TY - JOUR
T1 - Therapy and outcome in 51 children with mesoblastic nephroma
T2 - A report of the national Wilms' tumor study
AU - Howell, C. G.
AU - Othersen, H. B.
AU - Kiviat, N. E.
AU - Norkool, P.
AU - Beckwith, J. B.
AU - D'Angio, G. J.
N1 - Funding Information:
From the National Wilms" Tumor Study & Children's Cancer Research Center of The Children's Hospital of Philadelphia, Philadelphia, Penn. Supported in part by USPHS Grant No. CA 11722. Principal investigators enrolled in three participating cooperative study groups, Cancer and Acute Leukemia Group B, Children's Cancer Study Group, and Southwest Oncology Group, also received support from the NIH. Presented before the Thirteenth Annual Meeting of the American Pediatric Surgical Association, Phoenix, Arizona, May 29-June 1, 1982. Address reprint requests to C. G. Howell, M.D., Division of Pediatric Surgery, Medical College of Georgia, Augusta, Ga. 30912. 9 1982 by Grune & Stratton, Inc. 0022-3468/82/1706~9019501.00/0
PY - 1982/12
Y1 - 1982/12
N2 - Mesoblastic nephroma is a distinctive pathologic renal tumor with unique clinical, therapeutic, and prognostic patterns. This report reviews 51 patients (2.8% of 1905 patients submitted to NWTS with renal tumors) with this diagnosis from the NWTS contrasting this disease entity with Wilms' tumor. There were 33 males and 18 females, predominantly term babies born after uncomplicated pregnancies. The mean age at tumor excision was 3.44±0.6 mo (one child 9 yr). A palpable mass was the predominant presentation in 48 patients and in addition hematuria (9), hypertension (2), vomiting (3), and jaundice (1) were noteworthy. Diagnostic studies included IVP (49 positive, 2 negative) and ultrasound (15 positive, 1 negative). Adequate operative excision was achieved in 43 of 51 patients while 8 children had local extension and 10 had tumor spillage. Operation alone (23), predominantly since 1978, surgery plus chemotherapy (24), prior to 1978, and surgery, chemotherapy, and radiation therapy (4), prior to 1976, were the modes of therapy. The follow-up ranges from 4 mo to 11.5 yr. Survival was excellent; 50 patients survive (98%), only 1 dying of sepsis. These data suggest that mesoblastic nephroma contrasts with Wilms' tumor in that it occurs in a younger age group, has a benign biologic behavior, and a more favorable outcome. Aggressive multimodal treatment though utilized in the early years of the study is not essential to achieve this outcome.
AB - Mesoblastic nephroma is a distinctive pathologic renal tumor with unique clinical, therapeutic, and prognostic patterns. This report reviews 51 patients (2.8% of 1905 patients submitted to NWTS with renal tumors) with this diagnosis from the NWTS contrasting this disease entity with Wilms' tumor. There were 33 males and 18 females, predominantly term babies born after uncomplicated pregnancies. The mean age at tumor excision was 3.44±0.6 mo (one child 9 yr). A palpable mass was the predominant presentation in 48 patients and in addition hematuria (9), hypertension (2), vomiting (3), and jaundice (1) were noteworthy. Diagnostic studies included IVP (49 positive, 2 negative) and ultrasound (15 positive, 1 negative). Adequate operative excision was achieved in 43 of 51 patients while 8 children had local extension and 10 had tumor spillage. Operation alone (23), predominantly since 1978, surgery plus chemotherapy (24), prior to 1978, and surgery, chemotherapy, and radiation therapy (4), prior to 1976, were the modes of therapy. The follow-up ranges from 4 mo to 11.5 yr. Survival was excellent; 50 patients survive (98%), only 1 dying of sepsis. These data suggest that mesoblastic nephroma contrasts with Wilms' tumor in that it occurs in a younger age group, has a benign biologic behavior, and a more favorable outcome. Aggressive multimodal treatment though utilized in the early years of the study is not essential to achieve this outcome.
KW - Mesoblastic nephroma
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U2 - 10.1016/S0022-3468(82)80451-X
DO - 10.1016/S0022-3468(82)80451-X
M3 - Article
C2 - 6298397
AN - SCOPUS:0020422977
SN - 0022-3468
VL - 17
SP - 826
EP - 831
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 6
ER -