Treatments and outcomes for end-stage renal disease following Wilms tumor

被引:21
作者
Grigoriev, Yevgeny [2 ]
Lange, Jane [1 ]
Peterson, Susan M. [2 ]
Takashima, Janice R. [2 ]
Ritchey, Michael L. [3 ]
Ko, Dicken [4 ,5 ,6 ]
Feusner, James H. [7 ,8 ]
Shamberger, Robert C. [9 ]
Green, Daniel M. [10 ]
Breslow, Norman E. [1 ,2 ]
机构
[1] Univ Washington, Dept Biostat, Seattle, WA 98195 USA
[2] Fred Hutchinson Canc Res Ctr, Dept Biostat & Bioinformat, Seattle, WA 98104 USA
[3] Phoenix Childrens Hosp, Dept Urol, Phoenix, AZ USA
[4] Massachusetts Gen Hosp, Dept Surg, Boston, MA 02114 USA
[5] Massachusetts Gen Hosp, Dept Urol, Boston, MA 02114 USA
[6] Massachusetts Gen Hosp, Dept Pediat Surg, Boston, MA 02114 USA
[7] Childrens Hosp, Dept Hematol Oncol, Oakland, CA 94609 USA
[8] Res Ctr Oakland, Oakland, CA USA
[9] Childrens Hosp, Dept Surg, Boston, MA 02115 USA
[10] St Jude Childrens Res Hosp, Dept Epidemiol & Canc Control, Memphis, TN 38105 USA
关键词
Chronic kidney failure; Transplantation; Graft failure; DENYS-DRASH-SYNDROME; CANCER-RISK; TRANSPLANTATION; SURVIVAL; CHILDREN;
D O I
10.1007/s00467-012-2140-x
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Little is known about treatment outcomes for children who have end-stage renal disease (ESRD) after treatment for Wilms tumor (WT). Time-to-transplant, graft failure, and survival outcomes were examined for 173 children enrolled on the National Wilms Tumor Study who developed ESRD. Fifty-five patients whose ESRD resulted from progressive bilateral WT (PBWT) experienced high early mortality from WT that limited their opportunity for transplant (47% at 5 years) and survival (44% at 10 years) in comparison to population controls. The 118 patients whose ESRD was due to other causes (termed "chronic kidney disease"), many of whom had WT-associated congenital anomalies, had transplant (77% at 5 years) and survival (73% at 10 years) outcomes no worse than those for population controls. Graft failure following transplant was comparable for the two groups. Minority children had twice the median time to transplant as non-Hispanic whites and twice the mortality rates, also reflecting population trends. In view of the continuing high mortality in patients with ESRD, and the dramatic improvement in outlook following kidney transplantation, re-evaluation of current guidelines for a 2-year delay in transplant following WT treatment may be warranted.
引用
收藏
页码:1325 / 1333
页数:9
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