Response without shrinkage in bilateral Wilms tumor: significance of rhabdomyomatous histology

Journal of Pediatric Hematology/oncology
John AndersonJon Pritchard

Abstract

To test the hypothesis that poor response to chemotherapy in patients with bilateral Wilms tumor may be associated with the appearance of rhabdomyomatous histology, suggesting a differentiation response. Twenty-six patients with bilateral Wilms tumor were treated at the authors' hospital between 1985 and 1995. Radiologic response to presurgical chemotherapy was assessed, and postsurgery histology was reviewed. There was a significant association between rhabdomyomatous differentiation in postchemotherapy surgical specimens and poor radiologic response. Poor response did not, however, necessarily mean poor outcome: of 11 patients with rhabdomyomatous differentiation, 7 are alive and disease-free, 2 died of complications, and only 2 died of uncontrolled Wilms tumor. Rhabdomyomatous differentiation in postchemotherapy bilateral Wilms tumor is associated with poor radiologic response. This observation may indicate a differentiation response rather than an absolute failure of response to chemotherapy. Clinical measures other than tumor volume are needed to distinguish between tumors that respond to chemotherapy but do not shrink, and those that genuinely do not respond.

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Citations

Jul 3, 2010·Pediatric Radiology·Kirsteen McDonaldOystein E Olsen
Jan 1, 2004·The Lancet Oncology·John A KalapurakalMax J Coppes
Apr 12, 2011·African Journal of Paediatric Surgery : AJPS·A J W MillarFarieda Desai
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Aug 6, 2005·Journal of Pediatric Surgery·Alastair J W MillarFarieda Desai
Nov 16, 2010·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Joanna BegentJohn Anderson
Mar 16, 2018·Cancer Medicine·Brigitte Royer-PokoraJaume Mora
Jul 11, 2009·Expert Review of Anticancer Therapy·Peter F Ehrlich
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Aug 7, 2003·Journal of Pediatric Hematology/oncology·Daniel PollonoOsvaldo Ibañez
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Jan 6, 2017·Pediatric Surgery International·Alastair J W MillarAlan Davidson
May 19, 2017·Pediatric Surgery International·Alastair J W MillarAlan Davidson
Dec 8, 2020·Journal of Magnetic Resonance Imaging : JMRI·Laura PriviteraStefano Giuliani
Jun 27, 2021·Urologia·Xavier BonetJean-Luc Hoepffner

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