Effectiveness of Nephron Sparing Surgery and Radical Nephrectomy in the Management of Unilateral Wilms Tumor: A Meta-Analysis

Chen, Hongkun; Shu-qing, Yang; Qian, Cheng

doi:10.3389/fonc.2020.01248

Cited by 17 publications

(13 citation statements)

References 59 publications

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“…COG suggests that only the initiation of the treatment with surgery allows precise assessment of the local advancement stage and the histopathological type of the tumor, which is crucial for the selection of the type and intensity of postoperative treatment. The treatment results in both groups are comparable [18].…”

Section: Treatmentmentioning

confidence: 78%

Wilms tumor (nephroblastoma) – clinical and genetic aspects

Janeczko-Czarnecka

Ślężak

Pietras

et al. 2022

Nowotwory. Journal of Oncology

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Nephroblastoma (Wilms tumor -WT) is the most common kidney tumor among the pediatric population, fifth among malignant neoplasms and third among solid tumors. The most common type of WT is sporadic and unilateral. WT occurs either as an isolated, nonsyndromic WT or as syndromic one belonging to the spectrum of a variety of genetic syndromes. Molecular genetic testing should be considered in nonsyndromic WT and include a multigene panel or whole exome sequencing (WES); in syndromic cases single-gene testing, DNA methylation panel and chromosomal microarray. Outcomes of treatment in WT patients remain very good, but there are still subgroups with poor prognosis and increased relapse rates, especially in the blastemic and disseminated anaplasia types. WT survivors have increased risk of chronic kidney disease (CKD). They need further follow-up, not only by oncologists but also by nephrologists, to preserve kidney function or slow down CKD progression.

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Section: Treatmentmentioning

confidence: 78%

Wilms tumor (nephroblastoma) – clinical and genetic aspects

Janeczko-Czarnecka

Ślężak

Pietras

et al. 2022

Nowotwory. Journal of Oncology

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“…As of date, some excellent systematic reviews[ 40 41 ] and meta-analysis[ 42 ] on the topic of NSS in uWT are available. The first and only (RCT) study hitherto on the topic has been recently reported by a team of urologists from Belgaum, Karnataka, India.…”

Section: Discussionmentioning

confidence: 99%

“…Chen et al . [ 42 ] in a recent meta-analysis recommended the use of NSS for uWT. The procedure accounted for higher survivability and postoperative renal function and lesser incidence of relapse as compared to RN.…”

Section: Discussionmentioning

confidence: 99%

Nephron-Sparing Surgery in Nonsyndromic Unilateral Wilms' tumor

Sarin

2022

Journal of Indian Association of Pediatric Surgeons

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Background: Unilateral Wilms' tumor (uWT) is the most common renal malignancy in the pediatric population. Although the onset of surgical intervention like radical nephrectomy (RN) has substantially reduced the mortality rate, recent evidence has raised concerns regarding several postoperative complications associated with this procedure. Nephron-sparing surgery (NSS) has been reported to avoid such postoperative complications and have high technical success rate. However, not much literature is available comparing the efficacy of RN and NSS for managing nonsyndromic uWT, which makes it less acceptable globally. Materials and Methods and Results: A systematic identification of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines on four academic databases: MEDLINE, Scopus, EMBASE, and CENTRAL. Out of 1017 records, 20 manuscripts including 312 patients were included in the review; 4 patients treated by the author (unpublished data) have also been included. The studies included 7 retrospective case series with no comparison group, 4 retrospective case series with comparison group, 4 retrospective series with a cursory mention of NSS in uWT, 2 case reports, 1 protocolized prospective trial with comparison group, 1 administrative database analysis with comparison group, and 1 randomized controlled study. In all, 316 patients with nonsyndromic uWT were studied. The pretherapy volumes of the WT ranged from 2.4 to 640 ml. Majority of them were administered preoperative chemotherapy. About half of the patients ( n = 159) (50.3%) were Stage I tumors. Stage II, III, and IV tumors were seen in 23 (7.3%), 20 (6.3%), and 3 (1%) patients. Stage was not specified in 111 (35.1%) patients. Majority of them were “intermediate risk” WT. All these tumors were nonanaplastic. Surgical margins were reported positive in 13 (4%) patients. Overall and event-free survivals were 100% in most of the studies; only handful of relapses were noted in this systematic review. Conclusions: This qualitative systematic review recommends the use of NSS for nonsyndromic uWT. The procedure accounts for higher postoperative renal function and lesser incidence of hypertension as compared to the radical nephrectomy. Overall and event-free survivals are comparable or even better with NSS.

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“…The self-rating anxiety scale (SAS) ( 12 ) and the self-rating depression scale (SDS) ( 13 ) were used to assess the psychological state before and after nursing, which included 20 items, with a total score of 80 points. The higher the total score is, the worse the psychological state of the children is.…”

Section: Methodsmentioning

confidence: 99%

Effect of Orem’s Self-Care Theory Combined with Active Pain Assessment on Pain, Stress and Psychological State of Children with Nephroblastoma Surgery

Tang

Chen

2022

Front. Surg.

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BackgroundWith the development of medical technology and the innovation of various surgical options, the survival time of children with nephroblastoma is significantly prolonged. However, postoperative pain and stress response have been plagued by children with nephroblastoma during the postoperative treatment. At present, there is still a lack of effective care programs.MethodsWe accessed our institutional database to retrospectively screen clinical data from all children with nephroblastoma who were surgically treated in our hospital between July 2020 and July 2021. Some children received routine care, while others received Orem-based self-care theory and active pain assessment.ResultsAccording to the inclusion and exclusion criteria, 150 children with nephroblastoma who underwent surgical treatment were included in this study. On the third day after surgery, the scores of pain control effect and satisfaction degree of pain education in the study group were higher than those in the control group, and the physical and daily life influence, emotion influence, and pain experienced in the study group were lower than those in the control group. The differences were statistically significant (p < 0.001). There was no significant difference in C-SUPPH and ESCA scores between the two groups before nursing (p > 0.05). After nursing, the C-SUPPH and ESCA scores of the two groups were higher than those before nursing, and the C-SUPPH and ESCA scores of the study group were higher than those of the control group (p < 0.05). Before nursing, the levels of ACTH, Cor, and ANP between the two groups were not statistically significant (p > 0.05). The levels of ACTH, Cor, and ANP in the two groups were lower than those before nursing and 3 d and 7 d after nursing, and the index levels after 7 d of nursing were lower than those after 3 d of nursing. After nursing, the levels of ACTH, Cor, and ANP in the study group at each time point were lower than those in the control group (p < 0.05). There was no significant difference in SAS and SDS scores between the two groups before nursing (p > 0.05). After nursing, the SAS and SDS scores of both groups were lower than those before nursing, and the SAS and SDS scores of the study group were lower than those of the control group (p < 0.05). There was no significant difference in PSQI scores between the two groups before nursing (p > 0.05). After nursing, the PSQI scores of the two groups were lower than those before nursing, and the PSQI scores of the study were lower than those of the control group (p < 0.05). The average daily crying time, the average hospitalization time, and postoperative off-bed time in the study group were shorter than those in the control group (p < 0.05).ConclusionOrem’s self-care theory combined with active pain assessment can reduce pain in children undergoing nephroblastoma surgery, improve their stress response and psychological state, and improve their sleep quality, which is conducive to postoperative recovery and worthy of promotion.

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Effectiveness of Nephron Sparing Surgery and Radical Nephrectomy in the Management of Unilateral Wilms Tumor: A Meta-Analysis

Cited by 17 publications

References 59 publications

Wilms tumor (nephroblastoma) – clinical and genetic aspects

Wilms tumor (nephroblastoma) – clinical and genetic aspects

Nephron-Sparing Surgery in Nonsyndromic Unilateral Wilms' tumor

Effect of Orem’s Self-Care Theory Combined with Active Pain Assessment on Pain, Stress and Psychological State of Children with Nephroblastoma Surgery

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