Document Detail


Wilms' tumour: a comparison of surgical aspects in patients with or without pre-operative chemotherapy.
MedLine Citation:
PMID:  16899180     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the technical aspects of Wilms' tumour (WT) surgery in patients with and without pre-operative chemotherapy. DESIGN: Quasi-experimental. PLACE AND DURATION OF STUDY: Military Hospital (MH) and Combined Military Hospital (CMH), Rawalpindi, from January 1999 to December 2004. PATIENTS AND METHODS: Patients of WT, presenting between January 1999 and December 2001, were treated, using the NWTSG protocol, with primary surgery (group I). Between January 2001 and December 2004, WT patients were treated according to SIOP protocol, with pre-operative chemotherapy followed by surgery (group II). Volume reduction with chemotherapy, duration of surgery, rupture of tumour, extent of excision, adherence and damage to surrounding structures, blood loss, complications, stay in hospital and event-free survival (EFS) were compared in the two groups. RESULTS: Out of 22 patients in group I, 19 (86.4%) underwent primary surgery. Of the 23 patients in group II, 21 (91.3%) received pre-operative chemotherapy followed by surgery. Average volume reduction in this group was 54% with chemotherapy. Difference in duration of surgery and blood loss was significantly low in group II (p=0.003 and p < 0.001, respectively). In group I, rupture (6 vs 2), adherence (14 vs 10) and damage to surrounding structures (5 vs 2) were more. Complete macroscopic excision was possible in 90.5% of WT in group II as compared to 73.7% in group I. Immediate postoperative complications and length of hospital stay were similar in both groups. There was no difference in EFS. CONCLUSION: Pre-operative chemotherapy makes it technically easier and safer to operate, without jeopardizing the final outcome.
Authors:
C Aqeel Safdar; Mushahid Aslam; Safdar Hussain Awan; Iftikhar Ahmed; Shahida Badshah
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the College of Physicians and Surgeons--Pakistan : JCPSP     Volume:  16     ISSN:  1022-386X     ISO Abbreviation:  J Coll Physicians Surg Pak     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-10     Completed Date:  2006-11-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9606447     Medline TA:  J Coll Physicians Surg Pak     Country:  Pakistan    
Other Details:
Languages:  eng     Pagination:  521-4     Citation Subset:  IM    
Affiliation:
Department of Paediatric Surgery, Military Hospital, The Mall, Rawalpindi, Pakistan. aqeel.safdar@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Antineoplastic Agents / therapeutic use*
Chemotherapy, Adjuvant
Child
Child, Preschool
Disease-Free Survival
Female
Follow-Up Studies
Humans
Infant
Kidney Neoplasms / drug therapy*,  pathology,  surgery*
Length of Stay
Male
Neoadjuvant Therapy*
Neoplasm Staging
Pakistan
Postoperative Complications / etiology,  mortality
Treatment Outcome
Tumor Burden / drug effects
Wilms Tumor / drug therapy*,  pathology,  surgery*
Chemical
Reg. No./Substance:
0/Antineoplastic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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