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1. Breslow NE, Ou SS, Beckwith JB, Haase GM, Kalapurakal JA, Ritchey ML, Shamberger RC, Thomas PR, D'Angio GJ, Green DM: Doxorubicin for favorable histology, Stage II-III Wilms tumor: results from the National Wilms Tumor Studies. Cancer; 2004 Sep 1;101(5):1072-80
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  • [Title] Doxorubicin for favorable histology, Stage II-III Wilms tumor: results from the National Wilms Tumor Studies.
  • BACKGROUND: After randomized trials in the 1980s, doxorubicin (DOX) was added to dactinomycin plus vincristine as standard chemotherapy for patients who had Stage III Wilms tumor (WT) of favorable histology (FH).
  • Double-agent chemotherapy was retained for patients with Stage II disease.
  • METHODS: The relative risks (RR) (DOX vs. no DOX) of disease recurrence and mortality were estimated for patients with Stage II-III/FH WT who were enrolled in the third and fourth National Wilms Tumor Studies (NWTS-3 and NWTS-4).
  • RESULTS: No statistically significant effects of DOX were found for patients with Stage II tumors.
  • For patients with Stage III tumors, the 8 year recurrence-free survival (RFS) and overall survival (OS) rates for randomized patients on NWTS-3 were 84% and 89%, respectively, for patients who received DOX (n = 130) and 74% and 83%, respectively, for patients who did not receive DOX (n = 118).
  • Including all patients with Stage III disease who received DOX (n = 678) and did not receive DOX (n = 138), the RRs of recurrence were 0.47 (P = 0.007) and 0.40 (P = 0.011), and local recurrence respectively, after adjustment for radiation therapy (RT) dose, whereas the RR of mortality adjusted for RT and study was 0.68 (P = 0.17).
  • The 20-year risk of CHF after primary DOX treatment on NWTS-3 and NWTS-4 was 1.2%.
  • CONCLUSIONS: The inclusion of data from nonrandomized patients yielded estimates of DOX treatment effects for Stage III/FH WT that were stronger, albeit more susceptible to bias, than reported previously.
  • Despite a lower reported risk of CHF, conclusive evidence that frontline therapy with DOX definitively improves survival remains elusive.

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  • [Copyright] Copyright 2004 American Cancer Society.
  • (PMID = 15329918.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / R01 CA054498; United States / NCI NIH HHS / CA / CA 42326; United States / NCI NIH HHS / CA / CA 54498
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 1CC1JFE158 / Dactinomycin; 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin
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2. Balaguer Guill J, Fernández Navarro JM, Cañete Nieto A, Muro Velilla MD, Hernández Martí M, Castel Sánchez V: [Renal tumors in infants aged less than 1 year]. An Pediatr (Barc); 2006 May;64(5):433-8
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  • [Title] [Renal tumors in infants aged less than 1 year].
  • [Transliterated title] Tumores renales en niños menores de un año.
  • OBJECTIVE: To determine the frequency and distribution of primary renal tumors diagnosed in a pediatric oncology unit in children younger than 1 year and identify their clinical and histopathological characteristics, the treatment used, and outcomes.
  • MATERIAL AND METHODS: We retrospectively reviewed the medical records of infants with primary tumors of the kidney diagnosed between January 1972 and February 2003.
  • RESULTS: A total of 137 tumors were diagnosed in our unit during the period studied.
  • Among the 15 WT, 9 were stage I, 1 was stage II, one was stage III, 2 were stage IV, and 1 was stage V.
  • Overall survival at 5 years was 0.67 (SE 0.12) for WT and 0.89 (SE 0.1) for MN, respectively, with a mean follow-up of 290 months.
  • The first-line therapy in these patients is surgery since this type of tumor shows little chemosensitivity and chemotherapy is poorly tolerated in infants.
  • [MeSH-major] Kidney Neoplasms

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  • (PMID = 16756884.001).
  • [ISSN] 1695-4033
  • [Journal-full-title] Anales de pediatría (Barcelona, Spain : 2003)
  • [ISO-abbreviation] An Pediatr (Barc)
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Spain
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3. Kalapurakal JA, Green DM, Haase G, Anderson JR, Dome JS, Grundy PE: Outcomes of children with favorable histology wilms tumor and peritoneal implants treated in National Wilms Tumor Studies-4 and -5. Int J Radiat Oncol Biol Phys; 2010 Jun 1;77(2):554-8
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  • METHODS AND MATERIALS: Among favorable histology WT patients enrolled in the National Wilms Tumor Study (NWTS)-4 and NWTS-5, 57 children had PIs at the time of nephrectomy.
  • The majority of children (42 of 57 [74%)] had Stage III tumors; 15 had Stage IV disease.
  • All patients received multimodality therapy.
  • Of 56 children who underwent primary surgery, 48 (84%) had gross total resection of all tumors.
  • All patients received 3-drug chemotherapy with vincristine, dactinomycin, and doxorubicin.
  • Whole-abdomen radiotherapy (RT) was used in 47 patients (82%), and in 50 patients (88%) the RT dose was 10.5 Gy.
  • CONCLUSIONS: Multimodality therapy with surgery, whole-abdomen RT, and three-drug chemotherapy delivered according to the NWTS-4 and -5 protocols resulted in excellent abdominal and systemic tumor control rates.
  • All children should be monitored in long-term surveillance programs for the early detection and management of therapy-related toxicities.

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  • [Copyright] Copyright 2010 Elsevier Inc. All rights reserved.
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  • (PMID = 20457352.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / U10-CA-098543; United States / NCI NIH HHS / CA / U10 CA042326-15; United States / NCI NIH HHS / CA / U10 CA098543; United States / NCI NIH HHS / CA / U10 CA098543-01; United States / NCI NIH HHS / CA / U10 CA042326; United States / NCI NIH HHS / CA / U10-CA-042326
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Other-IDs] NLM/ NIHMS117097; NLM/ PMC2868597
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4. Hosokawa Y, Saiki S, Hanafusa T, Meguro N, Maeda O, Kinouchi T, Kuroda M, Usami M, Kotake T: [A case of adult Wilms' tumor]. Hinyokika Kiyo; 2001 Sep;47(9):641-3
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  • Wilms' tumor is very rarely found in adults and there are no established treatment guidelines for such tumors in adults.
  • Computed tomography scan revealed a large right renal mass with enlarged lymph nodes.
  • The disease was classified as stage III according to the National Wilms' Tumor Study classification.
  • The patient received adjuvant chemotherapy consisting of ifosfamide, cisplatin, and etoposide.
  • Development of better therapeutic approaches to adult Wilms' tumor is awaited.
  • [MeSH-major] Kidney Neoplasms / therapy. Wilms Tumor / therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Etoposide / administration & dosage. Female. Humans. Ifosfamide. Lymph Node Excision. Lymphatic Metastasis. Middle Aged. Neoplasm Staging. Nephrectomy. Treatment Outcome

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  • (PMID = 11692602.001).
  • [ISSN] 0018-1994
  • [Journal-full-title] Hinyokika kiyo. Acta urologica Japonica
  • [ISO-abbreviation] Hinyokika Kiyo
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
  • [Number-of-references] 12
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5. Naguib SF, El Haddad A, El Badawy SA, Zaghloul AS: Multidisciplinary approach to wilms' tumor: a retrospective analytical study of 53 patients. J Egypt Natl Canc Inst; 2008 Dec;20(4):410-23

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  • AIM OF THE WORK: The aim of this work was to assess the epidemiologic aspects, clinico-pathological features and the results of multidisciplinary treatment of Wilms' tumor (WT) in pediatric patients treated at the National Cancer Institute (NCI), Cairo University, between January 2002 and December 2004.
  • Neoadjuvant chemotherapy was given to patients suffering from poor general condition, extensive tumor thrombus in the renal vein, irresectable and bilateral (stage V) nephroblastoma.
  • Otherwise, up-front nephrectomy was the standard therapeutic approach in this study.
  • Tumors were located in the left kidney in 52.8%, right kidney in 41.5% and bilaterally in only 5.7% of the cases.
  • Stage I and III were the most common (29.4% each), followed by stage II and IV (17.7% each), and finally by stage V (5.9%).
  • Neoadjuvant chemotherapy was given to 27 cases while up-front nephrectomy was undertaken in 26 cases.
  • Intra-operative spillage occurred in 12% of patients who had preoperative chemotherapy and 31% of those who had upfront nephrectomy.
  • Complete remission (CR) was achieved in 74%, while death during neoadjuvant therapy took place in 4% of the cases.
  • Disease progression during treatment was noticed in 8%.
  • These patients were all treated with radio- and chemotherapy.
  • Therapy-related complications were mainly related to chemotherapy in 49% of patients and surgery in 5.9%.
  • Regional lymph node biopsy and accurate marking of residual disease are essential components of surgical treatment and heroic surgical attempts are unnecessary.
  • Neoadjuvant chemotherapy, which is still a fertile source of debate, could possibly help to avoid excessive post-operative radiotherapy and its potential complications.
  • Tumor stage and age of patient were found to affect the results of treatment of Wilms' tumor; but the only statistically significant determinant of prognosis was histologic differentiation.
  • Finally, further studies including molecular markers are needed to augment therapy for the blastemal predominance subtype or for favorable histology associated with loss of heterozygosity (LOA) at chromosomes 1p and 16q aiming at improved survival.

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  • (PMID = 20571600.001).
  • [ISSN] 1110-0362
  • [Journal-full-title] Journal of the Egyptian National Cancer Institute
  • [ISO-abbreviation] J Egypt Natl Canc Inst
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Egypt
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6. Furtwaengler R, Reinhard H, Leuschner I, Schenk JP, Goebel U, Claviez A, Kulozik A, Zoubek A, von Schweinitz D, Graf N, Gesellschaft fur Pädiatrische Onkologie und Hämatologie (GPOH) Nephroblastoma Study Group: Mesoblastic nephroma--a report from the Gesellschaft fur Pädiatrische Onkologie und Hämatologie (GPOH). Cancer; 2006 May 15;106(10):2275-83
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  • BACKGROUND: Surgery alone is the appropriate first-line treatment for patients with mesoblastic nephroma (MN).
  • The median observation time was 4.2 years.
  • Five patients older than 6 months received preoperative chemotherapy.
  • Twenty-nine tumors were classic MN, and 21 tumors were cellular MN.
  • Nine patients had a Stage III MN, 5 of those patients had tumor ruptures, and 8 had positive surgical margins.
  • After they underwent nephrectomy, 40 patients received no further treatment.
  • Patients with a cellular MN, patients with age 3 months or older, and patients with Stage III MN had lower EFS.
  • Three patients developed recurrent disease, and 2 of those patients died.
  • Nonetheless, a subgroup of patients with MN (Stage III cellular MN in patients age 3 months or older) tends to develop recurrences more often.
  • Further prospective studies will be needed to verify this finding and should help determine whether these patients may benefit from adjuvant therapy.
  • [MeSH-major] Kidney Neoplasms / diagnosis. Kidney Neoplasms / therapy. Nephroma, Mesoblastic / diagnosis. Nephroma, Mesoblastic / therapy
  • [MeSH-minor] Age Factors. Biopsy, Needle. Chemotherapy, Adjuvant. Child. Child, Preschool. Cohort Studies. Female. Germany. Humans. Immunohistochemistry. Infant. Infant, Newborn. Logistic Models. Male. Neoplasm Staging. Nephrectomy / methods. Pediatrics. Prognosis. Proportional Hazards Models. Retrospective Studies. Risk Assessment. Societies, Medical. Statistics, Nonparametric. Survival Analysis. Treatment Outcome

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  • [Copyright] Copyright 2006 American Cancer Society
  • (PMID = 16596620.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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7. Ondrus D, Hornák M, Breza J, Mat'oska J, Schnorrer M, Belan V, Kausitz J: Delayed orchiectomy after chemotherapy in patients with advanced testicular cancer. Int Urol Nephrol; 2001;32(4):665-7
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  • [Title] Delayed orchiectomy after chemotherapy in patients with advanced testicular cancer.
  • INTRODUCTION: The therapeutic procedures in the management of testicular cancer are determined by histological findings in the removed testis and by the extent of the disease at the time of diagnosis.
  • However, all advanced tumors could be treated by primary chemotherapy regardless of the histological findings.
  • When the diagnosis of advanced tumor is evident, it is possible to start the treatment without orchiectomy.
  • The aim of this study was to evaluate the advantages of neo-adjuvant chemotherapy with delayed orchiectomy in the management of advanced testicular cancer.
  • MATERIAL AND METHODS: A total of 36 patients with advanced germ cell testicular cancer underwent primary PVB or BEP chemotherapy without previous orchiectomy.
  • Detailed medical, surgical and urological examination showed pulmonary metastases and/or extensive abdominal tumorous masses imitating acute abdominal crisis and impaired drainage of the kidney due to ureteral obstruction.
  • Eleven patients had a bulky disease in the retroperitoneum (Stage IIC), two had enlarged retroperitoneal lymph nodes (Stage IIB), two had enlarged mediastinal lymph nodes (Stage III) and other 16 patients had also pulmonary metastases, and 5 pts had pulmonary metastases only.
  • The patients were treated with cisplatin-containing combination chemotherapy.
  • Following completion of chemotherapy, orchiectomy was performed alone or simultaneously with retroperitoneal lymph node dissection (RPLND) and/or lung metastasectomy in cases with persistent residual mass.
  • Following orchiectomy the patients were regularly checked and in cases with viable malignant tumor found in the testis sequential chemotherapy was administered.
  • Similarly when the relapse of the disease was detected, the patients were treated with sequential chemotherapy.
  • RESULTS: Complete disappearance of metastases was observed in 12 patients following chemotherapy alone.
  • The viable tumor in the removed tissue was found in one patient.
  • Delayed orchiectomy was performed simultaneously with surgical removal of residual mass in the retroperitoneum in 24 patients and as a separate procedure in 12 patients who have been considered to be complete responders following chemotherapy alone.
  • Residual viable tumor in testicular specimen was found in three patients, necrotic or fibrotic tissue in 18, and mature teratoma in 15 patients.
  • Overall survival of the patients was 26/36 (72.7%) at mean of 56.9 months (range 7-145 months, median 50 months) since the start of the treatment.
  • CONCLUSIONS: In patients with advanced germ cell testicular cancer preference must be given to the early beginning of intensive chemotherapy without the need of tissue diagnosis of primary tumor that should be obtained by orchiectomy.
  • Benefit of this therapeutic approach is the timely management of acute abdominal and/or pulmonary symptoms of life-threatening distant metastases.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / therapeutic use. Cisplatin / therapeutic use. Germinoma / drug therapy. Orchiectomy. Testicular Neoplasms / drug therapy. Vinblastine / therapeutic use
  • [MeSH-minor] Adult. Chemotherapy, Adjuvant. Humans. Lung Neoplasms / secondary. Male. Middle Aged. Neoplasm, Residual. Survival Rate. Teratoma / secondary. Time Factors. Treatment Outcome

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  • (PMID = 11989561.001).
  • [ISSN] 0301-1623
  • [Journal-full-title] International urology and nephrology
  • [ISO-abbreviation] Int Urol Nephrol
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 5V9KLZ54CY / Vinblastine; Q20Q21Q62J / Cisplatin; PVB protocol
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8. Takamizawa S, Okamoto S, Bishop W, Wen J, Kimura K, Sandler A: Differential apoptosis gene expression in pediatric tumors of the kidney. J Pediatr Surg; 2000 Feb;35(2):390-5
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  • [Title] Differential apoptosis gene expression in pediatric tumors of the kidney.
  • BACKGROUND/PURPOSE: Apoptosis, or programmed cell death, is essential in maintaining normal homeostasis of tissues.
  • This study evaluates the expression of apoptotic mRNA species in pediatric renal tumors to determine whether a pattern of differential apoptosis gene expression correlates with tumor grade and type.
  • METHODS: Twenty-five frozen tissue specimens were obtained from patients undergoing biopsy or resection of pediatric renal tumors before chemotherapy: Wilms' tumor stage II (WT-II, n = 4); Wilms' tumor stage III/IV (WT-III/IV, n = 4); clear cell sarcoma of the kidney stage III (CCSK, n = 2); rhabdoid tumor of the kidney stage III/IV (RTK, n = 4); and normal kidney (NK, n = 11).
  • RESULTS: The expression of apoptotic mRNA species varied markedly between tumors.
  • Surprisingly, antiapoptotic factors (e.g., bcl-2 and bcl-xl) were not overexpressed in poor prognostic tumors (CCSK, RTK) compared with those with good prognosis (WT).
  • Expression of TRAIL (a ligand for DR4 and DR5) was significantly lower in CCSK and RTK than in normal kidney (9.5+/-1.5% v. 56.1+/-10.1%; P = .01).
  • CONCLUSIONS: Proapoptotic receptors are expressed at greater levels in good prognostic tumors, and this finding is compatible with their clinical behavior.
  • Knowledge of differential apoptotic gene expression is of potential value in predicting prognosis and treating such tumors with targeted ligands.
  • [MeSH-major] Apoptosis / genetics. Gene Expression. Kidney Neoplasms / pathology

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  • (PMID = 10693703.001).
  • [ISSN] 0022-3468
  • [Journal-full-title] Journal of pediatric surgery
  • [ISO-abbreviation] J. Pediatr. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / HLA-DR Antigens; 0 / RNA, Messenger; 0 / Tumor Necrosis Factor-alpha
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9. Boccon-Gibod L, Rey A, Sandstedt B, Delemarre J, Harms D, Vujanic G, De Kraker J, Weirich A, Tournade MF: Complete necrosis induced by preoperative chemotherapy in Wilms tumor as an indicator of low risk: report of the international society of paediatric oncology (SIOP) nephroblastoma trial and study 9. Med Pediatr Oncol; 2000 Mar;34(3):183-90
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  • [Title] Complete necrosis induced by preoperative chemotherapy in Wilms tumor as an indicator of low risk: report of the international society of paediatric oncology (SIOP) nephroblastoma trial and study 9.
  • BACKGROUND: The SIOP Nephroblastoma therapeutic protocols include a period of preoperative chemotherapy followed by nephrectomy and a period of postoperative chemotherapy.
  • Now that 90% of children with Wilms tumor can be cured, attention is even more focused on the identification of patients who could benefit from less aggressive postoperative therapy, thus minimizing the morbidity and late effects associated with treatment.
  • The prognostic implications of total necrosis in nephroblastoma after chemotherapy have not been investigated hitherto.
  • PROCEDURE: Between November 1, 1987 and June 30, 1993, 599 patients referred to the SIOP-9 Nephroblastoma Trial and Study were preoperatively treated and classified as stages I-IV nonanaplastic Wilms tumor.
  • RESULTS: Of these 599 patients, pathologic examination of the nephrectomy specimen revealed a completely necrotic Wilms tumor (CNWT) with no viable tumor remaining in 59 (10%): these comprised 37 stages I-III and 22 stage IV.
  • Stages I-III patients represented 63% of CNWT and had a 97% overall survival rate.
  • The only death was related to veno-occlusive disease and occurred in a stage I patient in the month following nephrectomy.
  • Stage IV patients represented 37% of CNWT (vs. only 10% of all other cases of unilateral nonanaplastic Wilms tumor) and had a 100% rate of survival.
  • The data also uphold the hypothesis that Wilms tumors of blastemic pattern are most aggressive, but also are extremely responsive to chemotherapy.
  • CONCLUSIONS: Patients with unilateral nonanaplastic WT that showed total necrosis following preoperative chemotherapy had excellent outcome and should benefit from less aggressive postoperative treatment in further trials.
  • Other very responsive tumors, such as Wilms with <10% viable tumor, should also be assessed.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Kidney Neoplasms / drug therapy. Wilms Tumor / drug therapy
  • [MeSH-minor] Adolescent. Child. Europe. Female. Humans. Male. Necrosis. Neoplasm Staging. Prognosis. Remission Induction. Risk Factors. Survival Analysis. Treatment Outcome

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  • (PMID = 10696124.001).
  • [ISSN] 0098-1532
  • [Journal-full-title] Medical and pediatric oncology
  • [ISO-abbreviation] Med. Pediatr. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] UNITED STATES
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10. Seseke F, Rebmann S, Zöller G, Lakomek M, Ringert RH: [Risk factors for perioperative complications in renal surgery for Wilms' tumor]. Aktuelle Urol; 2007 Jan;38(1):46-51
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  • [Transliterated title] Risikofaktoren perioperativer Komplikationen in der Chirurgie des Wilms-Tumors.
  • BACKGROUND: There is controversy about preoperative chemotherapy in the treatment of Wilms' tumor.
  • Therefore, risk factors of perioperative complications were analysed in our series of patients with Wilms' tumor with a special focus on the effects of preoperative chemotherapy.
  • PATIENTS AND METHODS: Case histories of 37 patients [mean age 3.9 (range: 0.6 - 14) years] were retrospectively analysed concerning follow-up, clinical and histopathological stage, size of the primary tumor, as well as duration and extent of preoperative chemotherapy.
  • 11/37 patients had no or shortened preoperative chemotherapy.
  • All complications occurred in patients of clinical stages III and IV, maximal tumor diameter > 10 cm after unusually extended operative procedures.
  • 4 patients showed only poor response to preoperative chemotherapy.
  • Patients with doxorubicin pre-treatment showed a higher risk of postoperative small bowel obstruction.
  • The influence of preoperative chemotherapy on the complications rate is inconstant.
  • However, the comorbidity of more intense preoperative chemotherapy in patients of stage IV may contribute to a higher risk of surgical complications.
  • [MeSH-major] Kidney Neoplasms / drug therapy. Kidney Neoplasms / surgery. Neoadjuvant Therapy. Postoperative Complications / etiology. Wilms Tumor / drug therapy. Wilms Tumor / surgery
  • [MeSH-minor] Adolescent. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Child, Preschool. Combined Modality Therapy. Dactinomycin / adverse effects. Dactinomycin / therapeutic use. Doxorubicin / adverse effects. Doxorubicin / therapeutic use. Female. Follow-Up Studies. Humans. Infant. Intestinal Obstruction / chemically induced. Male. Neoplasm Staging. Retrospective Studies. Risk Factors. Vincristine / adverse effects. Vincristine / therapeutic use

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  • (PMID = 17290329.001).
  • [ISSN] 0001-7868
  • [Journal-full-title] Aktuelle Urologie
  • [ISO-abbreviation] Aktuelle Urol
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 1CC1JFE158 / Dactinomycin; 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin; SIOP protocol
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11. Perlman EJ: Pediatric renal tumors: practical updates for the pathologist. Pediatr Dev Pathol; 2005 May-Jun;8(3):320-38
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  • [Title] Pediatric renal tumors: practical updates for the pathologist.
  • Pediatric renal tumors were targeted by the National Wilms Tumor Study Group for 4 decades with extraordinary success.
  • All renal tumors must first be registered on the Renal Tumor Classification and Banking Protocol, followed by registration on 1 of 4 primary therapeutic protocols based on histology, stage, and molecular analysis.
  • Changes in staging criteria include classification of all tumor spillage as stage III, and requirement of regional lymph node evaluation for eligibility for stage I Wilms tumors (WTs) weighing less than 550 g in infants younger than 24 months and for stage I clear cell sarcoma.
  • Patients with unilateral favorable histology WT with loss of heterozygosity for chromosomes 1p and 16q will receive more aggressive chemotherapy at each stage.
  • Patients with bilateral WT and patients with diffuse hyperplastic perilobar nephroblastomatosis will be eligible for a novel therapeutic protocol requiring pathologic classification based on response of tumor to previous therapy.
  • Stage I anaplastic WT will be targeted with more aggressive chemotherapy than in the past.
  • For the first time, pediatric renal cell carcinoma will be eligible for a cooperative group protocol.
  • All rhabdoid tumors outside the central nervous system will be eligible for a single protocol.
  • In conclusion, these new protocols bring considerable change in their overall organization, in eligibility, and in therapy.
  • [MeSH-major] Antineoplastic Protocols. Kidney Neoplasms / therapy

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  • (PMID = 16010493.001).
  • [ISSN] 1093-5266
  • [Journal-full-title] Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society
  • [ISO-abbreviation] Pediatr. Dev. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 75
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12. Vujanić GM, Sandstedt B, Harms D, Kelsey A, Leuschner I, de Kraker J, SIOP Nephroblastoma Scientific Committee: Revised International Society of Paediatric Oncology (SIOP) working classification of renal tumors of childhood. Med Pediatr Oncol; 2002 Feb;38(2):79-82
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  • [Title] Revised International Society of Paediatric Oncology (SIOP) working classification of renal tumors of childhood.
  • The previous International Society of Paediatric Oncology (SIOP) trials and studies recognized three prognostic groups of renal tumors of childhood: low risk, intermediate risk, and high risk tumors, which were further defined in the SIOP (Stockholm) Working Classification of Renal Tumors of Childhood (1994).
  • The results of the latest SIOP Trials and Studies showed that certain histological features which remain after preoperative chemotherapy, such as blastema, are of prognostic significance while others are not.
  • Therefore, in the next SIOP Trials and Study a revised classification of renal tumors will be followed.
  • It still recognizes the three tumor risk groups with different types in each of them, but for treatment purposes, only three major types of nephroblastoma need to be recognized: completely necrotic (low risk tumor), blastemal (high risk tumor), and others (intermediate risk tumors).
  • Patients will be treated according to tumor histology and stage.
  • Trials which include preoperative chemotherapy have shown that the presence of necrotic tumor or chemotherapy induced changes in the renal sinus or perirenal fat can be ignored for distinguishing between stage I and II, but if present at resection margins or lymph nodes, it should be regarded as stage III.
  • Prognostic significance of all histological component of Wilms tumors will be studied prospectively in the new trial.
  • [MeSH-major] Kidney Neoplasms / pathology. Wilms Tumor / pathology

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  • [Copyright] Copyright 2002 Wiley-Liss, Inc.
  • [CommentIn] Med Pediatr Oncol. 2003 Jul;41(1):102 [12764768.001]
  • [CommentIn] Med Pediatr Oncol. 2002 Feb;38(2):77-8 [11813169.001]
  • (PMID = 11813170.001).
  • [ISSN] 0098-1532
  • [Journal-full-title] Medical and pediatric oncology
  • [ISO-abbreviation] Med. Pediatr. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Genetic Markers
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13. Goel MC, Mahendra V, Roberts JG: Percutaneous management of renal pelvic urothelial tumors: long-term followup. J Urol; 2003 Mar;169(3):925-9; discussion 929-30
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  • [Title] Percutaneous management of renal pelvic urothelial tumors: long-term followup.
  • Patients with low stage pT0-1 disease were treated primarily with percutaneous surgery.
  • All pelvicaliceal tumors were taken for biopsy and treated with percutaneous resection.
  • Patients with multi-segmental pelvicaliceal system involvement, stage greater than pT1, high grade histology or additional ureteral tumors were considered for nephroureterectomy.
  • Topical chemotherapy (mitomycin C or epirubicin) was administered via nephrostomy tube or intravesical instillation after Double-J stent (Medical Engineering Corp., New York, New York) insertion.
  • RESULTS: Of the 24 cases 2 had squamous cell carcinoma, 5 had grade III transitional cell carcinoma, 15 had grade I to II transitional cell carcinoma and 2 had no tumor.
  • Early recurrences were detected by excretory urography (IVP) in 3 cases, small pelvic recurrences by IVP in 2, fiberoptic ureterorenoscopy in 2 and bladder tumors by flexible cystoscopy in 3 after 1 year.
  • Three synchronous, grade I bladder tumors were managed conventionally.
  • All patients with high grade disease died of malignancy except one (with no further treatment) and 6 of the 15 patients with low grade noninvasive transitional cell carcinoma underwent nephroureterectomy during followup either due to progression of disease, concomitant tumor or complications.
  • High grade tumors or tumors greater than T1 were treated with nephroureterectomy early during management.
  • CONCLUSIONS: Percutaneous resection of transitional cell tumor should be considered primarily in patients with early stage disease excluding tumors crossing caliceal infundibula, ureteropelvic junction tumor, tumor extending over multiple calices and synchronous ureteral tumors.
  • The long-term outcome of low grade tumors is good and they should be managed by either form of minimally invasive surgery.
  • Nephron sparing is possible in a large percentage of low grade disease but high grade tumors should be treated with nephroureterectomy.
  • [MeSH-major] Carcinoma, Transitional Cell / therapy. Kidney Neoplasms / therapy
  • [MeSH-minor] Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / therapy. Endoscopy. Female. Follow-Up Studies. Humans. Kidney Pelvis. Male. Middle Aged. Neoplasm Recurrence, Local. Nephrectomy. Ureter / surgery

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  • [CommentIn] J Urol. 2003 Mar;169(3):936-7 [12576816.001]
  • (PMID = 12576814.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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14. Falardeau P, Champagne P, Poyet P, Hariton C, Dupont E: Neovastat, a naturally occurring multifunctional antiangiogenic drug, in phase III clinical trials. Semin Oncol; 2001 Dec;28(6):620-5
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  • [Title] Neovastat, a naturally occurring multifunctional antiangiogenic drug, in phase III clinical trials.
  • Recent studies have indicated that bone marrow angiogenesis is increased in multiple myeloma, suggesting that treatment with an antiangiogenic agent might be useful.
  • Among the new antiangiogenic drugs in development, Neovastat (AE-941; Aeterna Laboratories, Quebec City, Canada) can be classified as a naturally occurring multifunctional antiangiogenic agent.
  • Furthermore, no treatment-related mortality or loss of body weight was observed.
  • In the oncology field, 482 patients have received Neovastat, of which 146 with solid tumors were exposed to the drug for more than 6 months.
  • Two phase III clinical trials are currently underway.
  • A phase III double-blind placebo-controlled study is being conducted to evaluate the efficacy of Neovastat in addition to induction chemotherapy/radiotherapy combined modality treatment in patients with unresectable non-small cell lung cancer stage IIIA and IIIB.
  • A second phase III randomized, double-blind placebo-controlled study evaluates the efficacy of Neovastat as a monotherapy in metastatic renal cell carcinoma patients who have progressed following a first-line immunotherapy.
  • [MeSH-major] Angiogenesis Inhibitors / therapeutic use. Bone Marrow / blood supply. Bone Marrow / drug effects. Multiple Myeloma / drug therapy. Tissue Extracts / therapeutic use
  • [MeSH-minor] Animals. Cartilage / chemistry. Clinical Trials as Topic. Drug Screening Assays, Antitumor. Humans. Kidney Neoplasms / drug therapy. Lung Neoplasms / drug therapy. Neoplasm Metastasis / drug therapy. Neovascularization, Pathologic. Sharks

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  • [Copyright] Copyright 2001 by W.B. Saunders Company.
  • (PMID = 11740820.001).
  • [ISSN] 0093-7754
  • [Journal-full-title] Seminars in oncology
  • [ISO-abbreviation] Semin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Tissue Extracts; 0 / shark cartilage extract
  • [Number-of-references] 42
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15. Granzen B, Efferth T, Keller U, Beniers AJ, Mertens R, Jakse G, Füzesi L: Differential expression of the drug resistance markers DNA topoisomerase II alpha and glutathione S-transferase-pi in the histological compartments of Wilms' tumors. Anticancer Res; 2001 Jan-Feb;21(1B):771-6
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  • [Title] Differential expression of the drug resistance markers DNA topoisomerase II alpha and glutathione S-transferase-pi in the histological compartments of Wilms' tumors.
  • Some patients, however, fail to respond to chemotherapy.
  • The objective of this study was to analyze the immunohistochemical distribution of two markers of cytostatic drug resistance, e.g.
  • Eight patients had stage I disease, seven stage II, three stage III, four stage IV, and one stage V disease.
  • Five tumors showed high malignancy histology.
  • Investigations were carried out on formalin-fixed and paraffin-embedded tissue sections using the indirect immunoperoxidase method.
  • It was more frequently found in anaplastic tumors.
  • Topo II alpha was, however, less expressed in the blastemal and stromal elements of specimens after preoperative treatment.
  • While no expression of GST-pi was found in preoperatively untreated Wilms' tumors, it was present in epithelial compartments in 57% of tumors after chemotherapy.
  • In conclusion, preoperative chemotherapy led to compartment-specific alterations in the expression levels of both markers indicating a contribution to treatment response of Wilms' tumors.
  • [MeSH-major] DNA Topoisomerases, Type II / analysis. Drug Resistance, Neoplasm. Glutathione Transferase / analysis. Isoenzymes / analysis. Kidney Neoplasms / enzymology. Neoplasm Proteins / analysis. Wilms Tumor / enzymology
  • [MeSH-minor] Antigens, Neoplasm. Chemotherapy, Adjuvant. Child. Child, Preschool. Combined Modality Therapy. DNA-Binding Proteins. Epithelial Cells / enzymology. Female. Follow-Up Studies. Humans. Infant. Male. Neoplasm Staging. Neoplastic Stem Cells / enzymology. Nephrectomy. Premedication. Stromal Cells / enzymology

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  • [ErratumIn] Anticancer Res 2001 Jul-Aug;21(4A):2861
  • (PMID = 11299842.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / DNA-Binding Proteins; 0 / Isoenzymes; 0 / Neoplasm Proteins; EC 2.5.1.18 / Glutathione Transferase; EC 5.99.1.3 / DNA Topoisomerases, Type II; EC 5.99.1.3 / DNA topoisomerase II alpha
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16. Gupta V, Weigand T, Rangineni R: Phase I-II dose escalation study of celecoxib (C) in combination with paclitaxel (T) and carboplatinum (CP) in non small cell lung cancer (NSCLC). J Clin Oncol; 2004 Jul 15;22(14_suppl):7310

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  • : 7310 Background: Preclinical data suggests COX-2 inhibitors prevent development of cancer,shrink established tumors,and inhibit angiogenesis in dose dependent manner with "optimal"blood levels of 1.8-5ug/ml of celecoxib(C).
  • METHODS: 34 patients with inoperable stage I-III and IV, with evaluable disease and PS 1,2 received C and prophylaxis with H2 blockers or proton pump inhibitors for 7d prior to CP AUC- 6 q4wks and T60mg/m2 weekly for at least 4 mo.Dose escalation of C was after 4 patients at each dose level.
  • GI and other side effects,heme,liver, kidney function were monitored weekly.
  • 2 patients had received prior non-taxane therapy.
  • Patients with StageI-III disease after 4mo induction chemotherapy received consolidation radiotherapy with or without chemotherapy.
  • There were 22 patients evaluable for response with 3CR,6PR,10SD, 3 progressive after 4mo of therapy.
  • One stage IV patient with brain mets at 800mg of C died postop with GI bleed from incidental carcinoid of small bowel and one at 1600mg of C(blood level 1200ng/ml) after anticoagulation for DVT(INR 2.4), and one at 800mg mg of C from grade 4 neutropenia and pneumonia.
  • 3. "Optimal" blood levels of celecoxib may not be easily achieved at 800mg/d of celecoxib and may require therapeutic monitoring to properly asses impact in clinical trials.
  • 4. The therapeutic role of celecoxib in combination with chemotherapy or by itself requires ongoing investigation.

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  • (PMID = 28015039.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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17. Tröbs RB, Hänsel M, Friedrich T, Bennek J: A 23-year experience with malignant renal tumors in infancy and childhood. Eur J Pediatr Surg; 2001 Apr;11(2):92-8
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  • [Title] A 23-year experience with malignant renal tumors in infancy and childhood.
  • A retrospective analysis of 77 children treated between 1974 and 1996 was undertaken to evaluate morbidity and the evolution of therapy.
  • Among patients with Wilms' tumors (WT), nephroblastoma (NB) of intermediate risk predominated (73%; 46 of 63 pats.).
  • Low-risk tumors occurred in 5 of 63 children (8%; mesoblastic nephroma 3, cystic partially diff.
  • Comparing relapse-free survival of stages I, II and III, respectively, there was a reduced survival rate for stage III (p=0.019).
  • According to the SIOP/GPOH protocol in 1989, the regimen was switched from primary surgery to preoperative chemotherapy without biopsy in 1989 (11 pats.).
  • During preoperative chemotherapy a venous occlusive disease of the liver occurred in 2 patients.
  • Preoperative chemotherapy led to an impressive tumor shrinkage in the majority of patients.
  • In our experience, reduction of tumor volume due to preoperative chemotherapy facilitates tumor removal by surgery and may prevent tumor spillage and the deleterious effects of radiation in young children.
  • Surgery without delay is necessary if the diagnosis is unclear or the tumor fails to respond to preoperative chemotherapy.
  • [MeSH-major] Kidney Neoplasms / surgery. Wilms Tumor / surgery
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Chemotherapy, Adjuvant. Child. Child, Preschool. Disease-Free Survival. Female. Humans. Infant. Male. Neoplasm Recurrence, Local / epidemiology. Neoplasm Staging. Prognosis. Retrospective Studies

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  • (PMID = 11371043.001).
  • [ISSN] 0939-7248
  • [Journal-full-title] European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift für Kinderchirurgie
  • [ISO-abbreviation] Eur J Pediatr Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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18. Albert A, Cruz O, Montaner A, Vela A, Badosa J, Castañón M, Morales L: [Congenital solid tumors. A thirteen-year review]. Cir Pediatr; 2004 Jul;17(3):133-6
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  • [Title] [Congenital solid tumors. A thirteen-year review].
  • [Transliterated title] Tumores sólidos congénitos. Revisión de 13 años.
  • Tumors diagnosed during the first month of life are infrequent: 0.5 to 2% of all childhood neoplasms.
  • This is an interesting group of tumors because their type, relative incidence, natural history and response to treatment differ from those seen in older children.
  • AIM: To contribute the experience of our institution in congenital tumors the last 13 years.
  • MATERIAL AND METHODS: The records of all neonates (< 31 days old) diagnosed with solid tumors since January 1990 to December 2002 have been retrospectively reviewed.
  • RESULTS: Twenty-seven neonates have been diagnosed with tumors in the last 13 years.
  • Neuroblastoma was the commonest tumor (10 cases, 37%), of which 4 were stage I, 4 stage IV-S and 2 stage III.
  • There were 8 teratomas (3 sacrocoxigeal, 1 retroperitoneal, 1 in the CNS, 1 orbitary and two oronasal), two hepatic tumors (1 hepatoblastoma, 1 hemangioendothelioma, two CNS tumors, two giant nevus (one on a hamartoma), and one each Wilms tumor, infantile fibrosarcoma and myofibroblastic tumor.
  • Treatment was surgical resection alone in 17 cases (68%) and surgery + chemotherapy in 8 (32%) (5 neuroblastomas, one CNS tumor, one Wilms tumor and one presacral teratoma who developed a yolk sac tumor); 3 patients died (11%): one at surgery, one of tumoural airway obstruction at birth and one with craniopharyngioma.
  • Among the 14 tumors that were initially not malignant, two can be locally agressive, one was an immature teratoma, the giant nevus with hamartoma developed in situ melanoma, the other nevus had meningeal melanosis with hydrocephalus, and one mature presacral teratoma developed a yolk sac tumor.
  • CONCLUSIONS: Diagnosis of congenital tumors is performed earlier in recent years due to the wide use of prenatal ultrasound.
  • Their natural history is more benign than in other age groups, except for CNS tumors and very large or obstructing tumors.
  • Complete surgical excision is the treatment of choice, most cases not need adjuvant chemotherapy.
  • [MeSH-major] Central Nervous System Neoplasms / congenital. Kidney Neoplasms / congenital. Liver Neoplasms / congenital. Neuroblastoma / congenital. Skin Neoplasms / congenital. Soft Tissue Neoplasms / congenital. Teratoma / congenital. Wilms Tumor / congenital
  • [MeSH-minor] Female. Follow-Up Studies. Humans. Infant, Newborn. Male. Neoplasm Recurrence, Local. Postoperative Complications. Pregnancy. Prenatal Diagnosis. Time Factors

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  • (PMID = 15503950.001).
  • [ISSN] 0214-1221
  • [Journal-full-title] Cirugía pediátrica : organo oficial de la Sociedad Española de Cirugía Pediátrica
  • [ISO-abbreviation] Cir Pediatr
  • [Language] spa
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] Spain
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19. Koga Y, Matsuzaki A, Suminoe A, Hatano M, Saito Y, Kinoshita Y, Tajiri T, Taguchi T, Kohashi K, Oda Y, Tsuneyoshi M, Hara T: Long-term survival after autologous peripheral blood stem cell transplantation in two patients with malignant rhabdoid tumor of the kidney. Pediatr Blood Cancer; 2009 Jul;52(7):888-90
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  • [Title] Long-term survival after autologous peripheral blood stem cell transplantation in two patients with malignant rhabdoid tumor of the kidney.
  • A 5-month-old male with stage II malignant rhabdoid tumor of the kidney (MRTK) and a 24-month-old male with stage III MRTK were treated with surgical resection of tumors and chemotherapy of alternating ICE (ifosfamide, carboplatin, and etoposide) and VDC (vincristine, doxorubicin, and cyclophosphamide), followed by high-dose chemotherapy using etoposide, carboplatin, and melphalan with autologous hematopoietic stem cell transplantation (SCT).
  • Two patients have been alive without any evidence of disease for 30 and 37 months after diagnosis, respectively, and require no medication.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Hematopoietic Stem Cell Transplantation. Kidney Neoplasms / mortality. Kidney Neoplasms / therapy. Rhabdoid Tumor / mortality. Rhabdoid Tumor / therapy
  • [MeSH-minor] Carboplatin / administration & dosage. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Doxorubicin / administration & dosage. Etoposide / administration & dosage. Humans. Ifosfamide / administration & dosage. Infant. Male. Melphalan / administration & dosage. Prognosis. Survival Rate. Tomography, X-Ray Computed. Transplantation, Autologous. Treatment Outcome. Vincristine / administration & dosage

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  • [Copyright] (c) 2009 Wiley-Liss, Inc.
  • (PMID = 19260106.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; BG3F62OND5 / Carboplatin; Q41OR9510P / Melphalan; UM20QQM95Y / Ifosfamide
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20. El Kababri M, Khattab M, El Khorassani M, Hessissen L, Kili A, Nachef MN, Cherradi N, Malihy A, Alhamany Z, Msefer-Alaoui F: [Clear cell sarcoma of the kidney. A study of 13 cases]. Arch Pediatr; 2004 Jul;11(7):794-9
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  • [Title] [Clear cell sarcoma of the kidney. A study of 13 cases].
  • [Transliterated title] Sarcome rénal à cellules claires. A propos d'une série de 13 cas.
  • Clear cell sarcoma of the kidney (CCSK) also called a "bone-metastasizing renal tumor of childhood" is the second common pediatric renal neoplasm.
  • PATIENTS AND METHODS: We have reviewed records of 13 cases of CCSK among 277 renal tumors (5%) diagnosed at the children's hospital of Rabat between 1990 and 2002.
  • Preoperative chemotherapy was given according to the SIOP9, SIOP93-01 and GFAOP 98 protocols.
  • The distribution local stage was I: three cases; II: three cases; III: six cases; IV: one case.
  • Postoperative chemotherapy and radiotherapy (21 600-30 600 cGy) was done in 10 cases.
  • Its aggressiveness and its ability to give bone metastases need to recognize early this diagnosis for an adapted treatment.
  • [MeSH-major] Kidney Neoplasms / pathology. Kidney Neoplasms / surgery. Nephrectomy. Sarcoma, Clear Cell / pathology. Sarcoma, Clear Cell / surgery
  • [MeSH-minor] Age of Onset. Child. Child, Preschool. Combined Modality Therapy. Female. Humans. Infant. Male. Neoadjuvant Therapy. Neoplasm Staging. Prognosis. Retrospective Studies. Sex Factors. Survival Analysis

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  • (PMID = 15234374.001).
  • [ISSN] 0929-693X
  • [Journal-full-title] Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
  • [ISO-abbreviation] Arch Pediatr
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] France
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21. Nag S, Tippin D, Ruymann FB: Intraoperative high-dose-rate brachytherapy for the treatment of pediatric tumors: the Ohio State University experience. Int J Radiat Oncol Biol Phys; 2001 Nov 1;51(3):729-35
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  • [Title] Intraoperative high-dose-rate brachytherapy for the treatment of pediatric tumors: the Ohio State University experience.
  • PURPOSE: To determine whether intraoperative high-dose-rate brachytherapy (IO-HDRBT) can be used to decrease the dose of external beam radiotherapy (EBRT) in the treatment of children with soft-tissue sarcomas and, thereby, reduce morbidity without compromising local control.
  • METHODS AND MATERIALS: From March 1992 through April 1999, 13 pediatric patients were treated with IO-HDRBT, low-dose EBRT, chemotherapy, and radical surgery at 21 sites that were not amenable to intraoperative electron beam therapy.
  • The IO-HDRBT dose at 5 mm depth was 10 to 12.5 Gy for close margins/microscopic disease at 14 sites and 12.5 to 15 Gy for gross disease at 7 sites.
  • The treatment volumes ranged from 4 to 96 cm(3) (mean 27).
  • The EBRT dose was limited to 27-30 Gy in most cases to minimize growth retardation and preserve normal organ function.
  • Of the 2 who died, 1 had Stage III pulmonary blastoma with a sacral recurrence; the other had Stage IV undifferentiated synovial sarcoma with a pulmonary recurrence.
  • One local failure occurred in a patient with gross residual disease after incomplete resection for Stage IV pulmonary blastoma.
  • One patient developed impaired orbital growth with mild ptosis.
  • The third patient required reimplantation of her autotransplanted kidney secondary to chronic urinary tract infection and ureteral reflux.
  • CONCLUSIONS: IO-HDRBT allowed for reduction in EBRT without compromising local control or disease-free survival in children with soft-tissue sarcomas.
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Combined Modality Therapy. Female. Humans. Intraoperative Period. Male. Survival Rate. Treatment Outcome

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  • (PMID = 11597815.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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22. Sawicz-Birkowska K, Czernik J, Bagłaj M, Czauderna P, Kantorowicz-Szymik S, Poznański WA, Mańkowski P, Madziara W, Prokurat A, Osemlak J: [Renal neoplasms in children]. Przegl Lek; 2004;61 Suppl 2:20-3
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  • Nephroblastoma is the most common kidney tumor in Polish children.
  • OBJECTIVE: to present clinical material and outcome of 533 children with renal tumors.
  • MATERIAL: 500 pts with nephroblastoma and 33 of non-Wilms: CMN, RCC,CSSK, RTK and others tumors were registered, mean age 4.5 years between 1993 till 2002.
  • Stage: CS I--148, CS II--191, CS III--114, CS IV--51, CS V--29 pts.
  • All pts with nephroblastoma were treated according to the first national PPGGL 01-92 protocol with pre-operative chemotherapy (ACT, VCR) for CS I-III and ACT, VCR, DOX in pts of stage IV, over the age of 6 months.
  • Pre-operative chemotherapy was done to 93.8% pts.
  • RESULTS: Radical nephrectomy post pre op chemotherapy was performed in 451 (98%) pts over 6 months and in 44 (8.2%) infants less than 6 months with nephroblastoma.
  • Partial nephrectomy for unilateral tumor post preoperative chemotherapy was made in 6 (1.2%).
  • In 26/29 (89.65%) of CS V nephroblastoma kidney sparing surgery was possible, and in 12 uni-lateral nephrectomy was performed.
  • RESULTS: 5-years overall survival of CS I pts (favorable and standard histology) is 93.48%, CS II--96.8%, CS III--84.4%, CS IV--67%, CS V--58%.
  • The results of treatment of 33 pts with non-Wilms renal tumors have improved lately.
  • CONCLUSIONS: The use of systemic neoadjuvant chemotherapy in all pts over 6 months according to the recommendation of SIOP Nephroblastoma protocol (01-92) produced tumor shrinkage, facilitated complete surgical nephrectomy, and was very advantageous in the treatment of renal tumors in children.
  • The results of treatment of non-Wilms tumor have also improved thanks to introduction of new and more aggressive regimens of chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Kidney Neoplasms / drug therapy. Kidney Neoplasms / surgery. Nephrectomy. Wilms Tumor / drug therapy. Wilms Tumor / surgery
  • [MeSH-minor] Adolescent. Chemotherapy, Adjuvant. Child. Child, Preschool. Disease-Free Survival. Female. Humans. Infant. Infant, Newborn. Male. Neoadjuvant Therapy. Neoplasm Staging. Poland. Prognosis. Remission Induction. Retrospective Studies. Risk Factors. Survival Analysis. Treatment Outcome

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  • (PMID = 15686041.001).
  • [ISSN] 0033-2240
  • [Journal-full-title] Przegla̧d lekarski
  • [ISO-abbreviation] Prz. Lek.
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Poland
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23. Reinhard H, Semler O, Bürger D, Bode U, Flentje M, Göbel U, Gutjahr P, Leuschner I, Maass E, Niggli F, Scheel-Walter HG, Stöckle M, Thüroff JW, Tröger J, Weirich A, von Schweinitz D, Zoubek A, Graf N: Results of the SIOP 93-01/GPOH trial and study for the treatment of patients with unilateral nonmetastatic Wilms Tumor. Klin Padiatr; 2004 May-Jun;216(3):132-40
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  • [Title] Results of the SIOP 93-01/GPOH trial and study for the treatment of patients with unilateral nonmetastatic Wilms Tumor.
  • BACKGROUND: The treatment of Wilms Tumor is integrated into clinical trials since the 1970's.
  • In contrast to the National Wilms Tumor Study Group (NWTSG) the SIOP trials and studies largely focus on the issue of preoperative therapy to facilitate surgery of a shrunken tumor and to treat metastasis as early as possible.
  • 847 of them had a histological proven Wilms Tumor, of whom 637 were unilateral localized, and 173 tumors had an other histology [40 congenital mesoblastic nephroma (CMN), 51 clear cell sarcoma (CCSK), 24 rhabdoid tumor (RTK) and 58 other tumors].
  • Preoperative chemotherapy in benign tumors was given to 1.3 % of the patients.
  • The main objective of the trial was the randomized question, if the postoperative two drug chemotherapy for stage I in intermediate risk or anaplasia can be reduced from conventional 3 courses to an experimental 1 course without loss of efficacy.
  • RESULTS: 519 patients with unilateral nonmetastatic Wilms did receive preoperative chemotherapy.
  • The histology in this group of patients was of intermediate risk in 469 (90 %) patients, 14 (3 %) tumors were low risk and 36 (7 %) high risk.
  • The stage distribution of the tumors was stage I in 315 (61 %), stage II N- in 126 (24 %), stage II N+ in 25 (5 %) and stage III in 36 (7 %) patients.
  • In 17 (3 %) patients the tumor stage remained unclear.
  • Tumor volume was measured in 487 patients before and in 402 after preoperative chemotherapy.
  • Randomisation was done in 43.7 % for stage I patients and there was no difference in EFS for both treatment arms (90 versus 91 %).
  • The EFS is identical for patients with stage I and II N- (0.92), as well as for stage II N+ and III (0.82).
  • The tumor volume after chemotherapy is a prognostic factor for intermediate risk tumors with the exception of epithelial and stromal predominant tumors.
  • These two subtypes often present as large tumors, they do not shrink during preoperative chemotherapy but they still have an excellent prognosis.
  • On the other hand the prognosis of patients with blastemal predominant subtype after preoperative chemotherapy is worse than in any other patient group of intermediate risk tumors.
  • There are less blastemal predominant tumors compared to primary surgery, but they are chemotherapeutic resistant selected by the preoperative chemotherapy.
  • The post-operative chemotherapy in stage I can be reduced to 4 weeks without worsening treatment outcome.
  • The reduction of the tumor volume could be identified as a helpful marker for stratification of post-operative treatment.
  • Post-chemotherapy blastemal predominant subtype of Wilms tumor has to be classified as high risk tumor.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Kidney Neoplasms / drug therapy. Neoadjuvant Therapy. Wilms Tumor / drug therapy
  • [MeSH-minor] Adolescent. Chemotherapy, Adjuvant. Child. Child, Preschool. Combined Modality Therapy. Disease-Free Survival. Female. Follow-Up Studies. Humans. Infant. Male. Neoplasm Staging. Nephrectomy. Nephroma, Mesoblastic / drug therapy. Nephroma, Mesoblastic / mortality. Nephroma, Mesoblastic / pathology. Nephroma, Mesoblastic / surgery. Prognosis. Rhabdoid Tumor / drug therapy. Rhabdoid Tumor / mortality. Rhabdoid Tumor / pathology. Rhabdoid Tumor / surgery. Sarcoma, Clear Cell / drug therapy. Sarcoma, Clear Cell / mortality. Sarcoma, Clear Cell / pathology. Sarcoma, Clear Cell / surgery

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  • (PMID = 15175957.001).
  • [ISSN] 0300-8630
  • [Journal-full-title] Klinische Pädiatrie
  • [ISO-abbreviation] Klin Padiatr
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
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24. Tournade MF, Com-Nougué C, de Kraker J, Ludwig R, Rey A, Burgers JM, Sandstedt B, Godzinski J, Carli M, Potter R, Zucker JM, International Society of Pediatric Oncology Nephroblastoma Trial and Study Committee: Optimal duration of preoperative therapy in unilateral and nonmetastatic Wilms' tumor in children older than 6 months: results of the Ninth International Society of Pediatric Oncology Wilms' Tumor Trial and Study. J Clin Oncol; 2001 Jan 15;19(2):488-500
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  • [Title] Optimal duration of preoperative therapy in unilateral and nonmetastatic Wilms' tumor in children older than 6 months: results of the Ninth International Society of Pediatric Oncology Wilms' Tumor Trial and Study.
  • PURPOSE: To determine the optimal duration of preoperative chemotherapy to further increase the proportion of stage I tumors by comparison of two regimens in the treatment of patients older than 6 months who have unilateral Wilms' tumor.
  • PATIENTS AND METHODS: Eligible patients (n = 382) initially received four weekly doses of vincristine (VCR) and two courses of actinomycin D (AMD) and were randomized either to be operated on (4-week group [n = 193]) or to receive 4 more weeks of the same chemotherapy regimen (8-week group [n = 189]).
  • The assessment criterion was the observed percentage of stage I tumors.
  • After surgery, patients were assigned according to tumor stage and histology to four different treatment groups: stage I and favorable histology (n = 5) were to have no further treatment (NFT); stage I and standard histology or anaplasia (n = 244), VCR and AMD for 17 weeks (AV); stages II and III and favorable or standard histology, VCR, AMD, and an anthracycline for 27 weeks (AVE) with no abdominal radiotherapy for stage II N0 disease (n = 75) or with a 15-Gy dose of abdominal irradiation (RTH) in case of stages IIN1 and III (n = 56).
  • Anaplastic tumors staged higher than I or clear-cell sarcoma of the kidney (14), AMD, VCR, an anthracycline, and ifosfamide for 36 weeks (DEVI).
  • RESULTS: No advantage was found in favor of prolonged preoperative treatment.
  • The percentages obtained for the 4-week and the 8-week groups, respectively, were as follows: stage I, 64% versus 62%; intraoperative tumor rupture rate, 1% versus 3%; 2-year EFS, 84% versus 83%; and 5-year OS, 92% versus 87%.
  • Two-year EFS and 5-year OS rates, respectively, of the different treatment groups were as follows: NFT, 100% for both EFS and OS; AV, 88% and 93%; AVE, 84% and 88%; AVE RTH, 71% and 85%; and DEVI, 71% and 71%.
  • The rate of abdominal recurrences in stage II N0 nonirradiated patients was 6.6%.
  • CONCLUSION: The 4-week schedule pre-nephrectomy chemotherapy regimen should be considered the standard treatment.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Kidney Neoplasms / drug therapy. Wilms Tumor / drug therapy
  • [MeSH-minor] Adolescent. Antibiotics, Antineoplastic / administration & dosage. Chemotherapy, Adjuvant. Child. Child, Preschool. Dactinomycin / administration & dosage. Drug Administration Schedule. Humans. Infant. Neoplasm Staging. Nephrectomy. Survival Analysis. Vincristine / administration & dosage

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  • (PMID = 11208843.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 1CC1JFE158 / Dactinomycin; 5J49Q6B70F / Vincristine
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25. Tang JY, Pan C, Xu M, Xue HL, Chen J, Zhao HL, Gu LL, Wang YP: [Results of Wilms' tumor trial (WT-99) in Shanghai children's medical center]. Zhonghua Er Ke Za Zhi; 2003 Feb;41(2):131-4
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  • OBJECTIVE: Wilms' Tumor Trial (WT-99) of Shanghai Children's Medical Center was designed and conducted by applying therapeutic regimens stratified by stage and histology in accordance with National Wilms' Tumor Study (NWTS) criteria of U.S.A.
  • The main aim of WT-99 was to reduce treatment of low-stage, favorable-histology (FH) tumors without impairing survival and to improve prognosis of stage III and IV (FH) and unfavorable-histology (UFH) tremors with more intensive chemotherapy.
  • METHODS: Diagnosis and treatment was decided by the multi-disciplinary team including oncologists, surgeons, pathologists, radiologists and diagnostic radiologists.
  • The regimen for patients at favorable-histology (FH) stage I and II and anaplastic stage I was vincristine (Vcr) and dactinomycin (Act-D) only, while for those at focal anaplastic stage II to IV and FH stage III and IV the regimen was Vcr, Act-D and adriamycin (Adr).
  • Patients at diffuse anaplastic stage II to IV and clear cell stage I to IV received four-drug regimen including Vcr, etoposide (VP16), Adr and cytoxan (CTX).
  • For those at rhabdoid stage I to IV the regimen was carboplatin, VP-16 and CTX.
  • Un-resectable patients received 2 courses of Ifosfamide, Vcr and VP-16 as pre-surgery therapy.
  • No radiation therapy was used for patients at stage I and FH stage II.
  • Pathologic analysis showed fourteen cases were at their FH, three at unfavorable-histology (UFH), two at clear cell and one at rhabdoid stage.
  • Five patients were at stage I, five at stage II, six at stage III, three at stage IV and one at stage V.
  • One relapsed after 24 months of CCR and reached the second CR after intensive chemotherapy.
  • No therapy-related death happened.
  • [MeSH-major] Kidney Neoplasms / therapy. Wilms Tumor / therapy
  • [MeSH-minor] Academic Medical Centers. Bone Transplantation. Child. Child, Preschool. China. Combined Modality Therapy. Female. Humans. Infant. Male. Neoplasm Staging. Transplantation, Autologous. Treatment Outcome


26. Wu HY, Snyder HM 3rd, D'Angio GJ: Wilms' tumor management. Curr Opin Urol; 2005 Jul;15(4):273-6
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  • PURPOSE OF REVIEW: The management of Wilms' tumor continues to evolve with two different approaches being taken by the National Wilms Tumor Study in North America and the International Society of Pediatric Oncology in Europe in regards to preoperative chemotherapy.
  • RECENT FINDINGS: Contralateral exploration of unilateral tumors will no longer be recommended in future National Wilms Tumor Studies.
  • Percutaneous biopsy for tissue diagnosis is quite accurate, but there are concerning complications with its use.
  • Doxorubicin decreased the risk of recurrence in stage III tumors by 50%, and its current dose is not associated with late congestive heart failure.
  • A longer course of chemotherapy (including doxorubicin) for clear cell sarcoma improves recurrence-free survival.
  • Patients with Wilms' tumor, aniridia, major genitourinary malformations, and mental retardation, the WAGR syndrome, have a 50% chance of unexplained end-stage renal disease 20 years after treatment.
  • SUMMARY: Less aggressive means of diagnosis and treatment for Wilms' tumor are continuing to achieve very good cure rates while lowering long term morbidity for low risk patients.
  • High-risk patients with unfavorable histology or the WAGR syndrome benefit from more intensive treatment and long-term follow-up.
  • [MeSH-major] Kidney Neoplasms / therapy. Wilms Tumor / therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Child. Combined Modality Therapy. Doxorubicin / administration & dosage. Humans. Kidney Failure, Chronic / etiology. Nephrectomy. Vincristine / administration & dosage

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  • (PMID = 15928519.001).
  • [ISSN] 0963-0643
  • [Journal-full-title] Current opinion in urology
  • [ISO-abbreviation] Curr Opin Urol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin
  • [Number-of-references] 19
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27. Fernández-Pineda I, Cabello Laureano R, Fernández-Hurtado MA, Granero Cendón R, Tuduri Limousín I, Morcillo Azcárate J, Aspiazu Salinas D, García Vallés C, De Agustín Asensio JC: [Surgical management of bilateral Wilms' tumor: our experience with 18 cases]. Cir Pediatr; 2009 Oct;22(4):186-8
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  • [Transliterated title] Manejo quirúrgico del tumor de Wilms bilateral: nuestra experiencia con 18 casos.
  • METHODS: We have reviewed the medical records of 18 patients diagnosed of bilateral Wilms' tumor between 1971 and 2007, evaluating age, sex, clinical situation, imaging studies, histology, treatment, complications and follow-up.
  • RESULTS: 65% of patients with synchronous Wilms' tumor was stage I-II, 30% stage III and 5% stage IV.
  • 100% of patients with metachronous Wilms' tumor was stage I-II.
  • All the tumors had favourable histology.
  • CONCLUSIONS: Preoperative chemotherapy allows a conservative surgical resection with a high overall survival (80-90%).
  • Individualized surgical treatment offers a conservative surgical resection with a lower incidence of long-term renal failure.
  • [MeSH-major] Kidney Neoplasms / surgery. Neoplasms, Multiple Primary / surgery. Wilms Tumor / surgery

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  • (PMID = 20405651.001).
  • [ISSN] 0214-1221
  • [Journal-full-title] Cirugía pediátrica : organo oficial de la Sociedad Española de Cirugía Pediátrica
  • [ISO-abbreviation] Cir Pediatr
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Spain
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28. Jia HM, Zhang KR, Shu H, Tian BL, Wang WL: Presacral extrarenal Wilms tumor in a child. Urology; 2009 Aug;74(2):308-10
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  • OBJECTIVES: Wilms tumor (WT) is one of the most common solid tumors in children.
  • RESULTS: The exact mechanism whereby a WT occurs in extrarenal tissues is unknown.
  • Although imaging examinations are helpful in the definition of retroperitoneal tumors, no characteristic findings are available to diagnose an extrarenal WT before surgery.
  • Surgical excision is the treatment of choice and the same general therapeutic rules should be followed as when the kidney has been affected.
  • The use of Stage III guidelines for chemotherapy and radiotherapy are appropriate for these patients.

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  • (PMID = 19285712.001).
  • [ISSN] 1527-9995
  • [Journal-full-title] Urology
  • [ISO-abbreviation] Urology
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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29. Kutluk T, Varan A, Büyükpamukçu N, Atahan L, Cağlar M, Akyüz C, Büyükpamukçu M: Improved survival of children with wilms tumor. J Pediatr Hematol Oncol; 2006 Jul;28(7):423-6
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  • Survival rates were analyzed according to the stage of disease, histopathology, and different treatment regimens used between 1972 and 1999.
  • At diagnosis, 51.1% of patients had advanced stage disease.
  • Ten patients had anaplasia, and; 97% (317 patients) of the tumors had favorable histopathology.
  • The 10-year OS rate was 60.6% for the entire group, but varied according to the years in which the patients were treated, the chemotherapy regimen, and stage of disease.
  • Children with stage I to IV disease had 10-year OS rates of 75%, 77.1%, 54.4%, and 30.4%, respectively.
  • The 10-year OS rates for children with stage III and IV disease increased from 46.4% and 13.4% for patients treated between 1972 to 1979 period to 75% and 54.5% for children treated during 1990 to 1999.
  • The 10-year OS rate for children with Wilms tumor improved as treatment strategies evolved, illustrating that pediatric oncology in Turkey is developing parallel to the Western world.
  • [MeSH-major] Kidney Neoplasms / pathology. Wilms Tumor / pathology
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Infant. Infant, Newborn. Male. Neoplasm Staging. Prognosis. Survival Rate. Time. Treatment Outcome. Turkey

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  • (PMID = 16825987.001).
  • [ISSN] 1077-4114
  • [Journal-full-title] Journal of pediatric hematology/oncology
  • [ISO-abbreviation] J. Pediatr. Hematol. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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30. Jiang YG, Chen JH, Jiang R, Hang G, Wang GH, Wang D, Li FC, Liu H, Shi CJ, Wu HJ, Yuan YG: [Testicular tumor in Mongolian men (report of 35 cases)]. Zhonghua Nan Ke Xue; 2006 May;12(5):397-400
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  • OBJECTIVE: To improve the diagnosis, therapy and prognosis of testicular tumor in Mongolian men.
  • METHODS: A retrospective review of 35 cases of testicular tumors in Mongolian men from seven medical centers dated from 1990 to 2004 was performed.
  • Regarding stage, 22, 2, and 5 of 29 germ cell tumors were seen initially as stage I, II, and III, respectively.
  • Combined therapy, including radical orchiectomy, radiotherapy and chemotherapy, were taken.
  • CONCLUSION: In this article, the rate of seminoma to germ cell tumors is higher than that of general population.
  • Better public awareness regarding testicular tumor in this population, advances in diagnosis and therapy will help to improve therapeutic effectiveness and prognosis.
  • [MeSH-major] Testicular Neoplasms / diagnosis. Testicular Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Child, Preschool. Combined Modality Therapy. Follow-Up Studies. Humans. Infant. Male. Middle Aged. Prognosis. Retrospective Studies. Survival Rate

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  • (PMID = 16755865.001).
  • [ISSN] 1009-3591
  • [Journal-full-title] Zhonghua nan ke xue = National journal of andrology
  • [ISO-abbreviation] Zhonghua Nan Ke Xue
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article; Multicenter Study
  • [Publication-country] China
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31. Owens CM, Veys PA, Pritchard J, Levitt G, Imeson J, Dicks-Mireaux C: Role of chest computed tomography at diagnosis in the management of Wilms' tumor: a study by the United Kingdom Children's Cancer Study Group. J Clin Oncol; 2002 Jun 15;20(12):2768-73
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  • [Title] Role of chest computed tomography at diagnosis in the management of Wilms' tumor: a study by the United Kingdom Children's Cancer Study Group.
  • PURPOSE: This study sought to determine whether the identification of minimal pulmonary metastatic disease by chest computed tomography (CT) performed at diagnosis in patients with Wilms' tumor and normal chest x-rays (CXR) could predict a subgroup of children at increased risk of pulmonary relapse.
  • After surgery, children with stage I Wilms' tumor received single-agent chemotherapy (vincristine), whereas children with stages II, III, and bilateral Wilms' tumor received combination chemotherapy.
  • Most children with stage III tumors were also treated with abdominal radiotherapy (20 Gy).
  • When only stage I patients were analyzed, there was a significant difference between the pulmonary relapse rate of 43% (three of seven) in the CT-positive group and 10% (five of 48) in the CT-negative group (P =.02).
  • Four of eight patients with stage I disease with pulmonary relapse died.
  • CONCLUSION: CT seemed to identify a subgroup of stage I patients who were at increased risk of pulmonary relapse.
  • These children had received only single-agent chemotherapy.
  • A prospective randomized trial is needed to clarify whether these children would benefit from combination chemotherapy.
  • [MeSH-major] Kidney Neoplasms / pathology. Lung Neoplasms / radiography. Lung Neoplasms / secondary. Neoplasm Staging. Tomography, X-Ray Computed. Wilms Tumor / radiography. Wilms Tumor / secondary
  • [MeSH-minor] Antineoplastic Agents, Phytogenic / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Child, Preschool. Female. Humans. Infant. Infant, Newborn. Male. Predictive Value of Tests. Prognosis. Recurrence. Retrospective Studies. Risk Factors. Vincristine / therapeutic use

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  • [CommentIn] J Clin Oncol. 2002 Jun 15;20(12):2763-4 [12065550.001]
  • (PMID = 12065552.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 5J49Q6B70F / Vincristine
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32. Monge AH, Pineda RP, del Rocio Estrada Hernandez M, Juárez EG, García JC: [Fallopian tube primary invasive adenocarcinoma associated with acute inflammatory pelvic disease. Case report and literature review]. Ginecol Obstet Mex; 2008 Feb;76(2):118-24
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  • [Transliterated title] Adenocarcinoma invasor primario de trompa de falopio concomitante con enfermedad pélvica inflamatoria aguda. Comunicación de un caso y revisión de la bibliografía.
  • The primary fallopian tube invader adenocarcinoma is a preoperative diagnosis rarely reported in the literature, because is the most uncommon of all gynecological tumors, with prevalence from 0.3 to 1.8%.
  • The treatment is predominantly surgical, as that of epithelial ovarian carcinoma, and consists of an intraperitoneal washing, total abdominal hysterectomy with bilateral salpingo-oophorectomy and a proper staging.
  • In the more advanced stages III and IV that required a radical debulking, we have to be very emphatic in citoreduction.
  • In some cases, as the persistence or recurrence of illness, it can be necessary adjuvant chemotherapy.
  • In some patients in early stage I or II with low risk, the complete staging could not be necessary.
  • There is controversy about administration criteria of adjuvant treatment, since there is not evidence of survival increase related to its use.
  • The five years survival rate was 64% for stage I, 42% for stage II, 32% for stage III, and 17% for stage IV.
  • [MeSH-minor] Abdomen, Acute / etiology. Acute Kidney Injury / etiology. Anti-Bacterial Agents / therapeutic use. Anuria / etiology. Ceftriaxone / therapeutic use. Clindamycin / therapeutic use. Female. Humans. Hysterectomy. Middle Aged. Ovariectomy. Peritonitis / drug therapy. Peritonitis / etiology

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  • (PMID = 18798405.001).
  • [ISSN] 0300-9041
  • [Journal-full-title] Ginecología y obstetricia de México
  • [ISO-abbreviation] Ginecol Obstet Mex
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Mexico
  • [Chemical-registry-number] 0 / Anti-Bacterial Agents; 3U02EL437C / Clindamycin; 75J73V1629 / Ceftriaxone
  • [Number-of-references] 10
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33. Brisse HJ, Schleiermacher G, Sarnacki S, Helfre S, Philippe-Chomette P, Boccon-Gibod L, Peuchmaur M, Mosseri V, Aigrain Y, Neuenschwander S: Preoperative Wilms tumor rupture: a retrospective study of 57 patients. Cancer; 2008 Jul 1;113(1):202-13
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  • BACKGROUND: According to current International Society of Pediatric Oncology (SIOP) Wilms recommendations, all preoperative tumor ruptures should be classified as stage IIIc.
  • METHODS: The authors performed a retrospective analysis of 57 children with clinical and/or radiologic (computed tomography [CT]) signs of preoperative tumor rupture of a series of 250 patients enrolled in Wilms SIOP protocols at their institution.
  • Surgery was performed after chemotherapy in 55 of 57 patients.
  • Peritoneal disease recurrence occurred in 3 of 57 patients, including 2 patients with stage III tumors who had initial intraperitoneal rupture and 1 patient with a stage I tumor.
  • Among the 48 patients who had radiologic signs of retroperitoneal-only rupture, the final pathologic stage was stage III in 22 patients, stage II in 9 patients, and stage I in 17 patients, and no abdominal disease recurrence was observed, although only 23 of 48 patients received flank radiotherapy.
  • In contrast, patients who have radiologic signs of localized retroperitoneal-only rupture at diagnosis most likely should not be upstaged, and their treatment may be determined according to pathologic stage only.
  • [MeSH-major] Kidney Neoplasms / complications. Rupture, Spontaneous / complications. Wilms Tumor / complications
  • [MeSH-minor] Chemotherapy, Adjuvant. Child, Preschool. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Infant. Male. Neoadjuvant Therapy. Neoplasm Recurrence, Local. Preoperative Care. Retrospective Studies. Tomography, X-Ray Computed

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  • [Copyright] (Copyright) 2008 American Cancer Society.
  • (PMID = 18457331.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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34. Hung IJ, Chang WH, Yang CP, Jaing TH, Liang DC, Lin KH, Lin DT, Hsiao CC, Hsieh YL, Chen JS, Chang TT, Peng CT, Shu SG, Lin MT, Chen BW, Lin KS, Taiwan Pediatric Oncology Group: Epidemiology, clinical features and treatment outcome of Wilms' tumor in Taiwan: a report from Taiwan Pediatric Oncology Group. J Formos Med Assoc; 2004 Feb;103(2):104-11
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  • [Title] Epidemiology, clinical features and treatment outcome of Wilms' tumor in Taiwan: a report from Taiwan Pediatric Oncology Group.
  • Patients received individualized multimodality treatment based upon the histology of the tumor and clinicopathologic stage.
  • The treatment included surgery, radiotherapy and 2-, 3-, and 4-agent active chemotherapeutic agents.
  • Seventy patients were eligible for analysis of treatment outcome.
  • Patients were divided into various subgroups according to the chemotherapy regimen used, tumor stage, age at diagnosis, gender, and tumor weight.
  • All bilateral tumors occurred in females.
  • The stage distribution was: I, 43.2%; II, 19.3%; III, 23.9%; IV, 6.8%; and V, 6.8%.
  • The median follow-up time was 89.1 months (range, 1.8 to 128.1 months).
  • The 5-year PFS rate was 0.7841 (SE, 0.0494; 53 of 70 patients) and the 5-year OS rate was 0.886 (SE, 0.038; 63 of 70 patients).
  • CONCLUSIONS: This study evaluated the epidemiological characteristics, clinical features, multimodality therapy regimens, and treatment outcome of WT in Taiwan.

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  • (PMID = 15083240.001).
  • [ISSN] 0929-6646
  • [Journal-full-title] Journal of the Formosan Medical Association = Taiwan yi zhi
  • [ISO-abbreviation] J. Formos. Med. Assoc.
  • [Language] ENG
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Singapore
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35. Tamaskar I, Pili R: Update on novel agents in renal cell carcinoma. Expert Rev Anticancer Ther; 2009 Dec;9(12):1817-27
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  • Renal cell carcinoma (RCC) is a disease with a variable natural history, sometimes presenting with a very indolent course and other times with an aggressive clinical course and unusual sites of metastasis.
  • Surgical resection for stage I-III tumors represents the standard of care and is the only curative option available to patients.
  • Prior to the advent of targeted therapy, cytokine therapy was the only treatment for RCC.
  • The use of IFN-alpha is currently limited to combination therapies.
  • In the majority of cases these drugs induce disease stabilization with eventual disease progression.
  • Mechanisms of drug resistance, novel combinations, sequences and schedules are the focus of current clinical investigations.
  • [MeSH-major] Antineoplastic Agents / pharmacology. Carcinoma, Renal Cell / drug therapy. Kidney Neoplasms / drug therapy
  • [MeSH-minor] Animals. Drug Delivery Systems. Drug Resistance, Neoplasm. Humans. Neoplasm Metastasis. Neoplasm Staging. Treatment Outcome

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  • (PMID = 19954293.001).
  • [ISSN] 1744-8328
  • [Journal-full-title] Expert review of anticancer therapy
  • [ISO-abbreviation] Expert Rev Anticancer Ther
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 58
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36. Greco M, Brugnara M, Zaffanello M, Taranta A, Pastore A, Emma F: Long-term outcome of nephropathic cystinosis: a 20-year single-center experience. Pediatr Nephrol; 2010 Dec;25(12):2459-67
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  • Nephropathic cystinosis (NC) is a severe disease that is complicated by early-onset chronic renal failure (CRF) and other complications related to cystine deposition in tissue.
  • Since the 1980s, the prognosis of NC has dramatically improved after the introduction of cysteamine treatment.
  • Overall, stage III CRF was reached at 10 years of age in >90% of patients, whereas >80% reached end-stage renal disease before the age of 14 years.
  • Of note, 3/23 patients developed rare forms of primary tumors that were successfully treated.
  • [MeSH-major] Cysteamine / therapeutic use. Kidney / drug effects. Kidney Failure, Chronic / drug therapy
  • [MeSH-minor] Adolescent. Angiotensin-Converting Enzyme Inhibitors / therapeutic use. Child. Child, Preschool. Cystinosis. Disease Progression. Drug Therapy, Combination. Early Diagnosis. Fanconi Syndrome. Female. Humans. Infant. Italy. Kaplan-Meier Estimate. Logistic Models. Male. Nephrotic Syndrome / complications. Nephrotic Syndrome / diagnosis. Nephrotic Syndrome / drug therapy. Nephrotic Syndrome / physiopathology. Retrospective Studies. Risk Assessment. Risk Factors. Time Factors. Treatment Outcome

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  • (PMID = 20803298.001).
  • [ISSN] 1432-198X
  • [Journal-full-title] Pediatric nephrology (Berlin, Germany)
  • [ISO-abbreviation] Pediatr. Nephrol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Angiotensin-Converting Enzyme Inhibitors; 5UX2SD1KE2 / Cysteamine
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37. Reinhard H, Aliani S, Ruebe C, Stöckle M, Leuschner I, Graf N: Wilms' tumor in adults: results of the Society of Pediatric Oncology (SIOP) 93-01/Society for Pediatric Oncology and Hematology (GPOH) Study. J Clin Oncol; 2004 Nov 15;22(22):4500-6
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  • They were treated according to the pediatric protocol and were analyzed for clinical presentation, stage distribution, and prognosis.
  • Tumor stages were defined according to SIOP, and treatment was risk-adapted according to SIOP 93-01/Society for Pediatric Oncology and Hematology (GPOH) protocol.
  • Specimens of all tumors were centrally reviewed.
  • RESULTS: Ten patients (33%) had metastatic disease at the time of diagnosis (liver, four patients; lung, three patients; liver and lung, three patients).
  • The local stage distribution showed a predominance of higher stages (stage I, eight patients; stage IIN-, three patients; stage IIN+, four patients; stage III, 15 patients).
  • Histologic studies revealed intermediate-risk in 23 of 30 tumors; two tumors were classified as high-risk; and three tumors were clear-cell sarcomas.
  • Two of 30 patients showed a nephroblastoma and a renal cell carcinoma simultaneously in the same kidney.
  • A complete remission was achieved in 24 patients; four patients relapsed after complete remission; and three of them reached a second remission with further treatment.
  • Event-free survival was 57%, with an overall survival of 83% (median observation time, 4 years).
  • CONCLUSION: Adults can be cured in a high percentage by a multimodal treatment according to pediatric protocols.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Kidney Neoplasms / drug therapy. Kidney Neoplasms / pathology. Wilms Tumor / drug therapy. Wilms Tumor / pathology
  • [MeSH-minor] Adolescent. Adult. Age Factors. Disease-Free Survival. Female. Humans. Male. Middle Aged. Neoplasm Staging. Prognosis. Retrospective Studies. Treatment Outcome

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  • (PMID = 15542800.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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38. Rini BI, Wilding G, Hudes G, Stadler WM, Kim S, Tarazi J, Rosbrook B, Trask PC, Wood L, Dutcher JP: Phase II study of axitinib in sorafenib-refractory metastatic renal cell carcinoma. J Clin Oncol; 2009 Sep 20;27(27):4462-8
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  • PURPOSE: To investigate the efficacy and safety of axitinib, an oral, potent, and selective inhibitor of vascular endothelial growth factor (VEGF) receptors 1, 2, and 3 in patients with metastatic renal cell carcinoma (mRCC) refractory to prior therapies that included, but were not limited to, sorafenib.
  • A one-arm, single-stage design was used to estimate the primary end point of objective response rate (ORR), defined by RECIST (Response Evaluation Criteria in Solid Tumors).
  • RESULTS: Of 62 patients recruited, 100% had received prior sorafenib, and 74.2% had received two or more prior systemic treatments.
  • Median PFS and OS times were 7.4 months (95% CI, 6.7 to 11.0 months) and 13.6 months (95% CI, 8.4 to 18.8 months), respectively.
  • CONCLUSION: Axitinib has antitumor activity in patients with mRCC refractory to prior VEGF-targeted therapy, including sorafenib.
  • A randomized, phase III trial to compare axitinib with sorafenib in patients who have mRCC refractory to one prior first-line therapy regimen is underway.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Carcinoma, Renal Cell / drug therapy. Imidazoles / therapeutic use. Indazoles / therapeutic use. Kidney Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Benzenesulfonates / therapeutic use. Female. Humans. Male. Middle Aged. Niacinamide / analogs & derivatives. Phenylurea Compounds. Pyridines / therapeutic use

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  • (PMID = 19652060.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Benzenesulfonates; 0 / Imidazoles; 0 / Indazoles; 0 / Phenylurea Compounds; 0 / Pyridines; 25X51I8RD4 / Niacinamide; 9ZOQ3TZI87 / sorafenib; C9LVQ0YUXG / axitinib
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