Influence of Pulmonary Nodules on Chest Computed Tomography and Risk of Recurrence in Stage IV Wilms Tumor

International Journal of Radiation Oncology, Biology, Physics
Robert S KirklandNatia Esiashvili

Abstract

Chest computed tomography (CT) is currently accepted as the main modality for initial disease staging and response assessment in Wilms tumor (WT). However, there is great variability in the number and size of lung metastases at the time of diagnosis and after induction chemotherapy. There is a lack of clinical evidence as to how this variability in tumor burden affects choice of therapy and disease outcome. This study sought to evaluate a previously proposed lung metastases risk stratification system based on CT findings and clinical outcomes in stage IV WT patients. Thirty-five pediatric patients with a diagnosis of stage IV WT with evaluable pre- and postdiagnosis CT scans between 1997 and 2012 were included in the analysis. Patients were divided into low-, intermediate-, and high-risk categories based on the size and number of pulmonary metastases before and after 6 weeks of chemotherapy. Association of the lung risk groups with lung recurrence-free survival and overall survival at each time point was analyzed with relevant covariates. Risk group distribution both at diagnosis and after induction chemotherapy was not influenced by tumor histology. Initial risk grouping suggested an association with disease-free survival at 5...Continue Reading

References

Apr 1, 1980·Pediatric Radiology·K Damgaard-Pedersen, T Qvist
May 29, 1999·International Journal of Radiation Oncology, Biology, Physics·J A MeiselD M Green
Sep 1, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Paul E GrundyUNKNOWN National Wilms Tumor Study Group
Jan 18, 2006·Journal of Pediatric Surgery·Peter F EhrlichUNKNOWN National Wilms' Tumor Study Group (National Wilms' Tumor Study 5)

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Mar 16, 2019·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Lulu XieKuiran Dong

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