用

页码：386 / 395

页数：9

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