PAPS paperThe prognostic significance of blastemal predominant histology in initially resected Wilms’ tumors: A report from the Study Group for Pediatric Solid Tumors in the Kyushu Area, Japan
Section snippets
Patients
In the Kyushu area in Japan, the registration system for pediatric solid malignant tumors was established in 1971 [5]. A total of 259 pediatric renal tumor were registered between 1971 and 2005. All of these cases were treated by either complete resection or incomplete resection before chemotherapy. Among these cases, 174 Wilms’ tumors, for which prognosis was confirmed by follow-up survey, were extracted for this study. The study was performed according to the Ethical Guidelines for Clinical
Results
There were 112 cases of mixed type, 17 cases of epithelial type, 15 cases of mesenchymal (stromal) type, and 26 cases of the blastemal predominant type of Wilms’ tumor that were defined during the re-classification. Anaplasia was recognized in four cases. (Table 3). The affected age was slightly older in the blastemal predominant type group than other groups (mixed, epithelial, mesenchymal type), however, the difference was not significant.
The treatment strategies of all cases were identical to
Discussion
It is well known that the pathology of Wilms’ tumors demonstrates tri-phasic features, namely, blastemal, epithelial, and stromal components. Concerning the NWTS protocol, which is based on the pathological findings obtained from initially resected tumor specimens, the tumors are generally considered to have favorable histology (nephroblastoma without anaplasia) or unfavorable histology (anaplasia). In the SIOP protocol, the classification depends on the pathological findings associated with
Acknowledgments
The authors thank Mr. Brian Quinn for reading the manuscript. This work was supported in part by a grant-in-aid for scientific research from the Japanese Society for the Promotion of Science.
References (16)
- et al.
Clinical characteristics and outcome of Wilms tumors with a favorable histology in Japan: a report from the Study Group for Pediatric Solid Malignant Tumors in the Kyushu area, Japan
J Pediatr Surg
(2006) - et al.
Current management of Wilms’ tumor in children
J Pediatr Urol
(2009) - et al.
Clinical impact of histologic subtypes in localized nonanaplastic nephroblastoma treated according to the trial and study SIOP-9/GPOH
Ann Oncol
(2001) - et al.
The new SIOP (Stockholm) working classification of renal tumors of childhood
Med Pediatr Oncol
(1996) - et al.
Revised International Society of Paediatric Oncology (SIOP) working classification of renal tumors of childhood
Med Pediatr Oncol
(2002) - et al.
The pathology of Wilms’ tumour (nephroblastoma): the International Society of Paediatric Oncology approach
J Clin Pathol
(2010) - et al.
Outcome of pediatric renal tumor treated using the Japan Wilms Tumor Study-1 (JWiTS-1) protocol: a report from the JWiTS group
Pediatr Surg Int
(2009) - et al.
Outcome of relapses of nephroblastoma in patients registered in the SIOP/GPOH trials and studies
Oncol Rep
(2008)