Đặc điểm lâm sàng, cận lâm sàng và hình ảnh học trước - sau hoá trị tân bổ trợ ở bướu nguyên bào thận một bên có dấu hiệu xâm lấn tại Bệnh viện Nhi đồng 2

Abstract

Wilms tumor is the most common pediatric renal malignancy. Local evidence from Vietnam on how neoadjuvant chemotherapy alters imaging risk features and how these changes relate to postoperative histopathology remains limited. to analyze the clinical, paraclinical and treatment characteristics of stage II to IV nephroblastoma at Children’s Hospital 2. A cross-sectional study from April 2013 to June 2016 on 64 cases of stage II - IV nephroblastoma diagnosed and treated with neoadjuvant chemotherapy. 85.7% of tumors are in the age group of 6 months - 5 years. The rate of tumors in males is higher than in females. The rate of tumors in the right kidney is higher than in the left kidney. After preoperative chemotherap, the rate of necrotic tumors increased from 4.7% to 10.9%. The rate of ruptured tumors in response to conservative treatment decreased from 9.4% to 3.2%. The rate of invasive perinephric fat tumors decreased from 85.9% to 43.8%. The rate of vascular invasive tumors decreased from 20.3% to 6.3%, of which the rate of invasive inferior vena cava decreased from 4.7% to 1.6%. The rate of regional lymph node metastasis decreased from 20.3% to 4.7%. The distant metastatic lesions all disappeared. The tumor volume reduced from 487.9cm³ to 206.8cm³ (p < 0.001). Degree of response to preoperative chemotherapy: The overall response rate was 89.1%; the stable or progressive disease was 10.9%. Nephroblastoma is often detected late and has a large volume at the time of diagnosis. Preoperative chemotherapy reduces tumor volume and tumor invasion, facilitating nephrectomy after chemotherapy.