title: Effects of chemotherapy on the cytogenetic constitution of Wilms' tumor.
abstract: The management of Wilms' tumors consists of a combination of surgery, chemotherapy, and possibly radiotherapy. To date, chemotherapy is being risk stratified according to histologic subtype and stage. Although the cytogenetic characteristics of Wilms' tumors are well established, the cytogenetic effects related to chemotherapy are widely unknown. We herein report on comparative genomic hybridization findings in 41 primary Wilms' tumors of blastemal type, of which 19 had received preoperative chemotherapy (PCT group) and 22 did not (non-PCT group). Overall, imbalances could be detected in 32 tumors, with +1q (17 cases), +7q (10 cases), +7p (6 cases), and -7p (6 cases) as the most common changes. Among these, +7q and -7p were both significantly associated with metastatic disease at the time of surgery (P = 0.002 and 0.007, respectively), and +7q was also associated with higher stage (stages III + IV; P = 0.003). There were significant differences in the cytogenetic constitution of tumors between the two treatment groups. As a trend, tumors in the preoperative-chemotherapy group had fewer changes (mean, 2.7) than those in the non-preoperative-chemotherapy group (mean, 3.8), and the frequencies of imbalances at 7p or +7q, respectively, were significantly lower compared with tumors in the non-preoperative-chemotherapy group (2 of 19 versus 10 of 22, P = 0.019; 1 of 19 versus 9 of 22, P = 0.011). In contrast, -1q was common in both the preop-CT group (10 of 19) and the non-preop-CT group (7 of 22). The results suggest that Wilms' tumor clones with +1q are not obliterated by preoperative chemotherapy, whereas cytogenetically more complex clones with +7q and/or imbalances at 7p seem more responsive and are more likely to be eliminated by chemotherapeutic treatment.
authors.affiliation: Department of Urology, University of Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Schlomm
authors.forename: Bastian
authors.initials: B
authors.lastname: Gunawan
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Schulten
authors.forename: Björn
authors.initials: B
authors.lastname: Sander
authors.forename: Karthinathan
authors.initials: K
authors.lastname: Thangavelu
authors.forename: Norbert
authors.initials: N
authors.lastname: Graf
authors.forename: Ivo
authors.initials: I
authors.lastname: Leuschner
authors.forename: Rolf-Hermann
authors.initials: RH
authors.lastname: Ringert
authors.forename: László
authors.initials: L
authors.lastname: Füzesi
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002869:Chromosome Aberrations / Q000139:chemically induced*; D002878:Chromosomes, Human, Pair 1 / Q000187:drug effects / Q000235:genetics; D002897:Chromosomes, Human, Pair 7 / Q000187:drug effects / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009367:Neoplasm Staging; D009693:Nucleic Acid Hybridization / Q000379:methods; D016019:Survival Analysis; D009396:Wilms Tumor / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents