Navigation Links
St. Jude study offers new hope for children with kidney tumors deemed inoperable
Date:3/24/2008

Physicians at St. Jude Children's Research Hospital have demonstrated that children with bilateral Wilms tumor, a cancer of the kidneys, can retain normal function in both kidneys by undergoing a procedure called bilateral nephron-sparing surgery, even when preoperative scans suggest that the tumors are inoperable.

Between 1999 and 2006, all St. Jude patients with bilateral Wilms tumor exhibiting favorable histology (cell characteristics) underwent bilateral nephron-sparing surgeries, or partial nephrectomies. Nephron-sparing surgery is designed to remove the malignant tumor, sparing as much healthy kidney tissue as possible. In all 10 instances where the procedure was used, the surgery was successful, often despite preoperative imaging studies suggesting that kidney preservation might not be possible.

Many times, physicians will look at a childs scans and assume that it is impossible to remove the tumor while preserving some uninvolved kidney, but our study indicates that surgeons should not rely solely on the imaging to make that decision, said Andrew Davidoff, M.D., division chief of General Pediatric Surgery at St. Jude and the senior author of a retrospective study that appears in the advance online publication of the journal Cancer.

Traditionally, patients with bilateral Wilms tumor have oneand sometimes bothkidneys removed in an attempt to eradicate the cancer. If one kidney is removed and the cancer recurs in the other kidney, the possibility of losing renal function is high. If both kidneys are removed, the child must endure dialysis and a possible kidney transplant.

In most cases, the surgeon will be able to save normal kidney on both sides, Davidoff said. The study indicates that, when combined with chemotherapy and radiation therapy, this surgical approach provides an opportunity to preserve renal function while maintaining a high probability of cure.

Wilms tumor is the third most common solid tumor in children, with approximately 500 cases diagnosed each year in the United States. Only 5 to 7 percent of those patients will have tumors in both kidneys. Because children with bilateral disease are at risk for developing renal failure, physicians must balance a desire to maintain long-term renal function with the goal of eliminating the cancer.

Since 1999, St. Jude patients whose bilateral Wilms tumor exhibits favorable histology have received chemotherapy, consisting of vincristine, dactinomycin and doxorubicin, followed by bilateral partial nephrectomies within 12 weeks of initiation of chemotherapy. Patients in the retrospective study ranged in age from 5 months to 9 years old and were generally referred to St. Jude because of poor response to therapy or unfavorable anatomy. Many of the children received radiation after undergoing surgery.

According to Davidoff, nephron-sparing surgery is a more complex procedure than a complete nephrectomy. Commonly, when a child has bilateral disease, the surgeon will remove the kidney that has the most tumor and do a partial nephrectomy on the other side, he said. But if a patient then develops problems in the remaining kidney, the options are limited because one kidney has been taken out of the equation. At St. Jude, we try to save as much kidney as possible in children with bilateral disease. Thus far, 100 percent of the time we have been able to save normal kidney on both sides.

All patients who exhibited favorable histology Wilms tumor are still alive, a mean of nearly four years after initial surgery. Nine of the patients exhibited normal renal function at their most recent follow-up exams.


'/>"/>

Contact: Summer Freeman
summer.freeman@stjude.org
901-495-3061
St. Jude Children's Research Hospital
Source:Eurekalert

Related medicine news :

1. U.S. Army Study Reports WoundStat(TM) is Most Effective
2. APIC Launches First National C. Difficile Prevalence Study
3. New Lung Association Study Shows $142 Billion Benefit of Converting to Zero-Emission Vehicles by 2030
4. APIC launches first national C. difficile prevalence study
5. Cato Study Finds Iran a Surprising Model for Kidney Markets
6. $2.4 million grant for study of corneal infections associated with contact lenses
7. Study Finds Single Dose of Iomai Patch With Pandemic Flu Vaccine Achieves Protective Levels
8. Disgusting videos used to study coping methods
9. Data study suggests cortisol could alleviate for chronic fatigue syndrome and fibromyalgia
10. Evanston-Northwestern Study Proves Effectiveness of MRSA Screening to Reduce Hospital Infections
11. MTM Study Reports Improved Quality and Economic Outcomes Using Medication Management Systems Assurance Pharmaceutical Care System(TM)
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... ... June 27, 2016 , ... A ... revolutionize the emergency ambulance transport experience for the millions of people who require ... has disrupted the taxi industry through the use of technology. Now, SmartEMS has ...
(Date:6/26/2016)... ... 2016 , ... On June 10-11, 2016, A Forever Recovery, a holistic treatment ... Longest Breakfast Table in Battle Creek, MI, where the rehabilitation facility is located. This ... of the world’s leading providers of cereal and other breakfast foods. Its residents often ...
(Date:6/26/2016)... ... 26, 2016 , ... Brent Kasmer, a legally blind and certified personal trainer is helping to ... app. The fitness app plans to fix the two major problems leading the fitness industry ... fits all type program , They don’t eliminate all the reasons people quit ...
(Date:6/25/2016)... ... June 25, 2016 , ... Austin residents seeking Mohs ... College of Mohs Surgery and to Dr. Russell Peckham for medical and surgical dermatology. ... treatment for skin cancer. The selective fellowship in Mohs Micrographic Surgery completed by Dr. ...
(Date:6/25/2016)... ... ... First Choice Emergency Room , the largest network of independent freestanding ... of its new Mesquite-Samuell Farm facility. , “We are pleased to announce Dr. ... James M. Muzzarelli, Executive Medical Director of First Choice Emergency Room. , Dr. ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... announced the establishment of Astellas Farma Colombia (AFC), a new affiliate with operations headquartered in Bogota. Colombia ... ... ... ... Astellas is a pharmaceutical ...
(Date:6/23/2016)... MEDIA, Pa. , June 23, 2016 ... treatments in an outpatient dialysis facility.  Treatments are usually ... to 6 hours per visit, including travel time, equipment ... on a patient, but especially grueling for patients who ... residents of a skilled nursing and rehabilitation centers for ...
(Date:6/23/2016)... YORK , June 23, 2016 ... waters, but it continues to present great opportunities to ... companies for today: Intrexon Corp. (NYSE: XON ... Arena Pharmaceuticals Inc. (NASDAQ: ARNA ), and ... more about these stocks and receive your complimentary trade ...
Breaking Medicine Technology: