Analysis Of Clinical Characteristics And Prognostic Factors Of 40 Children With Nephroblastoma

Objctive:To explore the clinical characteristics and prognostic factors of nephroblastoma in children.Methods: To analysis the clinical characteristics,the prognostic factors of 40 children with nephroblastoma in The fourth hospital of hebei medical University from January 2008 to December 2018.The clinical data was obtained through consulting medical records,and 36 patients were followed up by outpatient and ward visits and telephone follow-up.Fisher’s exact probability test was used to analyze the age,sex,location,clinical stage and pathological tape of the patients.survival analysis use Kaplan-Meier method and Long-rank test.Results:1.Among 40 children with nephroblastoma,18 were male(45%)and 22 were female(55%).The average age of onset was 3.4 years,and the median age of onset was 3 years.Among them,The main symptoms were abdominal mass in 22 cases(55%),gross hematuria in 14 cases(35%),abdominal pain in 2 cases(5%)and fever with abdominal distention in 2 cases(5%).2.40 children were diagnosed as nephroblastoma by puncture biopsy or surgical pathological biopsy.A total of 26 cases were classified according to the National Wilms’ Tumor Study Group(NWTSG)criteria.Among them,31 cases(86.1%)had good prognosis(FH),4 cases(11.1%)had poor prognosis(UFH),and 1 case(2.8%)had no definite pathological type.3.All 36 children included in the follow-up criteria were divided into clinical stages according to NWTSG-5 protocol.Among them,15(41.6%)were stage II,5(14%)were stage III and 16(44.4%)were stage IV.The 5-year Event-free survival(EFS)was 84.8%,60% and 35.8% respectively.No stage I or V children.4.A total of 36 children were followed up for a long time,including 21 cases(58.3%)with complete remission,3 cases(8.3%)with partial remission,4cases(11.1%)with recurrence and tumor survival,8 cases(22.2%)with progress in treatment,and 7 cases died of complications.The 5-year overall survival rate was 73.3%5.By collecting the data,and using SPSS 20.0 software,we can find that there was no significant difference in the prognosis of nephroblastoma patients in terms of gender,age,location of onset and initial symptoms.There were significant differences in clinical stages,pathological stage and that patients with radiotherapy indications Whether to implement.Conclusions:1.The prognostic factors of children with nephroblastoma were gender,age and main symptoms.2.The prognosis of nephroblastoma can be affected by clinical stage,pathological type and radiotherapy indication.3.With the increase of clinical stages,Event-free survival rates showed a downward trend and the prognosis was worse.The EFS of children with radiotherapy indications was significantly higher than that of those without radiotherapy for 5 years.4.The overall survival rate of the children is higher than the precondition by using WT-2009 diagnosis and treatment suggestion.WT-2016 is improved on the basis of this scheme,and can be compared and analyzed after further collection of cases.