Department of Pediatrics, Ali-Asghar Children Hospital, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
J Med Life. 2020 Oct-Dec;13(4):484-489. doi: 10.25122/jml-2019-0084.
Wilms' tumor is the most common kidney tumor of childhood. The outcome of this malignant tumor has improved due to the improvement of therapeutic strategies. The most important factor in determining the prognosis of these patients is the histopathology subtype of the tumor; unfavorable histopathology is seen in only 11.5% of the patients, which accounts for 52% of deaths. Therefore, the aim of this study was to determine the outcome of children with Wilms' tumor referred to our hospital over a period of 10 years. This is a retrospective cohort study, and the target population included all patients with Wilms' tumor referred to Ali Asghar Hospital and were treated according to the National Wilms tumor study 4 (NWTS-4) protocol. All patients' data were extracted from the medical records of the department. Overall survival and event-free survival (EFS) were analyzed by the Kaplan Mayer method in the SPSS software, version 23. Fifty-two patients (24 male and 28 female patients) with Wilms' tumor were included. The mean age of the subjects was 40 months. The most common stage among boys and girls was stage II (23.08% and 28.85%, respectively). Our findings revealed that the overall five-year survival of patients was 87±5%; this figure was determined as 100% for boys and 76.8% ± 1.6 for girls (P = 0.018). Our findings show a dramatic improvement in the outcome of children with Wilms's tumor, and our results are comparable with other results from developed countries. Gender may be an independent prognostic factor of children with Wilms' tumor.
威尔姆斯瘤是儿童最常见的肾肿瘤。由于治疗策略的改进，这种恶性肿瘤的预后得到了改善。决定这些患者预后的最重要因素是肿瘤的组织病理学亚型；不良的组织病理学仅见于 11.5%的患者，占死亡人数的 52%。因此，本研究旨在确定在过去 10 年期间我院收治的儿童威尔姆斯瘤患者的结局。这是一项回顾性队列研究，目标人群包括所有根据国家威尔姆斯肿瘤研究 4（NWTS-4）方案在阿里阿萨格尔医院就诊并接受治疗的威尔姆斯瘤患者。所有患者的数据均从该部门的病历中提取。使用 SPSS 软件版本 23 的 Kaplan Mayer 法分析总生存率和无事件生存率（EFS）。共纳入 52 例（男 24 例，女 28 例）威尔姆斯瘤患者。受试者的平均年龄为 40 个月。男孩和女孩中最常见的分期为 II 期（分别为 23.08%和 28.85%）。我们的研究结果表明，患者的总体五年生存率为 87±5%；这一数字在男孩中为 100%，在女孩中为 76.8%±1.6%（P=0.018）。我们的研究结果表明，威尔姆斯肿瘤患儿的预后有显著改善，我们的结果与发达国家的结果相当。性别可能是威尔姆斯肿瘤患儿的一个独立预后因素。
