Pan Ci, Cai Jiao-Yang, Xu Min, Ye Qi-Dong, Zhou Min, Yin Min-Zhi, Zhong Yu-Min, Chen Jing, Shen Shu-Hong, Tang Jing-Yan
, Shanghai, China.
Department of Hematology/Oncology, Shanghai Children's Medical Center, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
World J Pediatr. 2015 Nov;11(4):326-30. doi: 10.1007/s12519-015-0041-3. Epub 2015 Oct 11.
The clinical management of children with renal tumors including Wilms' tumor, clear cell sarcoma, rhabdoid tumor and other renal tumors in our center was designed according to the National Wilms' Tumor Study Group protocols.
A total of 142 consecutive patients who had been diagnosed as having renal tumors at Shanghai Children's Medical Center were reviewed retrospectively in the period of December 1998 and September 2012. Diagnosis and treatment were decided by a multidisciplinary team including oncologists, surgeons, pathologists and sub-specialized radiologists.
The median age of the patients at the time of diagnosis was 27 months. The tumor stages of the patients were as follows: stage I 24.6%, stage II 23.2%, stage III 32.3%, stage IV 14.1%, and stage V 5.6%. Favorable histology was diagnosed in 80.3%, anaplasia in 4.2%, clear cell sarcoma in 9.8%, rhabdoid tumor in 4.9%, and other renal tumors in 0.7% of the patients. The event-free and overall 5-year survival rates were 80% and 83%, respectively. Tumor relapse and progress was seen in 25 patients (17.6%). The median relapse time was 6 months (range: 2-37 months). Seven relapsing patients were retreated and four of them got second complete remission (three in stage II, one in stage I).
A multi-disciplinary team work model is feasible in developing countries, and the renal tumors protocols basically from developed countries are safe in developing countries.
我们中心对包括肾母细胞瘤、透明细胞肉瘤、横纹肌样瘤及其他肾肿瘤在内的儿童肾肿瘤的临床管理是依据美国国立肾母细胞瘤研究组的方案制定的。
回顾性分析了1998年12月至2012年9月期间在上海儿童医学中心连续诊断为肾肿瘤的142例患者。诊断和治疗由包括肿瘤学家、外科医生、病理学家和专科放射科医生在内的多学科团队决定。
患者诊断时的中位年龄为27个月。患者的肿瘤分期如下:I期24.6%,II期23.2%,III期32.3%,IV期14.1%,V期5.6%。80.3%的患者诊断为预后良好的组织学类型,4.2%为间变,9.8%为透明细胞肉瘤,4.9%为横纹肌样瘤,0.7%为其他肾肿瘤。无事件生存率和5年总生存率分别为80%和83%。25例患者(17.6%)出现肿瘤复发和进展。中位复发时间为6个月(范围:2 - 37个月)。7例复发患者接受了再次治疗,其中4例获得第二次完全缓解(3例II期,1例I期)。
多学科团队工作模式在发展中国家是可行的,基本源自发达国家的肾肿瘤治疗方案在发展中国家是安全的。