Inferior vena cava involvement in children with Wilms tumor

Diab, Abeer Al; Hirmas, Nader; Al-Mousa, Abdellatif; Abu-Hijlih, Ramiz; Aljlouni, Fatinah; Sultan, Iyad; Ghandour, Khalil

doi:10.1007/s00383-016-4034-7

Cited by 21 publications

(15 citation statements)

References 19 publications

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“…The survival rate of patients with WT is greater than 85-90% [9,10]. WT may also be accompanied by adjacent vascular invasion (renal veins, the IVC, and the right at-rium) [3]. WT patients with intravascular extension have similar or slightly worse overall survival than those without intravascular extension [5].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of intravascular extension with WT into the inferior vena cava has been reported 4% to 10% patients. Extension of tumor thrombus into the renal vein has been reported more common (59-85%) and into the right atrium is less reported (0.7-1%) [3].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have recommended preoperative chemotherapy for tumor thrombus with WT, which effec-tively leads to tumor shrinkage and venous tumor thrombus regression [3][4][5]. Primary surgical treatment should be performed after considering several factors such as age at diagnosis, size, location, and extent of the thrombus, surgical accessibility, clinical symptoms, and the high risk of pulmonary embolism [3,4,6]. But, recently preoperative chemotherapy is recommended for all WT patients except when the patient's vital signs are unstable [4,5].…”

Section: Introductionmentioning

confidence: 99%

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A Case of Wilms Tumor with a Tumor Thrombus in a Boy with WAGR Syndrome

Lee

Kim

Jeon

2020

Clin Pediatr Hematol Oncol

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Intravascular extension of Wilms tumor (WT) can occur in approximately 4-10% of patients. In general, it does not cause any clinical problems because most of these tumors are small. Although there is no standard treatment currently, preoperative chemotherapy and delayed nephrectomy is generally recommended for children with WT accompanied by tumor thrombus. We report a rare case of WT, aniridia, genitourinary anomalies, and mental retardation (WAGR) syndrome in a boy who also had a huge inferior vena cava thrombus, 7 cm length. The prevalence of bilateral WT and tumor thrombus in WAGR has not been identified. The patient was successfully treated with neoadjuvant chemotherapy to decrease the size of the tumor thrombus with WT and delayed nephrectomy following chemotherapy without any invasive intervention and did not show complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Case of Wilms Tumor with a Tumor Thrombus in a Boy with WAGR Syndrome

Lee

Kim

Jeon

2020

Clin Pediatr Hematol Oncol

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“…Although most IVCS is due to thrombosis of the IVC, not all IVC thromboses fully manifest as IVCS. In neonates, IVCS occurs secondary to external compression from oncologic pathology, intrinsic blockage from thrombus due to known or iatrogenic causes, or in utero thrombosis . The epidemiology of IVCS remains undetermined because of the broad clinical presentation.…”

Section: Introductionmentioning

confidence: 99%

“…In neonates, IVCS occurs secondary to external compression from oncologic pathology, intrinsic blockage from thrombus due to known or iatrogenic causes, or in utero thrombosis. [1][2][3][4] The epidemiology of IVCS remains undetermined because of the broad clinical presentation. In the Canadian registry of catheter-related venous thromboembolism (VTE) in children of all ages, IVC involvement occurred in 10% of the cases.…”

Section: Introductionmentioning

confidence: 99%

Inferior vena cava syndrome in neonates: An evidence‐based systematic review of the literature

Tieu

Paes

et al. 2019

Pediatric Blood & Cancer

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Neonatal inferior vena cava syndrome (IVCS), though uncommon, is associated with significant morbidity and mortality. Information on risk factors, diagnosis, treatment, and outcomes is limited. This review comprised 61 neonates across 33 reports. Thrombosis occurred in 98% and 42% involved a central venous catheter. Diagnosis was mainly established by ultrasound in 82%. Therapeutically, heparin was employed in 36% and thrombolysis in 18% of the cases. The overall mortality was 23%. An algorithm of clinical signs, investigation, and management is presented. Well‐designed prospective studies are needed to establish a concrete investigational approach to neonatal IVCS and institute safe, evidence‐based treatment.

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Minimally invasive surgery for unilateral Wilms tumors: Multicenter retrospective analysis of 50 transperitoneal laparoscopic total nephrectomies

Bouty

Blanc

Leclair

et al. 2020

Pediatric Blood & Cancer

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Purpose To evaluate feasibility and outcomes of minimally invasive surgery (MIS) in Wilms tumor (WT). Methods International multicenter review of MIS total nephrectomies for WT between 2006 and 2018. Medical records of confirmed WT were retrospectively assessed for demographic, imaging, treatment, pathology, and oncological outcome data. Results Fifty patients, with a median age of 38 months (6‐181), were included in 10 centers. All patients received neoadjuvant chemotherapy, as per SIOP protocol. Median tumor volume post‐chemotherapy was 673 mL (18‐3331), 16 tumors crossed the lateral border of the spine, and three crossed the midline. Six patients with tumors that crossed the lateral border of the spine (tumor volumes 1560 mL [299‐2480]) were converted to an open approach. There was no intraoperative tumor rupture. Overall, MIS was completed in 19% of the 195 nephrectomies for WT presenting during the study period. Tumor was stage I in 29, II in 16, and III in 5, and histology was reported as low in three, intermediate in 42, and high risk in five. Three patients had positive tumor margins. After a median follow‐up of 34 months (2‐138), there were two local recurrences (both stage I, intermediate risk, 7 and 9 months after surgery) and one metastatic relapse (stage III, high risk, four months after surgery). The three‐year event‐free survival was 94%. Conclusion MIS is feasible in 20% of WT, with oncological outcomes comparable with open surgery, no intraoperative rupture, and a low rate of local relapse. Ongoing surveillance is, however, needed to evaluate this technique as it becomes widespread.

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Inferior vena cava involvement in children with Wilms tumor

Cited by 21 publications

References 19 publications

A Case of Wilms Tumor with a Tumor Thrombus in a Boy with WAGR Syndrome

A Case of Wilms Tumor with a Tumor Thrombus in a Boy with WAGR Syndrome

Inferior vena cava syndrome in neonates: An evidence‐based systematic review of the literature

Minimally invasive surgery for unilateral Wilms tumors: Multicenter retrospective analysis of 50 transperitoneal laparoscopic total nephrectomies

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