| Objective:Wilms tumor is an embryogenic malignant tumor,and the incidence is increasing year by year.Bilateral nephroblastoma is rare,accounting for 3% to 10% of nephroblastoma,and the age of onset is lower than that of unilateral nephroblastoma.The treatment is relatively complicated and the survival rate is lower.With the development of medical technology,the prognosis of the disease has been greatly improved,but there is no relevant large-scale report in China.The purpose of this study was to retrospectively analyze the clinical data of 15 children with bilateral nephroblastoma admitted to our hospital,and summarize the clinical characteristics,perioperative changes,follow-up,and improve the understanding of bilateral nephroblastoma.Materials and Methods:Clinical data of bilateral nephroblastoma diagnosed in pediatric surgery of the First Affiliated Hospital of Zhengzhou University and West China Hospital of Sichuan University from January 2000 to January 2018,including general data,pathological classification,surgical status,chemotherapy regimen,follow-up outcome,and application Statistical analysis was performed by SPSS 21.0 statistical software.Fisher's exact probability method was used to test different grouping data.Survival analysis was performed by using Log-rank test for meaningful survival data.The difference was statistically significant when P<0.05.Result:From January 2000 to January 2018,the First Affiliated Hospital of Zhengzhou University and West China Hospital of Sichuan University,treated 15 children with bilateral nephroblastoma,9 male patients(9/15,60%)There were 6 female children(6/15,40%)with a male to female ratio of 3:2.The minimum age of onset was 3 months,the maximum age of onset was 25 months,and the average age of onset was 10.2 ± 6.3 months.Clinical manifestations of abdominal mass in 14 cases(14/15,93.33%),the remaining clinical manifestations of hematuria,abdominal pain,anemia,fatigue,tumor compression symptoms.Kidney tumors vary in diameter from a maximum of 130 mm to a minimum of 25 mm with an average of 80 ± 28.5 mm.6 cases(6/15,40%)with malformation,including 1 with partial hypertrophy,4 with unilateral or bilateral cryptorchidism,2 with cryptorchidism and hypospadias,and 1 with bilateral iris Lack of.As of the end of the study,6 patients were active for a long time,and the longest survival time was 12 years.The 3-year survival rate was 77.78% in children with bilateral nephroblastoma without associated malformation,and the 3-year survival rate was 0% in patients with malformation.The difference was statistically significant.The 3-year survival rates of good prognosis(FH)and poor prognosis(UH)were 77.78% and 16.67%,respectively,and the difference was statistically significant.There was no significant difference in preoperative chemotherapy,clinical stage,age of onset,and gender.Conclusion:1.The age of onset of bilateral nephroblastoma in children is earlier than that of unilateral nephroblastoma,and the abdominal mass is the main first symptom;2.Whether malformation is an important index affecting the prognosis of bilateral nephroblastoma in children: the prognosis of patients with malformation is significantly worse than those without accompanying malformation;histopathological typing can be used to predict the prognosis of bilateral nephroblastoma in children: FH type prognosis is better than UH type;3.The prognosis of bilateral nephroblastoma in children is worse than that of unilateral nephroblastoma,and the 3-year survival rate is 53.3%. |
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