title: Long-term outcome in pediatric renal tumor survivors: experience of a single center.
abstract: Medical records of 30 children with renal tumor diagnosed at Siriraj Hospital during 1996 to 2007 were reviewed. Mean age at diagnosis was 36 months; male to female ratio was 1.7:1. Clinical manifestations included abdominal mass (96.7%), hypertension (40.0%), abdominal pain (36.7%), hematuria (26.7%), postrenal obstruction (16.7%), and proteinuria (13.3%). Eight patients had Denys-Drash malformations, WAGR, Dandy-Walker malformation, or genitourinary anomalies. Twenty-seven patients (90%) had Wilms tumor. Sixteen patients were stage 3 or more at diagnosis. Rhabdoid tumor was found in 3 patients. All patients received chemotherapy, 13 patients also received radiation therapy. Acute complications included febrile neutropenia (44.4%), hypokalemia (37.0%), hyponatremia (29.6%), Fanconi syndrome (11.1%), urinary tract Infection (10.0%), and acute renal failure (7.4%). Mean follow-up time was 57.2 months. Ten patients died from progressive disease. Five-year patient survival was 69.7%. Two patients had chronic kidney disease. One of these had Denys-Drash malformations. Both patients received ifosfamide-carboplatin-etoposide protocol and abdominal radiation. Antihypertensive medications were needed in 9 patients for a mean duration of 164 days. None had persistent proteinuria or hematuria. No difference was found among mean estimated glomerular filtration rate at diagnosis, 1 year after treatment, and at last follow-up. Long-term follow-up, especially renal function, is recommended.
authors.affiliation: Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand.
authors.forename: Kleebsabai
authors.initials: K
authors.lastname: Sanpakit
authors.forename: Jurairut
authors.initials: J
authors.lastname: Triwatanawong
authors.forename: Achra
authors.initials: A
authors.lastname: Sumboonnanonda
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000002:abnormalities; D007677:Kidney Function Tests; D007680:Kidney Neoplasms / Q000150:complications* / Q000401:mortality / Q000628:therapy; D008297:Male; D017741:Survivors / Q000706:statistics & numerical data*; D016896:Treatment Outcome