在一个中低收入国家，改善了患有Wilms肿瘤的儿童的预后：儿科肿瘤学家对成功管理的贡献

IF 2.4 3区医学 Q2 UROLOGY & NEPHROLOGY

Asian Journal of Urology Pub Date : 2025-01-01 DOI:10.1016/j.ajur.2024.04.008

Usama Al-Jumaily , Hamid D. Habeeb Rjeib , Mohammed Fawzi Alqanbar , Safa Faraj , Dheyaa Aldeen Al-Khateeb

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引用次数: 0

摘要

目的儿童肾母细胞瘤（Wilms ' tumor， WT）的治疗在很大程度上依赖于多学科治疗策略。在缺乏适当的多学科团队的情况下，我们回顾了患有WT的儿童的数据，以确定他们的结果。该研究的主要目的是强调儿科肿瘤学家在低收入和中等收入国家WT管理中的作用，考虑到各种可用的初始治疗方法，缺乏多学科护理和克服障碍的管理策略。方法回顾性招募2014年1月至2021年12月在伊拉克一家大型三级医院诊断的年龄在18岁或以下的WT患者。最初，患者接受预处理活检、术前化疗或前期肾切除术。结果本研究共纳入54例患者。中位年龄为3.3岁。I期和III期患者分别为24例（44%）和12例（22%）。7例患者进行了预处理活检。23例患者行前期肾切除术。仅有2例患者的组织学表现为不良。20例患者术中并发症未披露。平均3年估计无事件生存率为64%（标准差6.6%），平均总生存率为76%（标准差6.8%）。不同疾病阶段间差异有统计学意义（p < 0.001）。与延长至2021年12月的研究相比，上一期研究2014年1月至2017年12月的总生存率仅为40%。结论在低收入和中等收入国家，儿童WT治疗可以取得令人满意的结果。获得针对低收入和中等收入国家的循证战略和多学科方法可能会使结果升级。

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Improved outcomes of children with Wilms’ tumor in a low-middle-income nation: The contribution of a pediatric oncologist to successful management

Objective

The treatment of Wilms’ tumor (WT) in children largely relies on a multidisciplinary strategy. In the absence of an appropriate multidisciplinary team, we reviewed the data of children with WT to determine their outcomes. The primary goal of the study was to highlight the role that a pediatric oncologist plays in the management of WT in low- and middle-income countries, taking into account the variety of initial treatments available, the lack of multidisciplinary care, and management strategies to overcome obstacles.

Methods

Retrospective recruitment was used to identify patients, aged 18 years or under, with WT diagnosis, in a major tertiary hospital in Iraq between January 2014 and December 2021. Initially, patients were treated with a pretreatment biopsy, preoperative chemotherapy, or upfront nephrectomy.

Results

In this study, 54 patients were enrolled. The median age was 3.3 years. The numbers of patients with stages I and III are 24 (44%) and 12 (22%), respectively. Seven patients had pretreatment biopsies. In 23 patients, upfront nephrectomy was performed. The histology of only two patients was unfavorable. In 20 patients, intraoperative complications were not disclosed. The mean 3-year estimated event-free survival was 64% (standard deviation 6.6%) and the mean overall survival was 76% (standard deviation 6.8%). There was a significant statistical difference according to stages of disease (p<0.001). Compared with the extended study until December 2021, the overall survival of the previous study from January 2014 to December 2017 was only 40%.

Conclusion

Promising results for pediatric WT can be attained in low- and middle-income nations. Acquiring an evidence-based strategy tailored to a low- and middle-income country and a multidisciplinary approach may escalate the outcome.

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来源期刊

Asian Journal of Urology UROLOGY & NEPHROLOGY-

CiteScore

4.00

自引率

3.80%

发文量

100

审稿时长

4 weeks

期刊介绍： Asian Journal of Urology (AJUR), launched in October 2014, is an international peer-reviewed Open Access journal jointly founded by Shanghai Association for Science and Technology (SAST) and Second Military Medical University (SMMU). AJUR aims to build a communication platform for international researchers to effectively share scholarly achievements. It focuses on all specialties of urology both scientifically and clinically, with article types widely covering editorials, opinions, perspectives, reviews and mini-reviews, original articles, cases reports, rapid communications, and letters, etc. Fields of particular interest to the journal including, but not limited to: • Surgical oncology • Endourology • Calculi • Female urology • Erectile dysfunction • Infertility • Pediatric urology • Renal transplantation • Reconstructive surgery • Radiology • Pathology • Neurourology.