Xie Chenjie,Gu Song,Tian Ruicheng,et al.Treatment and prognostic factors of recurrent wilm’s tumor in children[J].Journal of Clinical Pediatric Surgery,2021,20(05):430-436.[doi:10.12260/lcxewkzz.2021.05.007]
儿童复发肾母细胞瘤的治疗及预后相关因素分析
- Title:
- Treatment and prognostic factors of recurrent wilm’s tumor in children
- Keywords:
- Wilms tumor; Treatment; Prognosis; Root Cause Analysis; Child
- 分类号:
- R737.11;R730.5
- 摘要:
- 目的 探讨儿童复发肾母细胞瘤的治疗方案及影响预后的相关因素。方法 回顾性分析2006年4月至2019年12月间上海交通大学医学院普外科/肿瘤外科收治的23例复发肾母细胞瘤患者资料，从肿瘤分期、病理分型、术中情况、术后放疗情况、术后复发时间及复发部位、复发后治疗以及预后等方面进行统计分析。结果 Ⅱ期及Ⅲ期病例在复发时间（P=0.9301）及总体生存时间（P=1）方面比较，差异没有统计学意义；初发肿瘤是否为FH型（P=0.7383）、是否做过骨髓干细胞移植（P=0.6974）、复发后是否进行放疗（P=0.6573）以及不同复发时间（P=0.7323）比较，患者在总体生存时间上差异均无统计学意义。结论 肿瘤分期、初发肿瘤是否为FH型、复发后是否做过骨髓干细胞移植及放疗对总体生存时间无影响。术后密切随访，早期诊断复发肿瘤，积极再次手术以及术后予正规化疗及放疗等措施可以提高复发肾母细胞瘤患者的生存率。
- Abstract:
- Objective To explore the treatments and prognostic factors of recurrent Wilm’s tumor in children.Methods From April 2006 to December 2019,23 children of recurrent Wilm’s tumor were analyzed retrospectively,including tumor stage,pathological classification,intraoperative status,postoperative radiotherapy,postoperative recurrence time/site,postoperative treatment and prognosis.Results There were 11 boys and 12 girls with a median onset age of 42(6-109) months.The median recurrence time was 8(3-111) months.During a follow-up period of 29 to 172 months,there were 17 survivors and 6 deaths.No significant difference existed in recurrence time or total survival time between stages Ⅱ and Ⅲ.And there was no significant difference in overall survival time in terms of whether or not primary tumor was FH type,whether or not autologous bone marrow transplantation (ABMT) was performed,whether or not radiotherapy was offered and different recurrence times.Conclusion Tumor stage,FH type,ABMT and radiotherapy are not independent risk factors of total survival time.Close follow-ups,early diagnosis,active reoperation and postoperative chemoradiotherapy improve the survival rate of children with recurrent Wilm’s tumor.
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备注/Memo
收稿日期:2020-03-22。
基金项目:上海市科学技术委员会项目（编号：17441903200，17411950402）；上海市浦东新区科技发展基金（编号：PKJ2017-Y04）
通讯作者:徐敏,Email:jackxm1236@126.com